Question 1

A nurse is teaching guided imagery to a prenatal class.Identify an example of guided imagery from the options below.

Accepted Answer

Guided imagery is used as a means to create a relaxed state through the person's imagination,often using sensory words.Imagination allows the person to create a soothing and peaceful environment.Singing,back massage,and listening to music are other types of stress management techniques.

Question 2

Pediatric stressors related to self-esteem and changes in family structure reflect which maturational school age category?

Accepted Answer

The preadolescent age category experiences stress related to self-esteem issues,changing family structure due to divorce or death of a parent,or hospitalization.Adolescent stressors include identity issues with peer groups and separation from parents.Elementary school age stressors include friends,family,and school relations.Adult stressors centralize around life events.

Question 3

During the evaluation stage of the critical thinking model applied to a patient coping with stress,the nurse will

Accepted Answer

During the evaluation stage,the nurse compares current stress-related symptoms against established measurable outcomes to evaluate the effectiveness of the intervention.Selecting appropriate interventions and establishing goals are part of the planning process.

Question 4

After a natural disaster occurred,an emergency worker referred a family for crisis intervention services.One family member refused to attend the services,stating "No way,I'm not crazy." The best response the nurse can give is which of the following?

Accepted Answer

Crisis intervention is a type of brief therapy that is more directive than typical psychotherapy or counseling.It focuses on problem solving and involves only the problem created by the crisis.The goal of crisis intervention is to create stability for the person involved in the crisis while promoting self-reliance.The other options do not properly reassure the patient and build trust.

Question 5

An adult male reports new-onset seizurelike activity.An EEG and a neurology consultant's report rule out a seizure disorder.When considering the ego defense mechanism of conversion,the nurse's next best action would be to

Accepted Answer

The purpose of an ego defense mechanism is to help regulate emotional stress.By regulating emotional stress,the individual gains some protection from anxiety and stress.A conversion reaction involves repressing an anxiety-producing conflict and transforming it into a nonorganic symptom such as difficulty sleeping,appetite loss,or sudden blindness without medical cause.The nurse must assess the patient fully before implementing any nursing interventions.Although the patient may be malingering,confrontation is nontherapeutic because the patient is using this type of defense mechanism in response to some type of stressor.

Question 6

The nurse teaches stress reduction and relaxation training to a health education group of patients after cardiac bypass surgery.The nurse is performing which level of intervention?

Accepted Answer

Tertiary level interventions have the purpose of assisting the patient in readapting to life with an illness.Tertiary prevention focuses on the person who already has the disease and is recovering or rehabilitating.Tertiary prevention goals are to slow down the disease process,prevent further damage or pain from the disease,and prevent the current disease from creating other health problems.Primary level consists of stress prevention,promotion of wellness,and risk factor reduction before illness occurs.Secondary level occurs after symptoms appear and assists the person to develop resources to manage illness and stress.Quad level does not exist.

Question 7

Despite working in a highly stressful nursing unit and accepting additional shifts,a new nursing graduate has a strategy to prevent burnout.The best strategy would be for the new nurse to

Accepted Answer

An important step in preventing burnout is acknowledging one's own limitations,as well as what one's scope of work is while on the job.By doing this,the person will help to prevent emotional exhaustion and will limit the effects of chronic stress.Journaling and muscle relaxation are good stress-relieving techniques but are not directed at the cause of the workplace stress.Delegating if not applicable is an inappropriate coping mechanism.

Question 8

A trauma survivor is requesting sleep medication because of "bad dreams." Concerned about posttraumatic stress disorder,the nurse asks

Accepted Answer

People who have PTSD often have flashbacks,reexperiencing the trauma.The other answers involve assessment of problems not specific to PTSD.

Question 9

A teen with celiac disease continues to eat food she knows will make her ill several hours after ingestion.Given appropriate tertiary level interventions,the nursing intervention would be to

Accepted Answer

Tertiary level interventions have the purpose of assisting the patient in readapting to life with an illness.By adjusting the diet to meet dietary guidelines and also addressing adolescent emotional needs,the nurse will help the teen to eat an appropriate diet without health complications and see herself as a "typical and normal" teenager.Teaching about the food pyramid will not address the real issue,which is that the teen is still eating what she knows will make her ill.Administering antidiarrheal medications may help but is not a tertiary level intervention.Admonishing the teen and parents is not a tertiary level intervention,and because this approach is nontherapeutic,it may cause communication problems.

Question 10

A young adult's chief complaint is "seizure fits." A chart review shows a negative EEG report and a normal neurological consultation report.A psychosocial history reveals increased family stress,bankruptcy,and a recent divorce.The nurse recognizes that this young man's pseudo-seizures most likely are an example of which unconscious coping mechanism?

Accepted Answer

A conversion reaction is an ego defense mechanism that involves repressing an anxiety-producing conflict and transforming it into a nonorganic symptom such as difficulty sleeping,loss of appetite,or sudden blindness without medical cause.Compensation is making up for a deficiency in one aspect of self-image by strongly emphasizing a feature considered an asset.Dissociation involves experiencing a subjective sense of numbing and a reduced awareness of one's surroundings.Denial is seen as avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain.

Question 11

An adult who was in a motor vehicle accident is brought into the emergency department by paramedics,who report the following in-transit vital signs: Oral temperature: 99.0° F
Pulse: 102 beats per minute
Respiratory rate: 26 breaths per minute
Blood pressure: 140/106
The nurse can identify that which hormones are the likely causes of the abnormal vital signs?

Accepted Answer

Epinephrine and norepinephrine are catecholamine hormones secreted by the adrenal medulla that rapidly elevate heart rate and blood pressure.ACTH originates from the anterior pituitary gland and stimulates cortisol release; ADH originates from the posterior pituitary and increases renal reabsorption of water.ACTH,cortisol,and ADH do not increase heart rate.

Question 12

Identify a sociocultural factor that can lead to developmental problems.

Accepted Answer

Environmental and social stressors are believed to lead to developmental problems.Sociocultural refers to societal or cultural factors; poverty is a sociocultural factor.Stamina loss and obesity are health problems,and family relocation is a situational factor.

Question 13

An assessment finding example for caregiver strain would be which of the following?

Accepted Answer

A nurse will identify a caregiver's lack of self-care as a potential example of caregiver role strain.Sacrificing their own health to care for the identified patient places caregivers at risk for becoming ill themselves.If caregivers jeopardize their own health,they may not be able to care for the actual patient.In all of the other options,the caregiver is handling caregiver stress appropriately.

Question 14

The purpose of unconscious ego defense mechanisms is to do which of the following for the individual?

Accepted Answer

Ego defense mechanisms offer the individual psychological protection from emotional stress.They are used unconsciously to protect against worthlessness and feelings of anxiety.Problem-focused coping is a coping strategy rather than an ego defense mechanism.Evaluation of an event for its personal meaning is primary appraisal.The medulla oblongata controls heart rate,blood pressure,and respirations and is not triggered by ego defense mechanisms.

Question 15

A person states that he was not shoplifting from the store despite very clear evidence on the store surveillance tape.This person is demonstrating which ego defense mechanism?

Accepted Answer

Denial consists of avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain.Dissociation involves creating subjective numbness and less awareness of surroundings.Conversion involves repressing anxiety and manifesting it into a physiological problem.Compensation occurs when an individual makes up for a deficit by strongly emphasizing another feature.

Question 16

While giving a lecture on attention-deficit/hyperactivity disorder,the nurse encourages which of the following to reduce children's stress regarding homework assignments?

Accepted Answer

Time management skills are most related to homework assignment completion.Anemia prevention will improve energy levels but not stress.Routine health visits are important but do not directly affect ability to complete homework.Speech and other developmental aspects need to be developed if the child is to be successful,but skill development will not directly reduce homework-related stress.

Question 17

A woman who was sexually assaulted a month ago presents to the emergency department with complaints of recurrent nightmares,fear of going to sleep,repeated vivid memories of the sexual assault,and inability to feel much emotion.The nurse recognizes the signs and symptoms of which medical problem?

Accepted Answer

Posttraumatic stress disorder is characterized by vivid recollections of the traumatic event and emotional numbing and often is accompanied by nightmares.General adaptation syndrome is the expected reaction to a major stressor.Developmental crisis occurs as a person moves through life stages rather than in response to a trauma.Alarm reaction involves physiological events such as increased activation of the sympathetic nervous system that would have occurred at the time of the sexual assault.

Question 18

The nursing student gave a wellness lecture on the importance of accurate assessment and intervention from a personal,family,and community perspective.The other nursing students enjoyed the lecture about which nursing theory?

Accepted Answer

The Neuman systems model is based on an individual's/family's/community's relationship to stress and the reaction to stress.This model promotes wellness on primary,secondary,and tertiary levels.The other items listed as models are not nursing theories.Ego defense mechanisms are unconscious coping mechanisms.Situational refers to factors such as relocation or family job changes that are stressors.Evidence-based practice consists of relying on data or other reputable information sources to guide nursing care.

Question 19

In a natural disaster relief facility,the nurse observes that an elderly man has a recovery plan,while a 25-year-old man is still overwhelmed by the disaster situation.These different reactions to the same situation would be explained best by which of the following?

Accepted Answer

Maturational factors and sociocultural factors can affect people differently depending on their life experiences.An older individual would have more life experiences to draw from and to analyze on why he was successful,whereas a younger individual would have fewer life experiences based on chronological age to analyze for patterns of previous success.Nothing in the scenario implies that either man is in restorative care,has strong financial resources,or is immature or intelligent.

Question 20

A senior college student contacts the college health clinic about a freshman student living on the same dormitory floor.The senior student reports that the freshman is crying and is not adjusting to college life.The clinic nurse recognizes this as a combination of situational and maturational stress factors.The best comment to the senior student would be

Accepted Answer

A health care provider can help to reduce situational stress factors for individuals.Providing the student with a list of resources is one way to begin this process,as part of secondary prevention strategies.This is not a medical or psychiatric emergency,so calling 911 is not necessary.Not everyone who has sadness needs medications; some need counseling only.Not enough information is given to know whether the student would be best suited to leave college.

Quiz 85: Stress and Coping