Deck 4: Stress, Exercise, and Immobility

Question 1

A client who has been taking an antidepressant for 10 days reports continued depression and does not find the medication to be effective. Which response by the nurse is correct?
1)"I will increase the drug dosage after informing the physician."
2)"The medication will take at least 3 weeks to be effective."
3)"I will change the medication after informing the physician."
4)"Stop taking the medication if it is not effective for you."

Answer 1

2

Question 2

The nurse is interviewing an older adult client with +3 pitting edema in both ankles. The client reports a sedentary lifestyle since moving to an assisted-living facility. Which condition does the nurse recognize?
1)Symptoms of venous stasis
2)Presence of a pulmonary embolus
3)Effects related to hypertension
4)Age-related orthostatic hypotension

Answer 2

1

Question 3

In which stage of Hans Selye's general adaptation syndrome is the sympathetic nervous system (SNS) activated?
1)Alarm stage
2)Resistance stage
3)Exhaustion stage
4)Homeostasis

Answer 3

1

Question 4

Which physiological change occurs in stage 5 of the sleep cycle?
1)Heart rate decreases
2)Breathing becomes rapid
3)Breathing becomes regular
4)The brain produces delta waves

Question 5

The nurse is preparing a presentation for older adult clients regarding the effects of physical activity on the gastrointestinal system. Which physiological effect is most beneficial for this group of clients?
1)Decreases constipation
2)Improves peristaltic movement
3)Decreases the risk of diverticulosis
4)Lowers the risk of inflammatory bowel disease (IBD)

Question 6

A bedridden client has frequent gastrointestinal reflux. For which condition does the nurse assess?
1)Aspiration pneumonia
2)Peptic ulcer disease
3)Malabsorption
4)Constipation

Question 7

A client is scheduled for a heart valve replacement. Which strategic action of the primary health-care provider enhances the client's adaptive ability and coping mechanism to reduce stress?
1)Encouraging a family member to stay with the client in the preoperative setting
2)Permitting a family member to stay in the operating theater
3)Administering epinephrine to the client to reduce stress
4)Restricting the family members from talking to the client in the preoperative setting

Question 8

Which is the most commonly used over-the-counter sleep aid?
1)Diphenhydramine (Benadryl)
2)Phenylephrine (Neo-Synephrine)
3)Pseudoephedrine (Sudafed)
4)Acetylcholine (Miochol)

Question 9

The nurse is providing care for a client who is experiencing prolonged bed rest. Which change in cardiac function does the nurse anticipate?
1)Increase in stroke volume
2)Increase in heart rate
3)Increase in venous return
4)Increase in diastolic volume

Question 10

The nurse works in a community clinic and assists a variety of clients. According to McEwen's stress response theory, which client does the nurse identify as being at greatest risk for allostatic load?
1)An older adult client whose spouse has severe dementia and has been cared for in the home for several years. Recently the client has been diagnosed and treated for hypertension and cardiac rhythm disturbances.
2)A client who is a college student taking a full-time load of engineering classes. The client reports bouts of gastrointestinal (GI) upset prior to scheduled course examinations. The client also shares recently moving into a quieter dorm setting.
3)A young adult client who recently accepted a position with a new company. The client expresses concern about sleep disturbances. A new exercise regimen was started 2 weeks ago, but the client is seeking a short-term sleep aid.
4)An older female client who is recently widowed. The client shares a lack of energy and frequent periods of crying. She states, "I know that I will get over the grief with the passage of time. I remember feeling the same way when my parents died."

Question 11

The nurse is caring for multiple clients in an acute care setting during the night shift. The nurse is aware that which stage of sleep makes it difficult to wake someone?
1)Stage 1
2)Stage 2
3)Stage 3
4)Stage 5

Question 12

A client is on long-term bed rest. Which condition does the nurse recognize as a risk to the client due to immobility?
1)Orthostatic hypotension
2)Venous stasis
3)Hypertension
4)Dyspnea

Question 13

The nurse is providing care for a client who is experiencing chronic stress. Using Selye's stress response theory, which behavioral expectation does the nurse associate with this client?
1)A lack of negative manifestations indicates eustress
2)Physical health and mental well-being are negatively affected
3)Cortisol causes an increase in white blood cells (WBCs) and counteracts inflammation
4)Parasympathetic nervous system responses resume a state of relaxation

Question 14

A nurse is providing care for a client who is prescribed to be on strict bed rest. Which intervention is best for the nurse to utilize in order to recognize a complication of immobility?
1)Frequent assessment of the client's skin
2)Place the client in prone position
3)Place the client briefly in a chair
4)Reposition the client every 4 hours

Question 15

Which statement is correct regarding the effects of exercise?
1)Enlarges the muscle fibers
2)Decreases the rate of breathing
3)Increases the risk of colon cancer
4)Decreases the number of mitochondrial enzymes

Question 16

A client who is on prolonged bed rest develops kidney stones. Which factor does the nurse associate with the development of kidney stones?
1)Increase in blood glucose
2)Change in thyroid hormone
3)Fluctuation of growth hormone
4)Increase in parathyroid hormone

Question 17

A client is scheduled for a sleep study and asks about the reason for a polysomnography. Which is the best explanation for the nurse to provide?
1)It is a diagnostic test to examine sleep patterns
2)It is a diagnostic test to examine eye movement
3)It is a diagnostic test to examine respiratory functions
4)It is a diagnostic test to examine electrical activity of the brain

Question 18

Which nitric oxide-dependent vasodilation occurs in the coronary arteries with exercise?
1)Increase in platelet activation
2)Increase in thrombus formation
3)Increase in myocardial perfusion
4)Increase in endothelial inflammation

Question 19

A registered nurse (RN) is explaining the effects of exercise on the cardiovascular system to a newly hired nurse. Which statement by the newly hired nurse indicates effective teaching?
1)"Exercise prevents thrombus formation."
2)"Exercise increases fibrinogen levels."
3)"Exercise prevents angiogenesis."
4)"Exercise decreases the heart's mass."

Question 20

A client is hospitalized due to complications of immobility. The laboratory results indicate the client has developed septicemia. Which factor does the nurse recognize as causing septicemia?
1)Poor circulation
2)Open pressure injury
3)Lack of preventive care
4)Deficient dietary intake

Question 21

A 50-year-old male client is scheduled for a cardiac exercise stress test. The predicted maximal heart rate in beats/minute is __________.

Question 22

A nurse is assessing the sleep history of different clients for obstructive sleep apnea (OSA). Which client does the nurse recognize as exhibiting signs of OSA?
1)The client with excessive daytime sleepiness, snoring, and repetitive pauses in breathing during sleep
2)The client with drowsiness during the daytime, ability to sleep only 6 hours at night, snoring, and leg cramps at night
3)The client with difficulty getting back to sleep after waking during the night, hallucinations when awake and jerking of the legs during sleep
4)The client with sleepwalking, nightmares, and leg cramps at night

Question 23

Which gastrointestinal changes does the nurse expect in clients on bed rest? Select all that apply.
1)Slowed peristalsis
2)Diminished appetite
3)Increased diaphragm strength
4)Increased rate of intestinal absorption
5)Decreased abdominal and pelvic muscle strength

Question 24

A client is on prolonged bed rest. To which psychological changes will the client be susceptible? Select all that apply.
1)Increased anxiety
2)Increased mood swings
3)Altered tactile responses
4)Increased levels of concentration
5)Increased problem-solving ability

Question 25

Which nutritional advice given by a nurse to a client under stress is appropriate? Select all that apply.
1)"Eat a substantial snack before bedtime."
2)"Consume more products containing soy."
3)"Drink a glass of milk before going to bed."
4)"Add peanuts and brown rice to your diet."
5)"Add spinach and green vegetables to your diet."