Deck 6: Individual and Family Homeostasis, Stress, and Adaptation

Question 1

A nurse is meeting with a young woman who has recently lost her job after moving with her husband to a new city. She describes herself as being anxious and pretty depressed. What principle of stress and adaptation should be integrated into the nurses plan of care for this patient?

A) Adaptation often fails during stressful events and results in homeostasis.
B) Stress is a part of all lives, and, eventually, this young woman will adapt.
C) Acute anxiety and depression can be adaptations that alleviate stress in some individuals.
D) An accumulation of stressors can disrupt homeostasis and result in disease.

Answer 1

An accumulation of stressors can disrupt homeostasis and result in disease.

Question 2

You are the nurse caring for an adult patient who has just received a diagnosis of prostate cancer. The patient states that he will never be able to cope with this situation. How should you best understand the concept of coping when attempting to meet this patients needs?

A) Coping is a physiologic measure used to deal with change, and he will physically adapt.
B) Coping is composed of the physiologic and psychological processes that people use to adapt to change.
C) Coping is the human need for faith and hope, both of which create change.
D) Coping is a social strategy that is used to deal with change and loss.

Answer 2

Coping is composed of the physiologic and psychological processes that people use to adapt to change.

Question 3

The nurse is with a patient who has learned that he has glioblastoma multiforme, a brain tumor associated with an exceptionally poor prognosis. His heart rate increases, his eyes dilate, and his blood pressure increases. The nurse recognizes these changes as being attributable to what response?

A) Part of the limbic system response
B) Sympathetic nervous response
C) Hypothalamic-pituitary response
D) Local adaptation syndrome

Answer 3

Sympathetic nervous response

Question 4

You are the nurse caring for a 72-year-old woman who is recovering from a hemicolectomy on the postsurgical unit. The surgery was very stressful and prolonged, and you note on the chart that her blood sugars are elevated, yet diabetes does not appear in her previous medical history. To what do you attribute this elevation in blood sugars?

A) It is a temporary result of increased secretion of antidiuretic hormone.
B) She must have had diabetes prior to surgery that was undiagnosed.
C) She has suffered pancreatic trauma during her abdominal surgery.
D) The blood sugars are probably a result of the fight-or-flight reaction.

Question 5

A patient tells the nurse that she does not like to go to the doctor and is feeling anxious about being in this place. When the nurse checks her blood pressure, it is elevated along with her heart rate. The nurse rechecks her blood pressure about 10 minutes later and it is normal. The patient asks the nurse if she should be concerned that she may have hypertension. What statement should guide the nurses response?

A) She should not worry; it was stress related and her regular blood pressure is good.
B) The first blood pressure was part of a simple stress response; our long-term blood pressure is controlled by negative feedback systems.
C) Blood pressure is only one measure of hypertension; she should review this with the doctor and plan to recheck it on a regular basis.
D) The respiratory infection is the probably the cause of the elevated blood pressure, and, with treatment, her blood pressure should remain normal.

Question 6

A patient presents to the health center and the nurse practitioners assessment reveals an enlarged thyroid. The nurse practitioner believes the thyroid cells may be undergoing hyperplasia. How would the nurse practitioner explain this condition to the patient?

A) Hyperplasia is the abnormal decrease in cell and organ size and is a precursor to cancer.
B) Hyperplasia is an abnormal increase in new cells and is reversible with the stimulus for cell growth removed.
C) Hyperplasia is the change in appearance of the thyroid due to a chronic irritation and will reverse with the stimulus removed.
D)
Hyperplasia is a cancerous growth and will be removed surgically.

Question 7

A mother has brought her young son to the emergency department (ED). The mother tells the triage nurse that the boy was stung by a bee about an hour ago. The mother explains to the nurse, It hurts him so bad and it looks swollen, red, and infected. What can the triage nurse teach the mother?

A) The pain, redness, and swelling are part of the inflammatory process, but it is probably too early for an infection.
B) Bee stings frequently cause infection, pain, and swelling, and, with treatment, the infection should begin to subside late today.
C) The infection was probably caused by the stinger, which may still be in the wound.
D) The mothers assessment is accurate and the ED doctor will probably prescribe antibiotics to fix the problem.

Question 8

You are caring for an older female patient who is being treated for acute anxiety. She has a nursing diagnosis of Ineffective Coping related to a feeling of helplessness. What would be the most appropriate nursing intervention?

A) Put the primary onus for planning care on the patient herself.
B) Assess and provide constructive outlets for anger and hostility.
C) Assess the patients sources of social support.
D) Encourage an attitude of realistic hope to help her deal with helpless feelings.

Question 9

A 35-year-old woman comes to the local health center with a large mass in her right breast. She has felt the lump for about a year, but was afraid to come to the clinic because she was sure it was cancer. What is the most appropriate nursing diagnosis for this patient?

A) Self-esteem disturbance related to late diagnosis
B) Ineffective individual coping related to reluctance to seek care
C) Altered family process related to inability to obtain treatment
D) Ineffective denial related to reluctance to seek care

Question 10

The nurse at the student health center is seeing a group of students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What will be included in the nurses intervention?

A) The use of progressive tensing and relaxing of muscles to release tension in each muscle group
B) Using a positive self-image to increase and intensify physical exercise, which decreases stress
C) The mindful use of a word, phrase, or visual, which allows oneself to be distracted and temporarily escape from stressful situations
D) The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations

Question 11

The nurse is assessing a patient and finds two enlarged supraclavicular lymph nodes. The nurse asks the patient how long these nodes have noticeably enlarged. The patient states, I cant remember. A long time I think. Do I have cancer? Which of the following is an immediate physiologic response to stress the nurse would expect this patient to experience?

A) Vasodilation of peripheral blood vessels
B) Increased blood pressure
C) Decrease in blood glucose levels
D) Pupil constriction

Question 12

Your patient tells you that he has just been told that his computed tomography results were abnormal. You can expect that his sympathetic nervous system has stimulated his adrenal gland to release what?

A) Endorphins
B) Dopamine
C) Epinephrine
D) Testosterone

Question 13

The nurse is assessing a patient and learns that the patient and his wife were married just 3 weeks earlier. Which of the following statements should underlie the nurses care planning for this patient?

A) The patient and spouse should seek counseling to ease their transition.
B) The patient will have better coping skills being in a stable relationship.
C) Happy events do not normally cause stress.
D) Marriage causes transition, which has the potential to cause stress.

Question 14

The nurse is assessing a newly admitted patient who is an 84-year-old woman. The nurse learns that the patient has simultaneously experienced a hip fracture and the exacerbation of her chronic heart failure. What is an example of a bodily function that restores homeostasis by negative feedback when conditions
Shift out of normal range?

A) Body temperature
B) Pupil dilation
C) Diuresis
D) Blood clotting

Question 15

A patient who has a 40 pack-year history of smoking may have dysplasia of the epithelial cells in her bronchi. What would the nurse tell the patient about dysplastic cells in the bronchi?

A) This is a benign process that occurs as lung tissue regenerates.
B) Dysplastic cells have a high potential to become malignant.
C) This process involves a rapid increase in number of cells.
D) Dysplasia may cause uncontrolled growth of scar tissue.

Question 16

A teenage boy who was the victim of a near drowning has been admitted to the emergency department. The patient was submerged for several minutes and remains unconscious. What pathophysiological process has occurred as a result of the submersion?

A) Atrophy of brain cells
B) Cellular lysis
C) Hypoxia to the brain
D) Necrosis to the brain

Question 17

Your older adult patient has been diagnosed with urosepsis and has a temperature of 103.4F. You should be aware that the oxygen demands of the patients body would change in which direction and why?

A) Increase due to an increase in metabolism
B) Decrease due to a decrease in metabolism
C) Increase due to a decrease in metabolism
D) Decrease due to an increase in metabolism

Question 18

You are admitting a patient who presents with inflammation of his right ankle. When planning this patients care, which of the following statements regarding acute inflammation should you recognize?

A) Inflammation is essentially synonymous with infection.
B) Inflammation may impair the healing process.
C) Inflammation is a defensive reaction intended to remove an offending agent.
D) Inflammation inhibits the release of histamines in the tissues.

Question 19

An elderly man tells you that his wife died 14 months ago and that he cannot stop grieving over his loss. What should you encourage the patient to consider?

A) Improve his nutritional intake.
B) Make an appointment at a wellness clinic.
C) Walk on a daily basis.
D) Increase his interaction with his social network.

Question 20

You are caring for a 65 -year-old widower whose wife died 4 months ago. He tells you that he is not doing well and that his friends and family seem hesitant to talk with him about his wife. What could the nurse do to help the patient?

A) Refer him to a consciousness-raising group.
B) Refer him to a psychiatrist.
C) Refer him to a support group.
D) Refer him to a church or temple.

Question 21

A 44-year-old woman will undergo a bilateral mastectomy later today and the nurse in surgical admitting has begun the process of patient education. What positive outcome of providing the patient with information should the nurse expect?

A) Increased concentration
B) Decreased depression levels
C) Sharing of personal details
D) Building interdependent relationships

Question 22

You are the nurse caring for a 51 -year-old man who has just been told in a family meeting that he has stage IV colon cancer. You expect that the patient now has an increase in blood pressure, heart rate and respiratory rate. You spend time talking with this patient and his vital signs become closer to normal range. To what would you attribute this phenomenon?

A) Cortisol levels are decreasing.
B) Endocrine activity has increased.
C) The patient is adapting to noxious stressors.
D) The sympathetic response has been activated.

Question 23

While talking with the parents of conjoined twins who are medically unstable, you note that the father of the babies has an aggressive stance, is speaking in a loud voice, and makes several hostile statements such as, Id sure like to have words with that doctor who told us our babies would be okay. You know that this fathers cognitive appraisal has led to what?

A) Harm/loss feelings
B) Feelings of challenge
C) A positive adjustment to the possible loss of his children
D) The development of negative emotions

Question 24

The nurse is caring for a patient who was widowed 2 years prior to this current hospitalization, her fifth since the death of her husband. The woman says to the nurse, The doctor says my blood pressure is dangerously high. What is making my blood pressure so high? What does the nurse know about the probable cause of this patients hypertension?

A) Prolonged or unrelenting suffering can cause physical illness.
B) Physical illness is always caused by prolonged stress.
C) The elderly are at increased risk for hypertension due to stress.
D) Stress always exacerbates the physiologic processes of the elderly.

Question 25

You are the psychiatric-mental health nurse caring for a young, recently married woman, whose sister and niece were recently killed in a motor vehicle accident. This young woman is making arrangements for the funerals, and you know that your patient has insight into her current stressors. What do you know is occurring with this young woman?

A) The mediating process is occurring.
B) The patient is experiencing an expected level of denial.
C) The patients awareness of her stress makes it more acute.
D) The patient is emotionally overwhelmed.

Question 26

As an occupational health nurse at a large industrial plant, you are planning the return to work of an employee who was exposed to a chemical spill. To what type of stressor has this patient been exposed?

A) Physiologic
B) Psychosocial
C) Physical
D) Psychiatric

Question 27

You are caring for a patient in the urgent care center who presented with complaints of lethargy, malaise, aching, weakness, and loss of appetite. During the assessment, you note an area on the patients right posterior calf that is warm to touch, edematous, and tender to touch. You know the most probable cause of this patients symptoms is what?

A) Local inflammatory response
B) Systemic shock response
C) Local infectious response
D) Systemic inflammatory response

Question 28

You are discharging a 4-year-old boy from the emergency department. The boy was seen for an insect bite that became swollen and reddened and warm and painful to touch. The patients vital signs are all within normal range for age. While giving discharge instructions to the patients father, he asks why the child is not going to get antibiotics for the infected insect bite. What would be your best response?

A) This is a local inflammatory response to the insect bite; it is not an infection so antibiotics will not help.
B) In children who are previously healthy, inflammation and infections usually resolve without the need for drugs.
C) Ill make sure the doctor is made aware that youd like your son to have a course of antibiotics.
D) Infection is not the same as inflammation. What your son has is inflammation.

Question 29

A group of nursing students are applying the concept of steady state to the nursing care plan of a patient who is undergoing chemotherapy and radiotherapy for the treatment of lung cancer. What would be the
Most complete statement by the students about the concept of steady state?

A) The concept of steady state preserves life.
B) The mechanisms of steady state work to maintain balance in the body.
C) This concept compensates for biologic and environmental attacks on the body.
D) Steady state is the same as adaptation.

Question 30

A nursing student has presented a concept map of a medical patients health that demonstrates the maintenance of a steady state. The student has elaborated on the relationship of individual cells to compensatory mechanisms. When do compensatory mechanisms occur in the human body?

A) According to a diurnal cycle
B) When needed
C) Continuously
D) Sporadically

Question 31

A nurse is planning the care of a woman who has been admitted to the medical unit following an ischemic cerebrovascular accident. What would the nurse recognize as the longest-acting phase of the womans physiologic response to stress and its cause?

A) Sympathetic-adrenal-medullary response caused by persistent stress
B) Hypothalamic-pituitary response caused by acute stress
C) Sympathetic-adrenal-medullary response caused by acute stress
D) Hypothalamic-pituitary response caused by persistent stress

Question 32

Selyes general adaptation syndrome (GAS) is a theory of adaption to biologic stress. Selye compared the GAS with the life process: childhood, adulthood, and later years. What would occur during adulthood in the GAS?

A) Stressful events occur and resistance or adaption occurs.
B) Successful avoidance of stressful life events leaves the body vulnerable.
C) The accumulation of lifes stressors causes resistance to fall.
D) Vulnerability leads to eventual death.

Question 33

You are auditing the electronic health record of a 33-year-old patient who was treated for a postpartum hemorrhage. When reviewing the patients records, you can see various demonstrations of negative feedback loops. Which of the following constitute negative feedback loops? Select all that apply.

A) Serum glucose levels
B) Acid-base balance
C) Temperature
D) Blood clotting
E) Labor onset

Question 34

A group of nurses are planning the care of an older adult who is being rehabilitated following a stroke. A nurse notes that hypertension and cardiovascular disease could have occurred over time if the patient previously experienced a state of chronic arousal. In a state of chronic arousal, what can happen within the body?

A) Blood pressure decreases
B) Serum glucose levels drop.
C) Arteriosclerosis may develop.
D) Tissue necrosis may occur.

Question 35

A group of nurses are attending an educational inservice on adaptive and maladaptive responses to stress. When talking about the assessment of coping strategies in patients, the nurses discuss the use of drugs and alcohol to reduce stress. What is most important for the nurses to know about these coping behaviors?

A) They are effective, but alternative, coping behaviors.
B) They do not directly influence stress in the body.
C) They are adaptive behaviors.
D) They increase the risk of illness.

Question 36

You are assessing an older adult patient post-myocardial infarction. You attempt to identify your patients health patterns and to assess if these health patterns are achieving the patients goals. How should you best respond if it is found that the patients health patterns are not achieving their goals?

A) Seek ways to promote balance in the patient.
B) Refer the patient to social work.
C) Identify alternative models of health care.
D) Provide insight into the patients physiological failings.

Question 37

A patient is experiencing intense stress during his current hospital admission for the exacerbation of chronic obstructive pulmonary disease (COPD). Which of the patients actions best demonstrates adaptively coping?

A) Becoming controlling
B) Reprioritizing needs and roles
C) Using benzodiazepines as ordered
D) Withdrawing

Question 38

The nurse is performing discharge planning for a patient who has numerous chronic health problems. The nurse recognizes that lifestyle changes would likely benefit the patients health status. Which factor would the nurse identify as most important in determining health status?

A) Gender
B) Ethnicity
C) Social class
D) Interfamilial relationships

Question 39

The nurse is admitting a 51-year-old patient to the medical-surgical unit after a diagnosis of cellulitis of the calf. What factors does the nurse know impact the processes of inflammation, repair, and replacement? Select all that apply.

A) Severity of the injury
B) Social relationships
C) Condition of the host
D) Familial support
E) Nature of the injury