Deck 12: Stress Adaptation

Question 1

The nurse is aware that which function of antidiuretic hormone occurs when the hormone is released in the alarm stage of the general adaptation syndrome?
1)Promotes fluid retention by increasing the reabsorption of water by kidney tubules
2)Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle
3)Increases the use of fats and proteins for energy and conserves glucose for use by the brain
4)Promotes fluid excretion by causing the kidneys to reabsorb more sodium

Answer 1

1

Question 2

An 18-year-old is accepted to nursing school in another state. The adolescent states to the parents, "I know I am going away to college, but I am nervous about going." Which type of stressor is the student most likely experiencing?
1)External
2)Developmental
3)Situational
4)Biophysical

Answer 2

2

Question 3

The nurse is providing care for a patient who suddenly experiences a cardiac arrest. As the nurse responds to this emergency, which substance does the nurse's body secrete in large amounts to help prepare the nurse to react in this situation?
1)Epinephrine
2)Corticotrophin-releasing hormone
3)Aldosterone
4)Antidiuretic hormone

Answer 3

1

Question 4

A client approaches the nurse in the health clinic and states, "I have been dealing with my spouse's illnesses for years. Now my children want me to start babysitting my grandchildren. I don't know whether I can handle all this." Which is the nurse's most accurate interpretation of the client's statements?
1)Some events are producing more stress for the client than other events.
2)Coping abilities are extended to the limit and the client is unable to cope.
3)Many stressors or prolonged stressors make adaptation more likely to fail.
4)Coping strategies used in the past are no longer successful for the client.

Question 5

After sustaining injuries in a motor vehicle accident, a patient experiences a decrease in blood pressure and an increase in heart rate and respiratory rate despite surgical intervention and fluid resuscitation. Which stage of general adaptation syndrome (GAS) does the nurse recognize the patient is most likely experiencing?
1)Alarm
2)Resistance
3)Exhaustion
4)Recovery

Question 6

The nurse is providing care for a patient who sustains a laceration of the thigh in an industrial accident. Which step in the inflammatory process does the nurse expect the patient to experience first?
1)Cellular inflammation
2)Exudate formation
3)Tissue regeneration
4)Vascular response

Question 7

The nurse is aware that after a patient has an argument with the patient's spouse, the patient becomes verbally abusive to the nurse who is providing care. Which coping mechanism does the nurse recognize the patient is exhibiting?
1)Reaction formation
2)Displacement
3)Denial
4)Conversion

Question 8

A patient, who has been hospitalized for weeks, becomes angry and tells the nurse who is providing care, "I hate this place; nobody knows how to take care of me or I'd be home by now." Which response by the nurse is best in this situation?
1)"You seem angry; what's going on that makes you hate this place?"
2)"I'm sorry that we aren't caring for you according to your expectations."
3)"You were very sick; don't be angry; you're lucky to be alive."
4)"You shouldn't be angry with us; we're trying to help you."

Question 9

At the end of a guided imagery session, which physical assessment finding would suggest to the nurse the relaxation technique was successful?
1)Decreased blood pressure
2)Decreased peripheral skin temperature
3)Increased heart rate
4)Increased respiratory rate

Question 10

The nurse caring for a patient with unresolved anger. For which associated complication should the nurse assess?
1)Depression
2)Hypochondriasis
3)Somatization
4)Malingering

Question 11

The nurse is aware that when a patient becomes alarmed, the body will release a substance to promote a sense of well-being. Which substance is released?
1)Aldosterone
2)Thyroid-stimulating hormone
3)Endorphins
4)Adrenocorticotropic hormone

Question 12

The nurse is counseling a patient about behaviors to reduce stress. Which goal should the nurse put on the care plan?
1)"The patient will limit fat intake to 15% of the daily calories consumed."
2)"The patient will eat three meals at approximately the same time each day."
3)"The patient will limit the intake of sweet and salty foods."
4)"The patient will consume no more than three alcoholic beverages a day."

Question 13

The nurse is providing care for a patient who is in crisis. After assessing the situation, which action does the nurse perform first?
1)Determine the imminent cause of the crisis.
2)Intervene to relieve the patient's anxiety.
3)Decide on the type of help the patient needs.
4)Ensure the safety of both the nurse and the patient.

Question 14

A nurse identifies a patient's nursing diagnosis as "Diarrhea related to stress." Which nursing intervention does the nurse include in the nursing care plan to help the patient relieve the cause of the diarrhea?
1)Monitor and record the frequency of stools on the graphic record.
2)Administer prescribed antidiarrheal medications, as needed.
3)Encourage the patient to verbalize about stressors and anxiety.
4)Provide oral fluids on a regular schedule.

Question 15

A patient diagnosed with breast cancer decides on a treatment plan and feels positive about her prognosis. Assuming the cancer diagnosis represents a crisis, this patient is most likely experiencing which phase of crisis?
1)Precrisis
2)Impact
3)Crisis
4)Adaptive

Question 16

The nurse is providing care to a patient who expresses feeling of dread and of vague uneasiness. Nursing assessment reveals the patient's heart rate is elevated. Which nursing diagnoses is most appropriate for this patient?
1)Anger
2)Fear
3)Anxiety
4)Hopelessness

Question 17

The nurse asks, "Why do some of my patients get a headache when they have stress but others cry?" Which is the most appropriate response to the nurse's question?
1)"All patients react to stress differently."
2)"Stress responses can be physical, mental, behavioral, and spiritual."
3)"Some patients are more emotional than others."
4)"Some patients overreact to the stress they are experiencing."

Question 18

Before entering the room of a patient who is angry and yelling, the nurse removes the stethoscope from around the neck. Which is the best rationale for the nurse's action?
1)The stethoscope could be used by the patient to hurt the nurse.
2)The stethoscope may cause the patient to distrust the nurse.
3)The stethoscope can distract the nurse from focusing on the patient.
4)The stethoscope can function as another stressor for the patient.

Question 19

The nurse is providing care for a patient with numerous physiological complaints. A family member shares that the patient is pretending to have the symptoms of a stomach ulcer to avoid going to work. The nurse recognizes which somatoform disorder this patient is most likely experiencing?
1)Hypochondriasis
2)Somatization
3)Somatoform pain disorder
4)Malingering

Question 20

The nurse is presenting a workshop on stress and adaptation to adolescents at the local high school. A teenager tells the nurse, "Sometimes I feel stressed when I have to take a test. I feel my heart is going a little faster but I do focus better. What do you think?" Which is the most appropriate response by the nurse?
1)"No amount of stress is healthy, especially if your heart is going faster."
2)"As long as you are getting through the test, I think you will be just fine."
3)"A little stress is not necessarily a bad thing. It can help you to focus."
4)"You may need to develop some additional stress-reducing activities."

Question 21

An adult client attends a smoking cessation class. The client tells the nurse, "Even though I smoke, I don't smoke around children, in my car, or in my house." Which defense mechanism does the nurse recognize the client is exhibiting?
1)Displacement
2)Rationalization
3)Denial
4)Repression

Question 22

A patient admitted to the cardiac unit is going for a cardiac catheterization. The patient tells the nurse, "I am so anxious about this. I am afraid the procedure might trigger a heart attack." Which is the first action by the nurse?
1)Contact the physician for an antianxiety medication prior to the procedure.
2)Assure the patient this is a very common procedure for cardiac patients.
3)Instruct the patient prior to the procedure about what to expect of the procedure.
4)Offer the patient some stress-reducing techniques to use before the procedure.

Question 23

Two days after a patient undergoes abdominal surgery, the surgical incision is red and slightly edematous and oozing a small amount of serosanguinous (pink-tinged serous) fluid. On the basis of these data, at which conclusion will the nurse arrive? Select all that apply.
1)The wound is most likely infected.
2)There is a vascular response to inflammation.
3)Damaged cells are being regenerated.
4)Exudate formation is occurring.
5)The wound is progressing as expected.

Question 24

An older adult patient is tearful, shaky, and withdrawn. The patient shares with the nurse, "I am worried to death" about losing an aging spouse and being "all alone." For which reasons does the nurse diagnose this reaction as anxiety rather than fear? Select all that apply.
1)It concerns future or anticipated events.
2)It concerns anticipation of danger rather than a present danger.
3)The response is expected in older adult patients.
4)There is a psychological threat rather than a physical threat.
5)The patient flinches when touched by the nurse.

Question 25

The nurse in the intensive care unit is experiencing an excessive amount of job-related stress. The nurse visits the employee health nurse and states, "I feel nervous and stressed all the time. Even when I go home, I don't feel better. What am I going to do?" Which are the most appropriate response(s) from the health nurse? Select all that apply.
1)"If you are doing the best you can and still feel this way, maybe you need to find another job."
2)"I'm happy to see you are here and asking for help dealing with your anxiety."
3)"Have you talked to some of your colleagues about the way you feel?"
4)"I will make a list for you of some coping strategies that may be helpful."
5)"I suggest you see your physician for a prescription of antianxiety medication."

Question 26

During the alarm stage of general adaptation syndrome (GAS), which metabolic changes occur? Select all that apply.
1)Rate of metabolism decreases.
2)The liver converts more glycogen to glucose.
3)Use of amino acids decreases.
4)Amino acids and fats are more available for energy.
5)Physiological responses will last at least 24 hours.

Question 27

A female client comes to the clinic for her annual physical. During the examination, the nurse palpates a lump in the left breast and informs the client of the finding. The client responds, "Yes, I found it a few months ago but just didn't want to think about it." The nurse recognizes the client is using which approach to coping with the lump?
1)Altering
2)Adapting
3)Changing
4)Avoiding

Question 28

For which reasons is it important for the nurse to understand stress and adaptation? Select all that apply.
1)The nurse needs to self-identify stressors and develop healthy adaptation responses.
2)Understanding stress helps the nurse identify client stressors and adaptive responses.
3)Understanding stress will aid the nurse in balancing stress experienced by patients.
4)The nurse needs to know the very specific adaptation strategies used for patients.
5)The nurse is unable to address psychological issues without understanding stress.

Question 29

The nurse is providing care for a patient in an acute care facility. The patient tells the nurse, "Ever since we experienced an earthquake, I keep having flashbacks of the event. I can't sleep for fear of another one happening during the night." Which condition does the nurse associate with the patient's statements?
1)Anxiety
2)Lack of coping skills
3)Post-traumatic stress disorder (PTSD)
4)Crisis