Deck 32: Stress and Coping

Question 1

The nurse is assessing the patient's use of coping skills in response to stressful situations. The nurse identifies which question to be the most useful?

A) "Have you been evaluated for stress?"
B) "Do you have someone you can go to for help when you are stressed?"
C) "How have you managed stressful situations in the past?"
D) "Does stress cause you to experience muscle tension or headaches?"

Answer 1

"How have you managed stressful situations in the past?"

Question 2

The nurse is educating the patient about alternative therapies. Which statement by the patient indicates a need for more information?

A) Alternative therapies can include relaxation techniques.
B) Alternative therapies are used in conjunction with medical therapies.
C) Alternative therapies can be used when patients are experiencing stress.
D) Some alternative therapists require certification.

Answer 2

Alternative therapies are used in conjunction with medical therapies.

Question 3

The nurse is performing a physical assessment of patient who is undergoing a bone marrow biopsy. What finding by the nurse indicates the patient is experiencing stress?

A) Blood pressure of 120/84
B) Temperature of 99.5 °F (37.5 °C)
C) Heart rate of 110 beats/min
D) Respiratory rate of 10 breaths/min

Answer 3

Heart rate of 110 beats/min

Question 4

The nurse is caring for a patient on a medical-surgical inpatient unit when the patient tells the nurse he is very sad and is considering suicide. What is the first thing the nurse should do?

A) Notify the health care provider.
B) Make a referral to psychiatric services.
C) Implement one-on-one observations.
D) Document in the electronic medical record.

Question 5

The nurse is caring for a patient with a new diagnosis of diabetes type 2. Which statement indicates a negative coping response?

A) "I will look up information on the Internet about diabetes."
B) "I will join a support group."
C) "I will only focus on learning to manage my medication first."
D) "I will make changes slowly so I can adapt to each change."

Question 6

The nurse is assessing level of stress in a patient from another culture. Which question is the most appropriate in helping the nurse understand the impact of the patient's belief system?

A) "Do you engage in prayer to help you during times of stress?"
B) "Do you go to church or other form of organized worship?"
C) "Do you have certain beliefs that are helpful during times of stress?"
D) "Do you want spiritual counseling while you are here?"

Question 7

The nurse is providing discharge instructions for a patient with multiple sclerosis. Which discharge instruction is aimed at preventing a future exacerbation?

A) Engage in some form of exercise as tolerated.
B) Avoid highly stressful situations.
C) Check your skin regularly for pressure sores.
D) Eat a diet with lots of fiber.

Question 8

The nurse is teaching a patient about the difference between mild anxiety and moderate anxiety. Which statement by the patient indicates a need for further education?

A) "Mild anxiety can help me remember things."
B) "Moderate anxiety will narrow my focus."
C) "Mild anxiety will help me be creative."
D) "Moderate anxiety will increase my perception."

Question 9

The nurse is educating the patient on the use of relaxation therapy. Which statement by the patient indicates a need for further education?

A) "I should relax my muscles from head to toe."
B) "I visual the relaxed muscle."
C) "I should do this three times a week."
D) "I focus on muscles that are tense."

Question 10

When the nurse measures the patient's blood glucose levels after an acute myocardial infarction (MI), the nurse knows this action is based on which rationale?

A) Damaged muscle tissue releases glucose.
B) Corticosteroids increase glucose.
C) Myocardial infarctions are often seen in diabetics.
D) All patients should have their blood glucose checked.

Question 11

The nurse is seeing a patient during a follow-up visit after discharge in which the patient had a nursing diagnosis of Difficulty coping. Which statement by the patient would be a cause for concern?

A) "I am sleeping better most nights."
B) "I feel less anxious."
C) "I do not need to do the relaxation exercises anymore."
D) "I am continuing my exercises every day."

Question 12

The nurse knows when the body responds to the release of hormones during "fight or flight," that response includes which physiological signs?

A) Decreased respiratory rate
B) Slowing of the digestive process
C) Glucose being mobilized from the liver
D) Pupils dilating
E) Smooth muscles in the bronchi constricting

Question 13

The nurse knows that when coordination between multiple health care disciplines is needed, which role should be utilized?

A) Pastoral care
B) Case manager
C) Social worker
D) Dietitian

Question 14

The nurse knows which goal to be appropriate for the nursing diagnosis of Caregiver stress?

A) The patient will report an ability to focus on discharge instructions.
B) The caregiver will attend a coping skills class on a weekly basis.
C) Caregiver will use respite care for the family loved one once a week for the next month.
D) The patient will discuss strategies for coping with relationship violence within 24 hours.

Question 15

The nurse knows the one theory explaining the variation in response to stress among individuals is identified by which term?

A) Stress appraisal
B) Sense of coherence
C) Allostasis
D) Homeostasis

Question 16

The nurse identifies which goal to be appropriate for the nursing diagnosis of Difficulty coping?

A) The patient will report an ability to remember discharge instructions.
B) The patient's family will understand how to access respite care services.
C) The patient will discuss possible coping strategies during weekly counseling sessions.
D) The patient will attend an online support group weekly.

Question 17

The nurse recognizes which goal to be appropriate for the nursing diagnosis of Anxiety?

A) The patient will attend a weekly support group.
B) The patient will discuss possible coping strategies during weekly office visits.
C) The patient will report increased ability to concentrate on care instructions before discharge.
D) The patient's family will use respite care once a week for the next month.

Question 18

The nurse is caring for a patient who is undergoing a major cardiac procedure. When the patient complains of a racing heart and nausea, the nurse recognizes these complaints as part of what hormone response?

A) Sense of coherence
B) Stress appraisal
C) Fight or flight
D) Sympathoadrenal response

Question 19

The nurse is providing education to a patient around anger management strategies. Which statement indicates a need for further education by the patient?

A) "Exercise can help me deal with the anger."
B) "I can use humor."
C) "I can punch things."
D) "I can take a time-out."

Question 20

The nurse knows that when patients are experiencing stress, which physiologic changes can be seen in their signs and symptoms?

A) Increase in heart rate
B) Flaccid muscles
C) Pupil dilation
D) Decrease in blood pressure
E) Increase in respiratory rate

Question 21

The nurse manager of the unit is implementing a program to assist the nursing staff in managing compassion fatigue. Which interventions will be the most successful?

A) Support group that nurses can participate in that meets on the unit
B) Exercise competitions to encourage nurse to exercise and log their time
C) Organized break times so nurses can get off the unit for breaks and lunches
D) Quiet area on the unit where the nurses can go during break
E) Promotion of work-life balance
F) None of above

Question 22

The nurse identifies which factors that center on the childhood stress related to school experiences?

A) Goal achievement
B) Family dissolution
C) Life changes
D) Test anxiety
E) Competition

Question 23

The nurse recognizes which personality factors that have been shown to buffer the impact of stress?

A) Resilience
B) Sense of coherence
C) Gender
D) Hardiness
E) Coping style

Question 24

The nurse manager of a busy oncology unit is concerned about compassion fatigue among the nursing staff. Which signs and symptoms would alert the nurse to this problem?

A) Nurses become very emotionally upset without an apparent cause.
B) Nurses start to avoid caring for certain patients.
C) Nurses start to call in sick more often.
D) Nurses begin working more overtime.
E) Nurses have difficulty showing empathy for patients.

Question 25

The nurse working with older adults wants to support healthy coping strategies. What actions by the nurse are most appropriate?

A) Installing boxing equipment in the recreation room
B) Provide reminiscing sessions for the adults to share personal stories
C) Arrange for gentle yoga to be provided at the senior center
D) Create activities designed to distract them from their losses
E) Encourage the adults to eat frequent, healthy snacks