Deck 32: Stress and Coping

Question 1

The nurse is educating the patient on the use of relaxing 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."

Answer 1

"I should do this three times a week."

Question 2

The nurse knows that one theory explaining the variation in response to stress among individuals is called:

A) stress appraisal.
B) sense of coherence.
C) allostasis.
D) homeostasis.

Answer 2

sense of coherence.

Question 3

The nurse is caring for a patient on a medical-surgical inpatient unit. 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.

Answer 3

Implement one-on-one observations.

Question 4

The nurse knows an appropriate goal for Stress overload is:

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 discuss strategies for coping with relationship violence within 24 hours.
D) The patient's family will use respite care once a week for the next month.

Question 5

The nurse knows that the body's response to the release of hormones in the "fight or flight" response is which of the following? (Select all that apply.)

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 6

The nurse knows an appropriate goal for the nursing diagnosis of Ineffective coping would be:

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 7

The nurse is seeing a patient during a follow-up visit after discharge in which the patient had a nursing diagnosis of Ineffective 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 8

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 9

The nurse is teaching her 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 10

The nurse knows that when patients are experiencing stress, the following change can be seen in their signs and symptoms: (Select all that apply.)

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

Question 11

The nurse knows that an appropriate goal for Readiness for enhanced coping would be:

A) The patient will report an ability to focus on discharge instructions.
B) The patient will attend a coping skills class on a weekly basis.
C) The patient will discuss possible coping strategies during weekly office visits.
D) The patient will discuss strategies for coping with relationship violence within 24 hours.

Question 12

The nurse is caring for a patient who is undergoing a major cardiac procedure. The patient tells you her heart is racing and she feels nauseated. You know this is part of hormone response known as:

A) sense of coherence.
B) stress appraisal.
C) fight or flight.
D) sympathoadrenal response.

Question 13

The nurse knows that when coordination between multiple health care disciplines is needed, the following role is used:

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

Question 14

The nurse is measuring her patient's blood glucose levels after an acute myocardial infarction (MI). She knows the rationale for doing this is:

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 15

The nurse is assessing the patient's use of coping skills in response to stressful situations. Which of the following questions is 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?"

Question 16

The nurse is providing discharge instructions for a patient with multiple sclerosis (an autoimmune disease). 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 17

The nurse is caring for a patient with a new diagnosis of diabetes type 2. Which of the following statements 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 18

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 19

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.

Question 20

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 37.5° C
C) Heart rate of 110 beats/min
D) Respiratory rate of 10 breaths/min

Question 21

The nurse knows that certain personality factors have been shown to buffer the impact of stress. These factors are: (Select all that apply.)

A) resilience.
B) sense of coherence.
C) gender.
D) hardiness.
E) coping style.

Question 22

The nurse knows that the coping strategies that are more frequently seen in older adults are: (Select all that apply.)

A) anger.
B) withdrawal.
C) information gathering.
D) avoidance.
E) problem focused.

Question 23

The nurse manager of a busy oncology unit is concerned about compassion fatigue among her nursing staff. Which of the following signs and symptoms would alter her to this problem? (Select all that apply.)

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 24

The nurse manager of the unit is implementing a program to assist the nursing staff in managing compassion fatigue. Which intervention will be the most successful? (Select all that apply.)

A) Support group that nurses can participate in that meets on the unit
B) Exercise completion 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 the above

Question 25

The nurse knows that childhood stress related to the school experience centers on: (Select all that apply.)

A) goal achievement.
B) family dissolution.
C) life changes.
D) test anxiety.
E) competition.