Deck 12: Stress Adaptation

Question 1

A patient is in crisis.After assessing the situation,what should the nurse do first?

A) Determine the imminent cause of the crisis
B) Intervene to relieve the patient's anxiety
C) Decide on the type of help the patient needs
D) Ensure the safety of both the nurse and patient

Answer 1

Ensure the safety of both the nurse and patient

Question 2

Before entering the room of a patient who is angry and yelling,the nurse removes her stethoscope from around her neck.The best rationale for doing so is that the stethoscope:

A) Could be used by the patient to hurt her
B) Might cause the patient not to trust her
C) Would distract her from focusing on the patient
D) Will function as another stressor for the patient

Answer 2

Could be used by the patient to hurt her

Question 3

A nurse identifies a patient's nursing diagnosis as "Diarrhea related to stress." Which nursing intervention should be included in the nursing care plan to help the patient relieve the cause of the diarrhea?

A) Monitor and record the frequency of stools on the graphic record
B) Administer prescribed antidiarrheal medications as needed
C) Encourage the patient to verbalize about stressors and anxiety
D) Provide oral fluids on a regular schedule

Answer 3

Encourage the patient to verbalize about stressors and anxiety

Question 4

At the end of a guided imagery session,which physical assessment finding would suggest that the relaxation technique was successful?

A) Decreased blood pressure
B) Decreased peripheral skin temperature
C) Increased heart rate
D) Increased respiratory rate

Question 5

A patient who has been 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?

A) Precrisis
B) Impact
C) Crisis
D) Adaptive

Question 6

An 18-year-old female has just been accepted to nursing school in another state.She says to her parents,"I know I am going away to college,but I am nervous about going." What type of stressor is this student most likely experiencing?

A) External
B) Developmental
C) Situational
D) Biophysical

Question 7

A patient complains of a vague,uneasy feeling of dread,and his heart rate is elevated.Which of the following nursing diagnoses is most appropriate for this patient?

A) Anger
B) Fear
C) Anxiety
D) Hopelessness

Question 8

You are caring for a patient who suddenly experiences a cardiac arrest.As you respond to this emergency,which substance will your body secrete in large amounts to help prepare you to react in this situation?

A) Epinephrine
B) Corticotrophin-releasing hormone
C) Aldosterone
D) Antidiuretic hormone

Question 9

After a patient has an argument with her husband,she becomes verbally abusive to the nurse who is caring for her.Which coping mechanism is this patient exhibiting?

A) Reaction formation
B) Displacement
C) Denial
D) Conversion

Question 10

When released in response to alarm,which of the following substances promotes a sense of well-being?

A) Aldosterone
B) Thyroid-stimulating hormone
C) Endorphins
D) Adrenocorticotropic hormone

Question 11

The nursing student asks his instructor,"Why do some of my patients get a headache when they have stress and others cry?" The most appropriate response by the instructor is which of the following?

A) "All patients react to stress differently."
B) "Stress responses can be physical, mental, behavioral, and spiritual."
C) "Some patients are more emotional than others."
D) "Some patients overreact to the stress they are experiencing."

Question 12

The nurse caring for a patient with unresolved anger.For which associated complication should the nurse assess?

A) Depression
B) Hypochondriasis
C) Somatization
D) Malingering

Question 13

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 the general adaptation syndrome is the patient most likely experiencing?

A) Alarm
B) Resistance
C) Exhaustion
D) Recovery

Question 14

What is the function of antidiuretic hormone when released in the alarm stage of the general adaptation syndrome?

A) Promotes fluid retention by increasing the reabsorption of water by kidney tubules
B) Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle
C) Increases the use of fats and proteins for energy and conserves glucose for use by the brain
D) Promotes fluid excretion by causing the kidneys to reabsorb more sodium

Question 15

A client approaches the nurse in the health clinic and states,"I have been dealing with my husband's illnesses for years.Now my children want me to start babysitting for my grandchildren.I don't know whether I can handle all this." What is the nurse's interpretation of this woman's statements?

A) Some events are producing more stress for her than other events.
B) Her coping abilities are extended to her limit and she is unable to cope.
C) When there are many stressors or when stressors continue for a long period of time, adaptation is more likely to fail.
D) Coping strategies that she has used in the past are no longer successful for her now.

Question 16

A patient sustains a laceration of the thigh in an industrial accident.Which step in the inflammatory process will the patient experience first?

A) Cellular inflammation
B) Exudate formation
C) Tissue regeneration
D) Vascular response

Question 17

A patient who has been hospitalized for weeks becomes angry and tells the nurse who is caring for him,"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?

A) "You seem angry; what's going on that makes you hate this place?"
B) "I'm sorry that we aren't caring for you according to your expectations."
C) "You were very sick; don't be angry; you're lucky to be alive."
D) "You shouldn't be angry with us; we're trying to help you."

Question 18

When counseling a patient about behaviors to reduce stress,which of the following goals should the nurse put on the care plan?

A) "The patient will limit his intake of fat to 15% of the daily calories consumed."
B) "The patient will eat three meals per day at approximately the same time each day."
C) "The patient will limit his intake sweet and salty foods."
D) "The patient will consume no more than three alcoholic beverages a day."

Question 19

You are caring for a patient with numerous physiological complaints.A family member tells you that the patient is pretending to have the symptoms of a stomach ulcer to avoid going to work.Which somatoform disorder is this patient most likely experiencing?

A) Hypochondriasis
B) Somatization
C) Somatoform pain disorder
D) Malingering

Question 20

The nurse is presenting a workshop on stress and adaptation to a group of teenagers at the local high school.A teenager approaches the nurse and says,"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?" What is the most appropriate response by the nurse?

A) "No amount of stress is healthy, especially if your heart is going faster."
B) "As long as you are getting through the test, I think you will be just fine."
C) "A little stress is not necessarily a bad thing. It can help you to focus."
D) "You may need to develop some additional stress-reducing activities."

Question 21

A 60-year-old male attends a smoking cessation class.He tells the nurse,"Even though I smoke,I don't smoke around children,in my car,or in my house" Which defense mechanism is this male exhibiting?

A) Displacement
B) Rationalization
C) Denial
D) Repression

Question 22

The nurse is working on an orthopedic unit in the local hospital.While assessing her patient the patient states,"Ever since we had the earthquake in California I can't sleep for fear of another one happening during the night,and I just keep having flashbacks of the earthquake." The nurse knows that these patient statements are most consistent with:

A) Anxiety
B) Lack of coping skills
C) Post-traumatic stress disorder
D) Crisis

Question 23

A 35-year-old female comes to the clinic for her annual physical.Upon examination,the nurse palpates a lump in the left breast.She informs the client of the finding and the client responds,"Yes,I found it a few months ago too but just didn't want to think about it." The nurse recognizes that this client has been using which approach to coping with the lump?

A) Altering
B) Adapting
C) Changing
D) Avoiding

Question 24

During the alarm stage of the general adaptation syndrome,which metabolic change(s)occur(s)? Select all that apply.

A) Rate of metabolism decreases.
B) Liver converts more glycogen to glucose.
C) Use of amino acids decreases.
D) Amino acids and fats are more available for energy.

Question 25

Why is it important for you as a nurse to understand stress and adaptation? Select all that apply.

A) You need to identify your own stressors and develop healthy adaptation responses.
B) Understanding stress will help you identify client stressors and adaptive responses.
C) Understanding stress will help you balance stress for your patients.
D) There are very specific adaptation strategies used for all patients and nurse must know them.

Question 26

Two days after a patient undergoes abdominal surgery,his surgical incision is red and slightly edematous; it is oozing a small amount of serosanguineous (pink-tinged serous)fluid.On the basis of these data,what can you conclude? Select all that apply.

A) The wound is most likely infected.
B) This is a vascular response to inflammation.
C) Damaged cells are being regenerated.
D) Exudate formation is occurring.

Question 27

The nurse believes that a patient may be experiencing a lot of stress at home.The patient is angry and states,"It is too much for me to handle.You don't know what I am going through." What is the most appropriate response(s)by the nurse? Select all that apply.

A) "I don't know what you are going through, can you tell me more?"
B) "Please don't be angry with me. We all do the best we can here."
C) "How long have you been dealing with this stress?"
D) "How do you usually manage your stress?"

Question 28

A nurse in the intensive care unit has been experiencing an excessive amount of stress in her workplace.She sees 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?" What is the most appropriate response(s)from the employee health nurse? Select all that apply.

A) "If you are doing the best you can and it is not working, maybe you need to find another job."
B) "I'm happy to see you are here and asking for help dealing with your anxiety."
C) "Have you talked to some of your colleagues about the way you feel?"
D) "I will make a list for you of some coping strategies that may be helpful."

Question 29

A 75-year-old patient is tearful,shaky,and withdrawn.She tells you that she is "worrying herself to death" about losing her aging husband and being "all alone." Why do you recognize this reaction as Anxiety rather than Fear? Select all that apply.

A) It concerns future or anticipated events.
B) It concerns anticipation of danger rather than a present danger.
C) There is no shakiness or tearfulness present.
D) There is a psychological rather than a physical threat.

Question 30

A patient admitted to the cardiac unit is going to the cardiac catheterization lab for a procedure.The patient tells the nurse,"I am so anxious about this.I am afraid the procedure might trigger a heart attack." What is the first action by the nurse?

A) Contact the physician for an anti-anxiety medication prior to the procedure.
B) Assure the patient that this is a very common procedure for all cardiac patients.
C) Instruct the patient prior to the procedure about what he can expect of the procedure.
D) Offer the patient some stress-reducing techniques to use before the procedure.