Deck 1: The Concept of Stress Adaptation

Question 1

A nurse is providing education on anxiety and stress management.Which of the following should be identified as the most important initial step in learning how to manage anxiety?

A)Diagnostic blood tests
B)Awareness of factors creating stress
C)Relaxation exercises
D)Identification of support systems

Answer 1

Awareness of factors creating stress

Question 2

A physically and emotionally healthy client has just been fired.During a routine office visit,he tells the nurse,"Perhaps this was the best thing to happen.Maybe I'll consider pursuing an art degree." The nurse determines the client perceives the stressor of his job loss as:

A)Irrelevant.
B)Harm/loss.
C)A threat.
D)A challenge.

Answer 2

A challenge.

Question 3

The school nurse is assessing a female high school student who is distraught because her parents can't afford horseback riding lessons.The nurse recognizes the student's perception is that the problem is:

A)Endangering her well-being.
B)Personally relevant.
C)Based on immaturity.
D)Exceeds her capacity to cope.

Answer 3

Personally relevant.

Question 4

Meditation has been shown to be an effective stress management technique.Which nursing assessment indicates meditation has been effective?

A)An achieved state of relaxation
B)An achieved insight into one's feelings
C)A demonstration of appropriate role behaviors
D)An enhanced ability to problem-solve

Question 5

The nurse identifies which symptom as typical of the fight-or-flight response?

A)Decreased heart rate
B)Increased peristalsis
C)Increased salivation
D)Pupil constriction

Question 6

The nurse in the intensive care unit (ICU)is giving report to the nurse on the cardiac step-down unit.The nurse states,"The patient is a 48-year-old woman admitted 3 days ago for chest pain and a stent placement.Vital signs are stable,but I am worried about her stress level.She said she just moved here due to a job transfer and her husband stayed behind to sell the house.She told me they have a high insurance deductible and she is worried about the hospital bill." Which factor has the most significant influence on the client's health?

A)Coping skills
B)Existing conditions
C)Individual vulnerability
D)Perceived threat

Question 7

A nurse is assessing a client's response to stress.The nurse concludes that the client is performing a secondary appraisal of a stressful event when the client determines:

A)The event is benign.
B)The event is irrelevant.
C)Resources are available.
D)The event is pleasurable.

Question 8

A client tells the nurse,"I experience stress on a regular basis.Why do I feel this way?" Which is the nurse's most appropriate response?

A)"Genetics has nothing to do with your temperament or feelings."
B)"Your reactions to past experiences influence your current feelings."
C)"Your stress level is lower when you are in good physical health."
D)"You'll experience less stress if you use appropriate coping skills."

Question 9

Which client statement alerts the nurse that the client may be responding maladaptively to stress?

A)"Avoiding contact with others helps me cope."
B)"I really enjoy journaling;it's my private time."
C)"I signed up for a yoga class this week."
D)"I made an appointment to meet with a therapist."

Question 10

The emergency department nurse is providing discharge instructions to a 23-year-old man who was injured in a motor vehicle crash.The client stated,"My heart was racing when I saw the car coming through the red light was going to hit me.I didn't know my heart could go that fast!" Which is the nurse's best response?

A)"Don't worry,your heart is strong because you are young and in good health."
B)"Everyone gets scared when they realize another car is going to hit them."
C)"You had a panic attack when you saw the car that hit you was not going to stop."
D)"Your body responded to the stress of knowing the car was going to hit you."

Question 11

When an individual's stress response is sustained over a long period,the nurse anticipates which physiological effect?

A)Decreased resistance to disease
B)Increased libido
C)Decreased blood pressure
D)Increased inflammatory response

Question 12

Miller and Rahe (1997)identified a correlation between the effects of life change and illness.This research led to the development of the Recent Life Changes Questionnaire (RLCQ).Which principle most limits the effectiveness of this tool?

A)Specific physical and psychological illnesses are not identified.
B)Numerical values associated with specific life events are randomly assigned.
C)Stress is viewed as a solely physiological response.
D)An individual's personal perception of the event is excluded.

Question 13

A school nurse is assessing a female high-school student who is overly concerned about her appearance.The client's mother states,"That's not something to be stressed about!" Which response by the nurse is best?

A)"Teenagers! They don't know a thing about real stress."
B)"Psychological or physical stress occur only when there is a loss."
C)"Poor physical condition can interfere with psychological well-being."
D)"A threat to self-esteem can result in psychological stress."

Question 14

A client has experienced the death of a close family member and at the same time becomes unemployed.The client's 6-month score on the Recent Life Changes Questionnaire is 110.The nurse:

A)Understands the client is at risk for significant stress-related illness.
B)Determines the client is not at risk for significant stress-related illness.
C)Needs further assessment of the client's coping skills to determine susceptibility to stress-related illness.
D)Recognizes the client may view the losses as challenges and perceive them as opportunities.

Question 15

A nursing instructor asks students when diseases of adaptation are likely to occur.Which student response indicates that teaching is effective?

A)"When an individual has limited experience dealing with stress."
B)"When an individual inherits maladaptive genes."
C)"When an individual experiences existing conditions that exacerbate stress."
D)"When an individual's physiological and psychological resources are depleted."

Question 16

A first-time mother is crying and asks the nurse,"How can I go to work if I can't afford child care?" Which is the nurse's initial action to assist the client with problem-solving?

A)Determine the risks and benefits for each alternative
B)Formulate goals for resolution of the problem
C)Evaluate the outcome of the implemented alternative
D)Assess the facts of the situation

Question 17

A student confides in the school nurse that he is "stressed out" about deciding whether to go to college or work to provide income the family needs.Which coping strategy is the nurse's best recommendation?

A)Meditation
B)Problem-solving training
C)Relaxation
D)Journaling

Question 18

A 32-year-old woman is speaking to the office nurse at an initial visit.The nurse asked,"What brings you in today?" The woman replied,"I have been having headaches three to four times a week for the past month or so.I'm not sleeping well and feel tired most of the time.I work 60 hours per week and am going through a divorce." The nurse determines the client's symptoms represent which of the following?

A)Adaptive coping
B)Maladaptive coping
C)Problem-solving
D)Self-awareness

Question 19

An unemployed college graduate confides in the clinic nurse that she is experiencing severe anxiety over not finding a teaching position and that she is having difficulty with independent problem-solving.Which nursing intervention is best?

A)Encourage her to use other coping mechanisms.
B)Complete the problem-solving process for her.
C)Assist her with the problem-solving process.
D)Encourage her to keep a daily journal of feelings.

Question 20

A nursing student comes down with a sinus infection toward the end of every semester.Which stage of stress is the student most likely experiencing when this occurs?

A)Alarm reaction
B)Resistance
C)Exhaustion
D)Fight or flight

Question 21

Which concepts are included in Hobfoll's Conservation of Resources theory? Select all that apply.

A)Availability of resources
B)Disequilibrium
C)Genetics
D)Past experiences
E)Resilience

Question 22

A nurse is working with a client who has recently been under a great deal of stress.Which nursing recommendations would be most helpful to assist the client to cope with stress? Select all that apply.

A)"Enjoy a pet."
B)"Spend time with a loved one."
C)"Listen to music."
D)"Focus on the stressors."
E)"Journal your feelings."

Question 23

A nurse is interviewing a distressed client who reports being fired after 15 years of loyal employment.Which of the following questions best assists the nurse to determine the client's appraisal of the situation? Select all that apply.

A)"What resources have you used previously in stressful situations?"
B)"Have you ever experienced a similar stressful situation?"
C)"Who do you think is to blame for this situation?"
D)"Why do you think you were fired from your job?"
E)"What skills do you possess that might lead to gainful employment?"

Question 24

A patient presents in the emergency department immediately following a shooting incident in a school where she has been teaching.There is no evidence of physical injury,but she appears very hyperactive and talkative.Which are common initial biological responses to stress? Select all that apply.

A)Constricted pupils
B)Watery eyes
C)Unusual food cravings
D)Increased heart rate
E)Increased respirations