A nurse on an inpatient mental health unit is teaching an adolescent client who has anorexia nervosa about relaxation techniques. Which of the following statements should the nurse make?

Choice A reason: Continuing a previous exercise routine while on the unit is not appropriate for a client with anorexia nervosa. Exercise can exacerbate the disorder by reinforcing compulsive behaviors related to weight control and caloric expenditure. Clients with anorexia often overexercise as part of their pathology, and encouraging continuation of this behavior would worsen their physical health, increase risk of cardiac complications, and undermine therapeutic goals. Therefore, this option is contraindicated. Choice B reason: Imagining a calming scene such as a beach is a visualization technique that can be beneficial for relaxation. Guided imagery helps reduce stress and anxiety by shifting focus away from intrusive thoughts. However, while this is a valid relaxation strategy, it is not the most evidence-based or universally recommended first-line technique for adolescents with anorexia nervosa. Visualization requires a certain level of concentration and may not be as immediately effective as physiologic methods like breathing exercises. Choice C reason: Deep breathing exercises are the most appropriate and effective relaxation technique for this client. Controlled breathing directly influences the autonomic nervous system, reducing sympathetic arousal and promoting parasympathetic activity. This leads to decreased heart rate, lowered blood pressure, and reduced anxiety. For clients with anorexia nervosa, deep breathing is safe, does not reinforce maladaptive behaviors, and can be easily taught and practiced in a clinical setting. It is a foundational relaxation technique supported by evidence for stress reduction in mental health care. Choice D reason: Progressive muscle relaxation is another effective relaxation strategy that involves tensing and then releasing muscle groups to reduce physical tension. While beneficial, it may not be ideal for clients with anorexia nervosa who often have muscle weakness, fatigue, or electrolyte imbalances. The physical demands of tensing muscles could be uncomfortable or unsafe for severely undernourished clients. Thus, although it is a valid relaxation technique, it is not the best choice in this specific clinical context compared to deep breathing.