A nurse is planning care for a client with obsessive-compulsive disorder (OCD). Which of the following interventions should the nurse include?

Choice A reason: Discussing risks is the provider’s responsibility, not the nurse’s, during informed consent. The nurse’s role is to witness the signature, ensuring the client signed voluntarily. Risks like memory loss or seizures are explained by the provider to ensure informed decision-making.

Choice B reason: The nurse’s signature on the consent form verifies that they witnessed the client’s voluntary signature, confirming the process’s integrity. This legal and ethical step ensures the client was not coerced and understands the procedure, aligning with informed consent standards for ECT.

Choice C reason: Assessing knowledge of alternatives is part of the provider’s role in discussing treatment options. The nurse’s signature only confirms witnessing the consent, not evaluating the client’s understanding of alternatives, which requires clinical judgment beyond the nurse’s consent role.

Choice D reason: Providing information about benefits is the provider’s responsibility during consent discussions. The nurse’s signature indicates they observed the client’s agreement, not that they delivered information about ECT’s efficacy, which is used for severe depression but requires provider explanation.

Choice A reason: Progressive muscle relaxation reduces physical tension but is not cognitive reframing. It targets somatic stress responses by relaxing muscles, not addressing cognitive distortions. Reframing involves altering thought patterns, making this statement unrelated to the taught stress management technique.

Choice B reason: Cognitive reframing involves replacing negative thoughts with positive ones to alter stress perception. This statement reflects understanding, as it targets cognitive distortions, a core component of cognitive-behavioral therapy, reducing stress by changing maladaptive thought patterns in the prefrontal cortex.

Choice C reason: Controlling blood pressure and heart rate refers to biofeedback, not cognitive reframing. Biofeedback uses physiological monitoring to manage stress, while reframing addresses cognitive processes, making this statement incorrect as it does not reflect the taught cognitive strategy.

Choice D reason: Focusing on a mental image and breathing describes guided imagery or meditation, not cognitive reframing. These techniques reduce stress through visualization, not by altering thought patterns, making this statement unrelated to the cognitive approach taught for stress management.