Nurse Is Teaching a Client to Use Cognitive Reframing to Manage the Stress of Public Speaking. Which of the Following Statements by the Client Indicates an Un

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Sample questions from Nurse Is Teaching a Client to Use Cognitive Reframing to Manage the Stress of Public Speaking. Which of the Following Statements by the Client Indicates an Un

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In an outpatient behavioral health clinic, a 28-year-old client receives psychoeducation on cognitive reframing to manage severe anxiety related to public speaking at work. Which statement by the client indicates an understanding of cognitive reframing?

   • A.Instead of thinking everyone wants me to fail, I will remind myself that the audience is interested in the topic.
   • B.I will avoid looking at anyone in the conference room so that I do not become overwhelmed.
   • C.I will tell myself that feeling nervous means I am unprepared and should cancel my presentation.
   • D.I must convince myself that my presentation will be completely flawless with zero errors.

   Rationale: Cognitive reframing involves identifying automatic, distorted negative thoughts (such as catastrophizing or mind reading) and intentionally replacing them with realistic, balanced, and constructive interpretations. Recognizing that the audience is interested rather than hostile is an accurate example of reframing. Canceling the speech reinforces avoidance and negative cognitive distortions. Avoiding eye contact is a maladaptive behavioral avoidance strategy rather than cognitive restructuring. Believing a presentation must be flawless reflects perfectionism and all-or-nothing thinking, which worsens performance anxiety.

2. 2.At change of shift on a medical-surgical unit, the charge nurse reviews assignments for four clients experiencing situational anxiety. Which task is most appropriate to delegate to unlicensed assistive personnel (UAP)?

   • A.Assessing whether a client's performance anxiety is related to an underlying panic disorder
   • B.Instructing a client on cognitive reframing strategies prior to a scheduled surgical procedure
   • C.Assisting a 51-year-old client with applying a warm compress and providing quiet companionship during pre-procedure rest
   • D.Evaluating the effectiveness of a client's newly initiated cognitive restructuring homework

   Rationale: Delegation must adhere to the scope of practice; UAP may perform standard comfort measures, hygiene, and non-invasive supportive interventions such as applying warm compresses or sitting quietly with a stable client. Initial client education, assessment of clinical anxiety, and evaluation of cognitive interventions require nursing judgment and cannot be delegated to assistive personnel. Instructing a client on cognitive strategies is a professional nursing responsibility. Assessing and evaluating clinical outcomes are non-delegable tasks under the RN scope of practice.

3. 3.During an annual wellness visit, a 16-year-old high school student reports panic-like symptoms when presenting projects in class. The nurse plans interprofessional coordination and cognitive behavioral strategies. Which client statement best reflects an understanding of cognitive reframing?

   • A.If I make even one small mistake during my slide deck, my entire grade will be ruined.
   • B.My heart racing is a sign of excitement and energy that will help me focus, not proof of disaster.
   • C.I will memorize every single word so that there is no possibility of forgetting anything.
   • D.I will ask my teacher to exempt me from all oral presentations for the rest of the school year.

   Rationale: Cognitive reframing reinterprets physiological cues (such as tachycardia) as adaptive arousal or readiness rather than catastrophic failure, reducing distress. Believing a small mistake ruins the entire grade is a catastrophic cognitive distortion. Requesting full exemption is an avoidance coping mechanism that prevents desensitization and mastery. Attempting to memorize every word demonstrates rigid perfectionism and increases vulnerability to performance failure.

4. 4.Refer to the client's chart. Which cognitive restructuring statement documented during the follow-up session demonstrates the most effective progress toward replacing catastrophic thinking?

   • A.I know that everyone in executive leadership is judging my competence based on this one meeting.
   • B.I will take my prescribed beta-blocker and stay completely silent if anyone asks a question.
   • C.I have decided to let my colleague deliver all of my presentation slides while I stand in the back.
   • D.I realized that even if I pause to gather my thoughts, the audience will just see it as a normal part of speaking.

   Answer and rationale are in the full material.

5. 5.In an occupational health clinic, four employees arrive reporting symptoms related to workplace presentation stress. Which client should the nurse evaluate first?

   • A.A 38-year-old reporting nausea and a bilateral tension headache before a quarterly review
   • B.A 45-year-old reporting diaphoresis and acute substernal chest tightness radiating to the left jaw before an executive briefing
   • C.A 29-year-old reporting dry mouth, trembling hands, and a heart rate of 102 bpm before a team meeting
   • D.A 52-year-old stating that everyone in the auditorium will laugh if notes are dropped

   Answer and rationale are in the full material.