Deck 47: Stress and Coping

Question 1

Mrs.Barton,72 years old,is seen in her physician's office 1 year after the death of her husband.Since his death she has been ill with shingles,and has just been released from the hospital after recovering from pneumonia.She says to the nurse,"I don't know why I have been so sick lately; I have looked after myself and have enjoyed good health all my life." What does research indicate may be a reason for Mrs.Barton's recent illness?

A)Reduced T cell function will render some clients susceptible to illness.
B)There is no correlation between the recent loss and client illness.
C)Psychosocial stress does not impact physical health.
D)Adaptation resources in the elderly are not adequate to fight illness.

Answer 1

Reduced T cell function will render some clients susceptible to illness.

Question 2

Brett is a 6-year-old child who is critically ill.While the nurse is preparing to administer a treatment to him,his mother becomes distraught and begins to cry loudly while stroking his face.What is the nurse's best response to this occurrence?

A)Tell the mother that she needs to control herself for the benefit of her child
B)Distract the mother by having her straighten the linens on the bed
C)Explain the procedure to the mother
D)Take the mother out of the room and comfort her

Answer 2

Take the mother out of the room and comfort her

Question 3

During a health clinic assessment,Mr.Banka describes his life as "in crisis." He reports that he has just lost his job,his wife is seeking a divorce,and he has been sick with a respiratory illness for 1 month.What statement,made by the nurse,reveals understanding of the care of a client in crisis?

A)"Once you reach the crisis state,you may remain there for several months until you recover."
B)"People generally find it easier to work through a crisis if someone is working with them."
C)"Men often handle crisis better individually,while women do better with a counsellor."
D)"Experiencing a crisis is never positive,so we must work to relieve your anxiety as soon as possible."

Answer 3

"People generally find it easier to work through a crisis if someone is working with them."

Question 4

Jackson,18 years old,was driving a car that has just skidded out of control and hit a tree.He was wearing a seatbelt,and the airbags in the car deployed enabling him to escape without physical injury.As he exits the car,his hypothalamus is triggered by the stress.Which of the following defines the stage of stress reaction he is experiencing?

A)Alarm reaction
B)Stage of resistance
C)Stage of exhaustion
D)Countershock phase

Question 5

Mr.Castillo has been admitted to the hospital with severe chest pain and has been diagnosed with myocardial infarction.The patient tells the nurse,"I don't think this is my heart.That spaghetti I ate for lunch tasted a little strange.I think I have food poisoning." What defense mechanism is this patient exhibiting?

A)Compensation
B)Denial
C)Displacement
D)Identification

Question 6

The victim of domestic abuse tells the nurse,"I know my spouse didn't mean to hurt me.The situation just got out of hand." The nurse recognizes that the client is exhibiting which of the following?

A)Intellectualization
B)Introjection
C)Projection
D)Minimization

Question 7

Mrs.Parker was released from the hospital after a myocardial infarction.She is seeing a nutritionist to help plan a healthier diet and has also begun an exercise program to help lose weight.Which of the following describes her coping strategies?

A)Problem focused
B)Emotion focused
C)Maladaptive
D)Short-term coping

Question 8

Mrs.Allimour has just received the news from her physician that her breast biopsy was negative.During discharge teaching the nurse finds the client to be easily distractible and unable to focus.What is the nurse's best interpretation of this situation?

A)The client did not understand that there is no malignancy.
B)Anxiety can result from both positive and negative stimuli.
C)The client feels there is no need for teaching.
D)Mrs.Allimour is mildly anxious,but should retain information taught.

Question 9

Which of the following are considered essential to problem solving as it relates to stress?

A)Willfully putting a thought or feeling out of mind
B)Analyzing or defining the problem
C)Conveying a sense of being in control
D)Reworking or replaying the situation

Question 10

Mrs.Cossella has just received news of the death of her sister.Over the next few hours,what physiologic response would the nurse attribute to the shock phase of the alarm reaction caused by the stress of this event?

A)Blood pressure drop from 130/80 to 120/75
B)Bounding pulse
C)Increase in urine output
D)Decrease in oxygen saturation

Question 11

The nursing student admits to being mildly anxious about an upcoming examination.What is the likely result of this level of anxiety?

A)The student's perception and learning is enhanced.
B)The student's attention is focused solely on studying for the examination.
C)The student's only topic of conversation is the examination.
D)The student cannot talk about the examination without crying.

Question 12

Jackson,18 years old,was driving a car that has just skidded out of control and hit a tree.He was wearing a seatbelt,and the airbags in the car deployed enabling him to escape without physical injury.As he exits the car,his hypothalamus is triggered by the stress.Which of the following physiological responses would the nurse expect to see in an individual related to changes in levels of epinephrine?

A)Flushed skin
B)Increased blood pressure
C)Pupils constrict
D)Increased urine output

Question 13

The nurse's previous interaction was ineffective at calming Mr.Moore,who remains angry at not being able to go out of the intensive care unit for a cigarette.He picks up his radio from his bedside and appears to intend to throw it at the nurse.What should the nurse do?

A)Leave the room
B)Tell Mr.Moore you are calling security
C)Ask Mr.Moore to put the radio down
D)Ask Mr.Moore if this has always been his reaction to stress

Question 14

The client who has been experiencing slight anxiety is now communicating in a manner that makes it difficult for the nurse to understand the client's needs.When discussing this client with the physician,the nurse indicates the opinion that the client has progressed to which level of anxiety?

A)Mild
B)Moderate
C)Severe
D)Panic

Question 15

Jackson,18 years old,was driving a car that has just skidded out of control and hit a tree.He was wearing a seatbelt,and the airbags in the car deployed,enabling him to escape without physical injury.As he exits the car,his hypothalamus is triggered by the stress.Which of the following endocrine responses happens first?

A)Release of antidiuretic hormone
B)Secretion of adrenocorticotropin
C)Increase in corticotropin releasing hormone
D)Release of norepinephrine

Question 16

The nurse elects to use a scale of stressful life events to assess the level of a newly admitted client's stress.What information should the nurse provide to the client about this scale?

A)"You will need to recall negative life events that have happened to you recently."
B)"You will need to recall stressful events that have occurred to you in the last 10 years."
C)"It gives us a stress level number that is used to compare your stress to others your age."
D)"It gives some idea about your stress related to both positive and negative recent events in your life."

Question 17

Mr.Moore was admitted to the intensive care unit to rule out myocardial infarction.The patient is upset because he is restricted to the unit and is not allowed to smoke cigarettes.This morning the patient became so angry that he threw his breakfast tray at the nurse.How should the nurse respond to this outburst?

A)Refuse to take care of this patient until he is under control
B)Apologize to the patient for the unit rules,but tell him the rules must be followed
C)Tell the patient that it is understandable that he is upset,but the no smoking rule is not negotiable
D)Tell the patient that he is acting like a child and that such behaviour will not be tolerated

Question 18

A nurse is developing a care plan where she needs to determine whether a client is experiencing anxiety or fear.What key point would help the nurse make this decision?

A)Anxiety is a milder form of fear.
B)Fear results in only a physiologic response.
C)The source of fear is identifiable.
D)Anxiety is generally based in reality,fear is not.

Question 19

The nurse identifies that a client has not met the expected outcome established for the nursing diagnosis of ineffective individual coping.What nursing action is priority?

A)Revise the nursing diagnosis
B)Reassess the patient,looking for previously unknown stressors
C)Rewrite the interventions used to address the problem
D)Explore reasons why the outcome was not achieved

Question 20

The newly licensed nurse feels overwhelmed by the demands of working on a busy acute care unit and caring for her growing family.What strategy should this nurse employ to lessen her stress?

A)Spend the lunch hour completing documentation while eating a sandwich
B)Set the alarm earlier in order to get to work early
C)Focus on work instead of on family until more familiar with the environment
D)Differentiate between "have to do" and "nice to do" at work

Question 21

Which of the following models of stress uses scales to assess and document a person's stressful life events?

A)Stimulus
B)Response
C)Transaction
D)Syndrome

Question 22

Ms.Petri is a student nurse presenting to her class on anxiety.Which of the following normal physiological responses to anxiety that she has included in her presentation indicates the need for further research on her part?

A)Increased heart rate
B)Increased respiratory rate
C)Low hematocrit
D)Low blood sugar

Question 23

Mr.Batra is a new immigrant experiencing much stress since hospitalization.He has no family support.What would be the best nursing intervention to help him cope with stress?

A)Keep patient busy so time goes by quickly
B)Provide as much privacy as possible
C)Provide for adequate rest and relaxation
D)Ask questions until patient expresses feelings

Question 24

Carter is a 2-year-old child who has experienced multiple hospital admissions to treat a congenital heart disorder.Upon today's admission,the nurse notices that the child is lying curled in the bed holding a stuffed animal and will not interact with his parents.How should the nurse interpret this behaviour?

A)The parents may have been abusing this child.
B)The child is probably developmentally delayed secondary to multiple hospitalizations.
C)The child is reacting as a normal 2-year-old.
D)The child could be suffering from a clinical depression.

Question 25

Mr.Walsh cut his leg open severely in an accident with a chain saw.It bled profusely until he applied a pressure dressing with his shirt.After a short period of time,a clot formed and the wound stopped bleeding.According to Selye,what is this response called?

A)Alarm reaction stage
B)Stage of resistance
C)Stage of exhaustion
D)Local adaptation syndrome

Question 26

Which nursing diagnosis is defined as "the state in which the individual experiences feelings of uneasiness and activation of the autonomic nervous system in response to a vague,nonspecific threat"?

A)Fear
B)Anxiety
C)Ineffective individual coping
D)Decisional conflict

Question 27

How does Selye's general and local adaptation syndromes conceptualize stress?

A)As a stimulus
B)As a response
C)As a transaction
D)As an interaction

Question 28

A student is preparing to take the final examination in Nursing 101.Which of the following findings would support that the student is experiencing a moderate level of anxiety?

A)Increased questioning
B)Slightly increased respiratory and heart rates
C)Palpitations
D)Inability to relax