A nurse is teaching a client about the use of cognitive reframing for stress management. Which of the following statements by the client indicates an understanding of the teaching?

“I will learn how to voluntarily control my blood pressure and heart rate."

"I will practice replacing negative thoughts with positive self-statements."

“I will focus on a mental image while concentrating on my breathing."

"I will progressively relax each of my muscle groups when feeling stressed."

Answer and Explanation

The Correct Answer is B

A. "I will learn how to voluntarily control my blood pressure and heart rate."
This statement indicates the client might be referring to techniques such as biofeedback or relaxation exercises that involve controlling physiological responses consciously. While these are relaxation techniques, they are not specifically cognitive reframing. Cognitive reframing focuses on changing negative thought patterns.

B. "I will practice replacing negative thoughts with positive self-statements."
This statement accurately reflects the concept of cognitive reframing. It involves identifying negative or unhelpful thoughts and consciously replacing them with positive, empowering, or rational thoughts. This technique is widely used in cognitive-behavioral therapy (CBT) to help individuals manage stress, anxiety, and various mental health issues.

C. "I will focus on a mental image while concentrating on my breathing."
This statement describes a relaxation technique where individuals visualize a calming image and synchronize their breathing with this mental image. While this practice is beneficial for relaxation, it is not cognitive reframing. Cognitive reframing specifically deals with changing the content of thoughts, not necessarily focusing on mental imagery.

D. "I will progressively relax each of my muscle groups when feeling stressed."
This statement describes a relaxation technique known as progressive muscle relaxation. It involves tensing and then relaxing different muscle groups to reduce physical tension and stress. While this technique is excellent for relaxation, it is not cognitive reframing. Cognitive reframing pertains to changing thoughts, not physical sensations.

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Correct Answer is A

Explanation

A. Hgb 10 g/dL
Anemia (low hemoglobin levels) is a common finding in individuals with anorexia nervosa due to inadequate nutrition, leading to a decreased production of red blood cells. Hemoglobin levels below the normal range are often seen in people with severe malnutrition, such as those with anorexia nervosa.

B. Blood glucose 100 mg/dL:
A blood glucose level of 100 mg/dL is within the normal range. Anorexia nervosa typically does not cause specific changes in blood glucose levels.

C. TIBC 11 mcg/dL:
Total Iron-Binding Capacity (TIBC) is a test that measures the blood's capacity to bind to iron. The given value of 11 mcg/dL is unusually low and might not be within the typical reference range. However, the significance of this value is not clear without the specific reference range for the laboratory performing the test.

D. Potassium 3.7 mEq/L:
A potassium level of 3.7 mEq/L is within the normal range. Electrolyte imbalances, including low potassium levels (hypokalemia), can occur in individuals with anorexia nervosa due to inadequate intake and purging behaviors. While this level is within the normal range, individuals with anorexia nervosa may still exhibit electrolyte imbalances that require monitoring and management.

A. Request that the client's partner sign the consent form. B. Inform the client about the risks of refusing ECT. C. Cancel the scheduled ECT procedure. D. Proceed with preparation for ECT based on implied consent.

Correct Answer is C

Explanation

A. Request that the client's partner sign the consent form:
While involving the client's partner might offer emotional support and facilitate communication, legal and ethical guidelines typically require the informed consent of the individual undergoing the procedure. Having a partner sign the form without the client's explicit consent would not adhere to these standards.

B. Inform the client about the risks of refusing ECT:
Educating the client about the potential risks and benefits of ECT, as well as discussing alternative treatments, is a crucial step in the informed consent process. However, merely informing the client does not replace the need for the client to provide explicit, written consent for the procedure to be performed legally and ethically.

C. Cancel the scheduled ECT procedure:
This is the correct action. Without the client's signed consent, the procedure cannot proceed. Canceling the ECT procedure respects the client's autonomy and adheres to legal and ethical standards surrounding informed consent. The healthcare team should continue to engage with the client, addressing any concerns and questions, to obtain their informed and voluntary consent before rescheduling the procedure if the client chooses to proceed.

D. Proceed with preparation for ECT based on implied consent:
Implied consent is not sufficient for significant medical procedures such as ECT. Implied consent implies agreement based on actions or behavior rather than explicit, informed agreement. For procedures like ECT, it is essential to have documented, explicit, and voluntary consent from the client before proceeding. Relying solely on implied consent would not meet the ethical and legal requirements for informed consent.

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A nurse is teaching a client about the use of cognitive reframing for stress management. Which of the following statements by the client indicates an understanding of the teaching?

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Correct Answer is C

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