Deck 7: Stress and Stress Management

Question 1

A female patient who initially came to the clinic with incontinence was recently diagnosed with endometrial cancer.She is usually well organized and calm but the nurse who is giving her preoperative instructions observes that she is irritable,has difficulty concentrating,and yells at her husband.Which action should the nurse take?

A) Ask the health care provider for a psychiatric referral.
B) Focus teaching on preventing postoperative complications.
C) Try to calm patient and reinforce and repeat teaching about the surgery.
D) Encourage the patient to have bladder repair at the same time as the hysterectomy.

Answer 1

Try to calm patient and reinforce and repeat teaching about the surgery.

Question 2

A middle-aged male patient with usually well-controlled hypertension and diabetes visits the clinic.Today he has a blood pressure of 174/94 and a blood glucose level of 190 mg/dL.What additional patient information may indicate that an intervention by the nurse is needed?

A) The patient indicates that he usually does blood glucose monitoring several times each day.
B) The patient states that he usually takes his prescribed antihypertensive medications on a daily basis.
C) The patient reports that he and his wife are getting divorced and are in a custody battle over their 12-year-old son.
D) The patient states that the results are related to his family history because both of his parents have high blood pressure and diabetes.

Answer 2

The patient reports that he and his wife are getting divorced and are in a custody battle over their 12-year-old son.

Question 3

A patient who is taking antiretroviral medication to control human immunodeficiency virus (HIV)infection tells the nurse about feeling mild depression and anxiety.Which additional information about the patient is most important to communicate to the health care provider?

A) The patient's blood pressure is 152/88 mm Hg.
B) The patient uses over-the-counter St. John's wort.
C) The patient recently experienced the death of a close friend.
D) The patient expresses anxiety about whether the drugs are effective.

Answer 3

The patient uses over-the-counter St. John's wort.

Question 4

The nurse teaches a patient who is experiencing stress at work how to use imagery as a relaxation technique.Which statement by the nurse would be most appropriate?

A) "Think of a place where you feel peaceful and comfortable."
B) "Place the stress in your life in an image that you can destroy."
C) "Bring what you hear and sense in your present work environment into your image."
D) "If your work environment is stressful, continue visualizing to overcome the distress."

Question 5

An overweight female patient who had enjoyed active outdoor activities is stressed because she is limited in what she can do because she has osteoarthritis in her hips.Which action by the nurse will best assist the patient to cope with this situation?

A) Ask the patient what activities she misses the most.
B) Have the patient practice frequent relaxation breathing.
C) Teach the patient to use imagery to decrease pain and decrease stress.
D) Encourage the patient to think about how weight loss might improve symptoms.

Question 6

A nurse prepares an adult patient with a severe burn injury for a dressing change.The nurse knows that this is a painful procedure and wants to provide music to help the patient relax.Which action is best for the nurse to take?

A) Use music composed by Mozart.
B) Ask the patient about music preferences.
C) Select music that has 60 to 80 beats/minute.
D) Encourage the patient to use music without words.

Question 7

A patient is extremely anxious about having a biopsy on a femoral lymph node in the groin area.Which relaxation technique would be best for the nurse to use at this time?

A) Meditation
B) Yoga stretching
C) Guided imagery
D) Relaxation breathing

Question 8

An adult patient arrived in the emergency department (ED)with minor facial lacerations after a motor vehicle accident and has an initial blood pressure (BP)of 182/94.Which action by the nurse is most appropriate?

A) Start an IV line to administer antihypertensive medications.
B) Discuss the need for hospital admission to control blood pressure.
C) Treat the abrasions and discuss the risks associated with hypertension.
D) Recheck the blood pressure after the patient is stabilized and has received treatment.

Question 9

A hospitalized patient with diabetes tells the nurse,"I don't understand why I can keep my blood sugar under control at home with diet alone,but when I get sick,my blood sugar goes up.This is so frustrating." Which response by the nurse is most appropriate?

A) "It is probably just coincidental that your blood glucose is higher when you are ill."
B) "Stressors such as illness cause the release of hormones that increase blood glucose."
C) "Increased blood glucose occurs because the liver is not able to metabolize glucose as well during stressful times."
D) "Your diet is different here in the hospital than at home and that is the most likely cause of the increased glucose level."

Question 10

An adult patient who is hospitalized following a motorcycle accident when a car ran a red light tells the nurse,"I didn't sleep last night because I worried about missing work at my new job and losing my insurance coverage." Which nursing diagnosis is appropriate to include in the plan of care?

A) Anxiety
B) Defensive coping
C) Ineffective denial
D) Risk prone health behavior

Question 11

A patient who is hospitalized with a pelvic fracture after a motor vehicle accident just received news that the driver of the car died from multiple injuries.What actions should the nurse take based on knowledge of the physiologic stress reactions that may occur in this patient ?

A) Assess for bradycardia.
B) Ask about epigastric pain.
C) Observe for decreased appetite.
D) Check for elevated blood glucose levels.
E) Monitor for a decrease in respiratory rate.

Question 12

A patient who suffers from frequent migraines tells the nurse,"My life feels chaotic and out of my control.I will not be able to manage if anything else happens." Which response should the nurse make initially?

A) "Regular exercise may get your mind off the pain."
B) "Guided imagery can be helpful in regaining control."
C) "Tell me more about how your life has been recently."
D) "Your previous coping strategies can be very helpful to you now."