Exam 5: Understanding Responses to Stress

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?

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?

The nurse wishes to use guided imagery to help a patient relax. Which comments would be appropriate to include in the guided imagery script?

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?

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.

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?

Which changes reflect short-term physiological responses to stress?

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?

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

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?

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?

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?

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?

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

An individual says to the nurse, "I feel so stressed out lately. I think the stress is affecting my body, also." Which somatic complaints are most likely to accompany this feeling?

Which scenario best demonstrates an example of eustress?

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?

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?

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?

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?