Question 1

According to the Recent Life Changes Questionnaire, which situation would most necessitate a complete assessment of a person's stress status and coping abilities?

Accepted Answer

A person returning to college after losing a job is dealing with two significant stressors simultaneously. Together, these stressors total more life change units than any of the single stressors cited in the other options.

Question 2

A patient tells the nurse, "My doctor thinks my problems with stress relate to the negative way I think about things and suggested I learn new ways of thinking." Which response by the nurse would support the recommendation?

Accepted Answer

Teaching the patient to recognize, reconsider, and reframe irrational thoughts is known as cognitive restructuring, which is a recommended treatment for stress-related problems attributed to negative thinking patterns. Imagery, journaling or feedback instruments may also be helpful interventions, but they are not specifically focused on changing negative thought patterns.

Question 3

A patient tells the nurse, "I know that I should reduce the stress in my life, but I have no idea where to start." What would be the best initial nursing response?

Accepted Answer

The best initial nursing response is to assess the patient's specific situation and work collaboratively with the patient to develop a plan to manage their stress. This involves exploring the root causes of the patient's stress and helping them identify potential coping strategies. Option A and B may be helpful suggestions, but they do not address the patient's individual situation. Option C assumes that meditation is the solution for everyone, which may not be the case.

Question 4

The adult child of a patient diagnosed with major depression asks, "Do you think depression and physical illness are connected? Since my father's death, my mother has had shingles and the flu, but she's usually not one who gets sick." Which answer by the nurse best reflects current knowledge about psychoneuroimmunology?

Accepted Answer

Psychoneuroimmunology is the study of how the immune system and the nervous system are interconnected. Research in this field has found that negative emotions and stress can weaken the immune system and increase the likelihood of illness. Therefore, the best answer is D. Option A is incorrect because emotions and physical responses are linked through the nervous and endocrine systems. Option B may be a possibility, but it is not the most accurate response. Finally, option C is incorrect because research does show that negative emotions and stress can impact the immune system.

Question 5

A nurse leads a psychoeducational group for depressed patients. The nurse plans to implement an exercise regime for each patient. Which of the following rationales should the nurse use when presenting this plan to the treatment team?

Accepted Answer

Exercise is known to help protect against the harmful effects of stress by reducing stress hormones and increasing endorphins, which can improve mood and overall mental health.

Question 6

A person with a fear of heights drives across a high bridge. Which division of the autonomic nervous system will be stimulated in response to this experience?

Accepted Answer

The sympathetic nervous system is responsible for the body's "fight or flight" response to perceived danger, including physical arousal such as increased heart rate and blood pressure. Crossing a high bridge can trigger this response in individuals with a fear of heights.

Question 7

Which changes reflect short-term physiological responses to stress?

Accepted Answer

Short-term physiological responses to stress include increased muscular tension, blood pressure, and triglycerides (A), release of epinephrine which increases heart and respiratory rates (B), corticosteroid release which increases stamina and impedes digestion (C), and cortisol release which increases gluconeogenesis and reduces fluid loss (D). These are immediate responses to stress, unlike long-term effects such as immune system suppression or increased risk of chronic diseases.

Question 8

Which scenario best demonstrates an example of eustress?

Accepted Answer

Eustress is a positive form of stress that can motivate and energize individuals. Preparing for a vacation with friends is typically a positive and exciting experience, thus representing eustress.

Question 9

Which nursing comments are likely to help a patient to cope, by addressing the mediators of stress?

Accepted Answer

The answer of Which nursing comments are likely to help...

Question 10

A patient experiencing significant stress associated with a disturbing new medical diagnosis asks the nurse, "Do you think saying a prayer would help?" Select the nurse's best answer.

Accepted Answer

The patient is seeking comfort during a stressful time and is asking about the potential benefits of prayer. It is appropriate for the nurse to acknowledge that prayer may give the patient comfort and lower their stress levels without imposing any personal beliefs on the patient. Option A implies that prayer is the only solution and could be seen as dismissive of the patient's concerns. Option C suggests an alternative relaxation technique but does not directly address the patient's question. Option D may come across as insensitive, dismissive, or lack empathy towards the patient's beliefs.

Question 11

When a nurse asks a newly admitted patient to describe social supports, the patient says, "My parents died last year, and I have no family. I am newly divorced, and my former in-laws blame me. I don't have many friends because most people my age just want to go out drinking." Which action will the nurse apply?

Accepted Answer

The best choice would be to discuss how divorce support groups could increase coping and social support. This patient has experienced multiple losses and is lacking social support, which can put them at risk for poor mental and physical health outcomes. Divorce support groups can provide a space for the patient to connect with others who have similar experiences and offer emotional support, which can help build resilience and coping skills. Encouraging dating or using the internet may not be appropriate or helpful for this patient at this time. Advising the patient about their approach to making friends could come across as dismissive or blaming.

Question 12

A patient who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the patient returns to the clinic 2 weeks later, which finding most clearly shows the patient is coping more effectively with stress?

Accepted Answer

The answer of A patient who had been experiencing significant...

Question 13

A patient newly diagnosed as HIV-positive seeks the nurse's advice on how to reduce the risk of infections. The patient says, "I used to go to church and I was in my best health then. Maybe I should start going to church again." Which response will the nurse offer?

Accepted Answer

Research has shown that spiritual practices can improve both immune function and psychological coping abilities, which can reduce the risk of infections and improve overall health outcomes for people living with HIV. Therefore, option C is the best response to the patient's inquiry.

Question 14

A person with a fear of heights drives across a high bridge. Which structure will stimulate a response from the autonomic nervous system?

Accepted Answer

The hypothalamus is part of the autonomic nervous system, which controls involuntary responses such as fear and anxiety. The fear of heights will stimulate the autonomic nervous system, which triggers a fight or flight response, including increased heart rate, sweating, and other physical symptoms. The thalamus, parietal lobe, and pituitary gland are not directly involved in the autonomic nervous system's response to fear.

Question 15

A patient reports, "I am overwhelmed by stress." Which question by the nurse would be most important to use in the initial assessment of this patient?

Accepted Answer

Asking about the patient's coping mechanisms and stress reduction techniques will allow the nurse to identify what strategies the patient currently uses to manage stress and whether they are effective or not. This information will help the nurse develop a plan to address the patient's stress. The other options may be relevant but are not as crucial in the initial assessment of a patient reporting feeling overwhelmed by stress.

Question 16

A recent immigrant from Honduras comes to the clinic with a family member who has been a Canadian resident for 10 years. The family member says, "The immigration to Canada has been very difficult." Considering cultural background, which expression of stress by this patient would the nurse expect?

Accepted Answer

In many cultures, including some Latin American cultures, stress and emotional distress are often expressed through physical or somatic complaints rather than verbalizing emotional difficulties.

Question 17

A patient nervously says, "Financial problems are stressing my marriage. I've heard rumours about cutbacks at work; I am afraid I might get laid off." The patient's pulse is 112 per minute; respirations are 26 per minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement?

Accepted Answer

The patient's vital signs indicate anxiety or stress. Guiding the patient in slow and deep breathing can help reduce anxiety and lower heart rate and blood pressure.

Question 18

A patient is brought to the emergency department after a motorcycle accident. The patient is alert and responsive and is diagnosed with a broken leg. The patient's vital signs are pulse (P) 72 and respiration (R) 16. After being informed surgery is required for the broken leg, which vital sign readings would be expected?

Accepted Answer

The anticipation of surgery can cause anxiety, leading to an increase in sympathetic nervous system activity, which typically results in elevated heart rate (pulse) and respiratory rate.

Question 19

A patient diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently, the patient has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the patient be encouraged to visualize?

Accepted Answer

The patient needs to overcome their fear of breathing difficulty when leaving home. Guided imagery can be helpful in reducing anxiety and promoting relaxation. Visualizing feeling relaxed and taking regular deep breaths when leaving home can help the patient to associate leaving home with a positive experience, reducing their fear and promoting activity. The other options do not directly address the patient's fear of activity and breathing difficulty.

Question 20

A patient tells the nurse, "I will never be happy until I'm as successful as my older sister." The nurse asks the patient to reassess this statement and reframe it. Which reframed statement by the patient is most likely to promote coping?

Accepted Answer

Reframing the statement to focus on finding contentment in succeeding at one's own job level promotes a more positive and achievable goal. The other options either focus on external factors beyond the patient's control or undermine their own abilities and worth.

Quiz 5: Understanding Responses to Stress