A nurse is teaching a client who has generalized anxiety disorder about ways to help manage stress. Which of the following instructions should the nurse give the client about using progressive relaxation?

"Think about a positive outcome to a stressful situation."

"Tighten a muscle group, then release the tension and move to the next one."

"Focus on a pleasant memory and express your emotions in writing."

"Picture taking the stress you feel and pushing it down and out of your feet."

Answer and Explanation

The Correct Answer is B

A. "Think about a positive outcome to a stressful situation." - This instruction describes a cognitive restructuring technique, which involves reframing negative thoughts with positive ones. While cognitive restructuring can be helpful for managing stress and anxiety, it is not specifically related to progressive relaxation.
B. "Tighten a muscle group, then release the tension and move to the next one." - This is the correct instruction for progressive relaxation. Progressive relaxation involves systematically tensing and relaxing muscle groups throughout the body to reduce physical tension and promote relaxation. By sequentially tensing and releasing muscle groups, the client learns to recognize and control muscle tension, which can help alleviate stress and anxiety.
C. "Focus on a pleasant memory and express your emotions in writing." - This instruction describes a journaling or expressive writing technique, which can be beneficial for processing emotions and reducing stress. However, it is not specific to progressive relaxation.
D. "Picture taking the stress you feel and pushing it down and out of your feet." - This instruction describes a visualization or imagery technique, where the client visualizes releasing stress from the body. While visualization can be a component of relaxation exercises, it is not specifically associated with progressive relaxation, which focuses on muscle tension and relaxation.

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Correct Answer is A

Explanation

Answer: A

Rationale: A) "Empty your ostomy pouch when it is half full.": This instruction is essential to prevent the pouch from becoming too heavy, which can cause leakage or discomfort. Regular emptying also helps maintain the integrity of the pouching system and prevents leaks.

B) "Notify the provider if your stoma becomes pink and moist.": While it's crucial to monitor the stoma's appearance for signs of complications, a pink and moist stoma typically indicates healthy tissue. This instruction may cause unnecessary concern for the client.

C) "Use a moisturizing soap to cleanse your stoma.": Moisturizing soap is not recommended for stoma cleansing, as it may leave a residue that interferes with the pouch's adhesion and can lead to skin irritation. Instead, the client should use warm water and a mild, non-moisturizing soap.

D) "Apply sterile gloves when changing your ostomy pouch.": While hand hygiene is essential when managing an ostomy, sterile gloves are not necessary for routine pouch changes. Clean, non-sterile gloves or thorough handwashing with soap and water are sufficient to prevent infection.

A. Suggest that the client attend adult day care three times per week. B. Review assisted living accommodations with the client. C. Discuss a long-term care referral for the client with the provider. D. Instruct the client about the use of telehealth services.

Correct Answer is D

Explanation

A. Suggest that the client attend adult day care three times per week: While adult day care can provide socialization opportunities and supervision for older adults, it may not be suitable for all clients, especially those who are still independent and prefer to live in their own homes. Additionally, attending adult day care may not directly address the client's diabetes management needs.
B. Review assisted living accommodations with the client: Assisted living accommodations are typically considered for individuals who require assistance with activities of daily living (ADLs) or who can no longer live independently. Since the client in this scenario lives independently, reviewing assisted living accommodations may not be appropriate at this time.
C. Discuss a long-term care referral for the client with the provider: Long-term care referrals are generally reserved for individuals who require ongoing assistance with ADLs and medical care that cannot be adequately provided in a home setting. Since the client is currently living independently and managing their diabetes, a long-term care referral may not be necessary.
D. Instruct the client about the use of telehealth services: This is the most appropriate intervention for the client in a rural area who may have limited access to healthcare resources. Telehealth services can provide remote monitoring, education, and support for managing diabetes while allowing the client to remain in their home environment. This intervention promotes independence and supports the client's ability to manage their condition effectively while living in a rural area.

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A nurse is teaching a client who has generalized anxiety disorder about ways to help manage stress. Which of the following instructions should the nurse give the client about using progressive relaxation?

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Correct Answer is D

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