Deck 42: Stress and Coping

Question 1

A client is angry about not being permitted to smoke and throws the breakfast tray at the nurse.What should the nurse do in response to this outburst?

A)Call the charge nurse and refuse to take care of this client until he is under control.
B)Apologize to the client for the unit rules,but tell him the rules must be followed.
C)Tell the client that it is understandable that he is upset,but the no-smoking rule is not negotiable.
D)Tell the client that he is acting like a child and that such behavior will not be tolerated.

Answer 1

Tell the client that it is understandable that he is upset,but the no-smoking rule is not negotiable.

Question 2

The nurse manager suspects the nursing staff is experiencing burnout because of complaints and an increase in absenteeism.The nurses also appear tired and anxious.What can the manager do to help reduce this burnout?

A)Ask the physician staff to take over some of the tasks they routinely ask the nurses to do.
B)Make certain that the nurses are well prepared for their responsibilities.
C)Assign each nurse to spend 30 minutes with the hospital psychologist daily.
D)Ask administration to require 30 minutes of exercise at the end of each shift.

Answer 2

Make certain that the nurses are well prepared for their responsibilities.

Question 3

The victim of domestic abuse tells the nurse,"I know my spouse didn't mean to hurt me.The situation just got out of hand." The nurse recognizes that the client is exhibiting which defense mechanism?

A)Intellectualization
B)Introjection
C)Projection
D)Minimization

Answer 3

Minimization

Question 4

A newly hospitalized client is demonstrating anxiety and stress.What intervention can the nurse plan to help this client?

A)Explain all procedures in detail before performing them.
B)Let the client make the majority of decisions about the plan of care.
C)Control the environment of healing.
D)Demonstrate staff competence by using multiple nurses for care.

Question 5

The nursing student admits to being mildly anxious about an upcoming examination.What is the likely result of this level of anxiety?

A)The student's perception and learning is enhanced.
B)The student's attention is focused solely on studying for the examination.
C)The student's only topic of conversation is the examination.
D)The student cannot talk about the examination without crying.

Question 6

The client has just received news of the death of a relative.Over the next few hours,what physiologic response should the nurse attribute to the shock phase of the alarm reaction caused by the stress of this event?

A)Drop in blood pressure from 130/80 to 120/75
B)A more bounding pulse
C)Slight increase in urine output
D)Some decrease in oxygen saturation

Question 7

The client tells the nurse that she does not wish to see her mother-in-law during this hospitalization because she does not like her.When the client's husband and her mother-in-law visit,the client is very cordial and acts happy to see both visitors.The nurse recognizes that this client may be using which defense mechanism?

A)Reaction formation
B)Rationalization
C)Regression
D)Reparation

Question 8

The assessment of a client undergoing testing for an anxiety disorder reveals an increased heart rate,an increased respiratory rate,a low-normal hematocrit,and a low blood sugar.Which finding is contrary to what could be explained by a normal response to anxiety?

A)The heart rate
B)The respiratory rate
C)The hematocrit
D)The blood sugar

Question 9

A client diagnosed with a myocardial infarction is overheard telling family about having food poisoning.What defense mechanism is this client exhibiting?

A)Compensation
B)Denial
C)Displacement
D)Identification

Question 10

The physician has just told the client that the results of a biopsy performed yesterday reveal no malignancy.During discharge teaching,the nurse finds the client to be easily distractible and unable to focus.What is the nurse's best interpretation of this situation?

A)The client did not understand that there is no malignancy.
B)Anxiety can result from both positive and negative stimuli.
C)Because there is no malignancy present,the client feels there is no need for teaching.
D)These findings reflect mild anxiety,but the client should retain information taught despite this distractibility.

Question 11

The parents of an adolescent who has a history of depression are concerned because the physician has prescribed an SSRI antidepressant for their child.What information should the nurse use to formulate a response to these parents' concerns?

A)These medications are addictive and difficult to discontinue when the depressive incident is past.
B)It is difficult for teenagers to manage the dosage regimen for many of these drugs because they must be taken with a full meal.
C)There is an FDA warning regarding antidepressant use in teenagers and the increased risk of suicide.
D)Most of the SSRI antidepressant medications will deliver a marked improvement in depression within 3 to 4 days of the first dose.

Question 12

A 2-year-old client,who has had multiple hospitalizations for treatment of a congenital disorder,is lying curled in bed holding a stuffed animal and will not interact with the parents.What should the nurse identify as causing this client's behavior?

A)The parents may have been abusing this child.
B)The child is probably developmentally delayed secondary to multiple hospitalizations.
C)The child is reacting as a normal 2-year-old.
D)The child could be suffering from a clinical depression.

Question 13

While attempting to choose a nursing diagnosis,the nurse must decide whether the client is experiencing anxiety or fear.What key point would help the nurse make this decision?

A)Anxiety is a milder form of fear.
B)Fear results in a physiologic response,whereas anxiety is psychologic.
C)The source of fear is identifiable,but anxiety may be vague.
D)Anxiety is generally based in reality,fear is not.

Question 14

The nurse identifies that a client has not met the expected outcome established for the nursing diagnosis Ineffective Individual Coping.What should the nurse do first?

A)Revise the nursing diagnosis.
B)Reassess the patient,looking for previously unknown stressors.
C)Rewrite the interventions used to address the problem.
D)Explore reasons why the outcome was not achieved.

Question 15

A client tells the nurse about being laid off from work,the spouse wanting a divorce,and being ill with a chest cold for a month.What statement should the nurse make that reflects understanding of a client in crisis?

A)"Once you reach the crisis state,you may remain there for several months until you recover."
B)"People generally find it easier to work through a crisis if someone is working with them."
C)"Men often handle crisis better individually,whereas women do better with a counselor."
D)"Experiencing a crisis is never positive,so we must work to relieve your anxiety as soon as possible."

Question 16

The nurse elects to use a scale of stressful life events to assess the level of a newly admitted client's stress.How should the nurse explain the use of this scale to the client?

A)"We will consider only the negative life events that have happened to you recently."
B)"You should try to remember any stressful event that has occurred to you in the last 10 years to include in the scale."
C)"This scale will give us a definite stress level number that can be used to compare your stress to that of others your age."
D)"This scale will give us some idea about your stress related to both positive and negative recent events in your life."

Question 17

The parents of a school-age client who was sexually abused by a minister want to know why someone who is sexually attracted to children would choose to go into the ministry.The nurse explains that the displacement of sexual drives into socially acceptable activities is which type of defense mechanism?

A)Repression
B)Sublimation
C)Substitution
D)Undoing

Question 18

The new nurse feels overwhelmed by the demands of working on a busy acute care unit and maintaining a growing family.What strategy should this nurse employ to lessen this stress?

A)Spend the lunch hour completing documentation while eating a sandwich.
B)Set the alarm earlier in order to get to work early.
C)Focus on work instead of on family until more familiar with the environment.
D)Differentiate between "have to do" and "nice to do" at work.

Question 19

The client who has been experiencing slight anxiety is now communicating in a manner that makes it difficult for the nurse to understand the client's needs.The nurse suspects the client has progressed to which anxiety level?

A)Mild
B)Moderate
C)Severe
D)Panic

Question 20

The nurse is caring for a critically ill child.While the nurse is preparing to administer a treatment to the child,the child's mother becomes distraught and begins to cry loudly while stroking the child's face.What is the nurse's best response to this occurrence?

A)Tell the mother that she needs to control herself for the benefit of her child.
B)Distract the mother by having her straighten the linens on the bed.
C)Explain the procedure that will occur with the treatment.
D)Take the mother out of the room and comfort her.

Question 21

A client asks what changes can be made to dietary intake to reduce the effects of stress.What changes should the nurse encourage the client to make?
Standard Text: Select all that apply.

A)Reduce sugar intake.
B)Eliminate excess salt.
C)Reduce caffeine intake.
D)Avoid vitamin supplements.
E)Follow a low-fat eating plan.

Question 22

During an assessment,the nurse learns that a client has been having periodic upper respiratory infections since experiencing the death of a close family member.The nurse identifies this client's reaction to stress as being a

A)stimulus.
B)response.
C)transaction.
D)negotiation.

Question 23

A client is informed of the need for surgery to correct a potentially life-threatening health problem.Afterward,the nurse determines that the client is experiencing physiological indicators of stress.What did the nurse assess to make this determination?
Standard Text: Select all that apply.

A)Dilated pupils
B)Diaphoretic
C)Tachycardia
D)Flaccid muscle tone
E)Excessive oral secretions

Question 24

The adult daughter of an older client,who provides and pays for the client's care and needs,tells the nurse that her time is limited because of work responsibilities.The client complains that all the daughter ever does is work.What basic need is being affected by the daughter's stress?

A)Love and belonging
B)Self-actualization
C)Physiological
D)Self-esteem

Question 25

The nurse asks a client what strategies he uses to cope with stress.The client does not respond.What should the nurse do?
Standard Text: Select all that apply.

A)Document that the client has no stress.
B)Move on with the assessment.
C)Ask the client whether crying occurs.
D)Suggest that the client use humor or exercise.
E)Question the use of anger.

Question 26

A client diagnosed with a chronic illness tells the nurse that the spouse is not helping the client with household activities,which is causing stress.Which diagnosis should the nurse identify as being appropriate for the client at this time?

A)Defensive Coping
B)Disabled Family Coping
C)Compromised Family Coping
D)Ineffective Coping

Question 27

After dealing with a variety of physical stressors,a client is entering the stage of exhaustion.The nurse should recognize that the end of this stage will depend upon which factors?
Standard Text: Select all that apply.

A)Release of hormones
B)Severity of the stressor
C)Reversal of body changes
D)External resources provided
E)Energy resources of the client

Question 28

A client repeatedly tells the nurse that "all will be well" and "I'm fine" in response to learning of a health problem that requires immediate surgery.The nurse realizes that which diagnosis is appropriate for the client at this time?

A)Compromised Family Coping
B)Ineffective Coping
C)Disabled Family Coping
D)Defensive Coping

Question 29

While assessing a client's ability to cope after being diagnosed with a chronic illness,the client admits to an increase in drinking and smoking.The nurse recognizes the client is utilizing which type of coping strategy?

A)Short term
B)Long term
C)Adaptive
D)Effective

Question 30

The nurse identifies that a client is experiencing the resistance stage of the general adaption syndrome.What did the nurse assess to make this clinical decision?

A)The client is unable to focus on activities and events.
B)The client is exhausted,and spends time sleeping.
C)There is localized swelling and inflammation of the client's leg wound.
D)The client's capillary blood glucose level is 180 mg/dL.

Question 31

The nurse is preparing to assess a client's stress and coping patterns.What will be included in this assessment?
Standard Text: Select all that apply.

A)Client's perception of stressors
B)Manifestations of stress
C)Employment status
D)Coping strategies
E)Weight changes

Question 32

A client is experiencing the shock phase within the general adaption syndrome.The nurse realizes that this phase affects which hormones?
Standard Text: Select all that apply.

A)Epinephrine
B)Estrogen
C)Norepinephrine
D)Corticotropin-releasing
E)Progesterone

Question 33

A client newly diagnosed with colon cancer finishes dinner and turns on the nightly news.The nurse suspects the client is experiencing which cognitive indicator of stress?

A)Problem solving
B)Self-control
C)Structuring
D)Daydreaming.

Question 34

During a health interview,the nurse decides to focus the assessment questions on the middle-aged client's amount of stress.What information did the nurse use to make this clinical decision?
Standard Text: Select all that apply.

A)Caring for aging parents
B)Needing to wear glasses to read
C)Newly married
D)Choosing a career
E)Not having the same amount of stamina and energy

Question 35

The nurse is concerned that a client diagnosed with a chronic illness is experiencing depression.What did the nurse assess in this client?
Standard Text: Select all that apply.

A)Weight gain
B)Irritability
C)No appetite
D)Constipation
E)Complaints of headache and dizziness

Question 36

After hearing the diagnosis of cancer,a client becomes withdrawn and refuses to talk with friends or family.The nurse realizes this client is demonstrating which type of reaction to stress?

A)Stimulus
B)Response
C)Combination
D)Transaction