Question 1

What does a person experience as stress increases? (Select all that apply.)

Accepted Answer

As stress increases, a person's problem-solving ability decreases, and they may struggle with indecisiveness. In severe cases, stress can lead to irrational behavior. Widened focus and attention to detail are not typically associated with increasing stress levels.

Question 2

When is it appropriate for the nurse to encourage a patient to use the problem-focused approach to reduce stress? (Select all that apply.)

Accepted Answer

A, B, C, E

Question 3

What symptoms would indicate depression in an older adult who has recently been admitted to a long-term care facility? (Select all that apply.)

Accepted Answer

Appetite changes, weight loss, complaints of minor physical ailments, and sleep disturbances are common symptoms of depression in older adults. Taking part in only one social activity a day is not necessarily indicative of depression.

Question 4

What is the intent of problem-focused coping strategies?

Accepted Answer

The intent of problem-focused coping strategies is to eliminate or reduce the cause of stress. This involves taking action to address the source of the stressor, such as solving a problem or finding a solution to a difficult situation.

Question 5

The timid, newly admitted 84-year-old widow has stayed in her room at the long-term care facility listening to her radio, which is playing loud jazz, and has been lying in bed fully clothed. How can the nurse help to relieve the resident's stress related to the relocation?

Accepted Answer

Encouraging the resident to verbalize her feelings related to relocation can help the nurse understand her perspective and provide appropriate support. Insisting that she come out and interact with others or bringing in other residents may cause more stress and anxiety for the resident. Changing her radio station may not address the root cause of her stress.

Question 6

The nurse is aware that the use of a defense mechanism is a normal response to stress. When does a defense mechanism become problematic?

Accepted Answer

A defense mechanism becomes problematic when it is used excessively, to the point that it interferes with daily functioning and prevents the individual from facing and resolving the stressor in a healthy manner.

Question 7

When are stress-related physical, behavioral, and cognitive changes more likely to occur?

Accepted Answer

Stress-related changes are more likely to occur when stress is varied and cumulative because the accumulation of different stressors over time can overwhelm an individual's coping mechanisms, leading to physical, behavioral, and cognitive changes.

Question 8

In general adaptation syndrome (GAS), what is the stage after the first alarm reaction has been successfully resolved in which body systems return to normal?

Accepted Answer

In the General Adaptation Syndrome (GAS) model, after the initial alarm reaction stage, the body enters the resistance stage if the stressor continues. This stage is where the body adapts to the stressor and attempts to return to a state of homeostasis or normal functioning.

Question 9

What is a positive effect of mild stress?

Accepted Answer

Mild stress can increase alertness and motivation, leading to an increased ability to focus and problem solve.

Question 10

How does physical illness increase stress in the older adult?

Accepted Answer

Physical illness can consume the older adult's energy and make it more difficult to cope with additional stressors, leading to an increase in overall stress levels.

Question 11

What is true of an older adult who used coping skills effectively during his younger years?

Accepted Answer

As an older adult faces different types of stressors, he may need to modify his old coping skills and develop new ones in order to effectively manage those stresses. Simply continuing to use the same coping skills without modification may not work in all situations, as different types of stresses may require different approaches. Thus, option B, he will modify old skills and develop new ones, is the best choice.

Question 12

An 80-year-old man recently became widowed, moved into a long-term care facility, and had to quit driving. He complains of fatigue and is irritable when questioned about his health. What would be the most appropriate action of the nurse?

Accepted Answer

The nurse should approach the patient to talk about his perceptions related to his relocation. The patient has gone through multiple significant life changes recently, which could be causing his fatigue and irritability. It is important for the nurse to assess the patient's emotional well-being and offer support to help him adjust to his new environment. Simply suggesting he take a nap or read a book may not address the underlying emotional issues he is experiencing. Reporting the complaints as expected adjustments to relocation without further assessment would not provide adequate support for the patient.

Question 13

The nurse assesses a behavior as a sign of depression in the newly admitted resident to a long-term care facility when the resident exhibits disorganization and displays which behavior?

Accepted Answer

Disorganization, such as not dressing properly, is a symptom of depression. Eating excessively, socializing with a limited number of residents, and arranging activities around a specific television program are not necessarily signs of depression.

Question 14

The student sitting in class waiting for the final examination develops nausea and excessive gas. What is a probable cause of these symptoms?

Accepted Answer

Reduction of peristalsis, which is the involuntary constriction and relaxation of the muscles of the intestine or another canal, could lead to nausea and excessive gas. This reduction of peristalsis is likely due to the student's anxiety or stress related to the upcoming final examination.

Question 15

The nurse is assessing an older adult who has been recently admitted to the long-term care facility. The resident has become active in the facility, goes to every activity, carefully makes her bed every day, does jigsaw puzzles, and chats with tablemates at mealtime. What defense mechanism is the resident exhibiting?

Accepted Answer

Substitution is being used here as the resident is engaging in new activities and forming new relationships to cope with the stress of being in a new environment, effectively substituting the loss of her previous home environment and routine with new ones.

Question 16

How does the body respond physically to stress?

Accepted Answer

When a person experiences stress, the body releases the hormone cortisol, which can suppress the production of digestive enzymes and decrease appetite. This is because during a stress response, the body is preparing for "fight or flight" and prioritizes blood flow and energy to the major muscle groups, rather than the digestive system.

Question 17

Which statement by a patient could be related to symptoms of stress?

Accepted Answer

Increased frequency of urination with minimal output is a symptom associated with stress and anxiety.

Question 18

The 80-year-old man who is experiencing stress because visual loss has caused him to quit driving says, "I have friends and family who will be my transportation. I can still get around and I'll have entertaining company." What coping mechanism is the man using?

Accepted Answer

The man is using emotional distancing as a coping mechanism by minimizing the personal significance of the stressor (his visual loss and inability to drive), thus reducing the emotional impact it has on him. He focuses on the positive aspect of having friends and family for transportation and the enjoyable company they provide, rather than dwelling on his loss of independence.

Question 19

A woman is in the emergency department after a car wreck. She is breathing rapidly and complains of dizziness and tingling in her extremities. She says, "I think I'm having a heart attack!" The nurse is aware that the symptoms may be related to which of the following?

Accepted Answer

The woman's rapid breathing suggests hyperventilation, which can cause symptoms such as dizziness and tingling in the extremities. It is not likely to be a heart attack, transient ischemic attack, hypotension, or asthma in this scenario.

Question 20

Why is depression a common symptom in older adults who have been admitted to a long-term care facility? (Select all that apply.)

Accepted Answer

Older adults who have been admitted to long-term care facilities often experience a loss of independence and freedom, which can be overwhelming and lead to depression. They may also feel isolated and lonely, thinking that they have no family support or that their loved ones have abandoned them. This lack of social support can exacerbate feelings of depression. While some older adults may find support and self-worth through activities and making new friends in the facility, many others struggle with adjusting to the new environment and may not actively seek assistance to reduce their depression. Self-knowledge may not be helpful in coping with new situations, especially when the older adult is faced with a significant loss of autonomy and control over their life.

Quiz 13: Coping and Stress