Deck 43: Stress and Coping

Question 1

A nurse is providing education to the local community group about how to recognise the negative effects of stress. An example of these effects on a person's self-esteem would be:

A) becoming overly dependent on others.
B) an inability to accept reality.
C) becoming a workaholic.
D) having trouble sleeping.

Answer 1

becoming a workaholic.

Question 2

The nurse identifies that a client has not met the expected outcome established for the nursing diagnosis Ineffective Individual Coping. What nursing action is priority?

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

Answer 2

Explore reasons why the outcome was not achieved.

Question 3

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

A) "You should try to remember any stressful event that has occurred to you in the last 10 years to include in the scale."
B) "This scale will give us a definite stress level number that can be used to compare your stress to others your age."
C) "This scale will give us some idea about your stress related to both positive and negative recent events in your life."
D) "We will consider only the negative life events that have happened to you recently."

Answer 3

"This scale will give us some idea about your stress related to both positive and negative recent events in your life."

Question 4

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

Question 5

During a primary health care centre assessment, the client describes his life as, "in crisis". He reports that he has just been made redundant from his job, his wife has told him she wants a divorce, and he has been sick with a respiratory illness for one month. What statement, made by the nurse, reveals understanding of the care of a client in crisis?

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

Question 6

The nurse is caring for a 9-year-old client who was sexually abused by a minister. The child's parents are angry and confused as to why someone who was sexually attracted to children would choose to go into the ministry. The nurse explains that displacement of sexual drives into socially acceptable activities is a defence mechanism known as which of the following?

A) Sublimation.
B) Repression.
C) Undoing.
D) Substitution.

Question 7

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 recognises that the client is exhibiting which of the following?

A) Projection.
B) Intellectualisation.
C) Minimisation.
D) Introjection.

Question 8

The client has just received news of the death of a relative. Over the next few hours, what physiological response would the nurse attribute to the shock phase of the alarm reaction caused by the stress of this event?

A) A more bounding pulse.
B) Slight increase in urine output.
C) Some decrease in oxygen saturation.
D) Drop in blood pressure from 130/80 to 120/75.

Question 9

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

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

Question 10

The nurse has been working with the family of a client with cystic fibrosis since the child's diagnosis six years ago. Over this time, the client's mother has gained 23 kilograms and has recently started taking prescription antidepressants. On the last visit, the mother said, "I just don't know how much longer we can go on". What nursing diagnosis should the nurse consider as an addition to the family's care plan?

Question 11

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 medical practitioner, the nurse indicates the opinion that the client has progressed to which level of anxiety?

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

Question 12

What nursing intervention should be planned to minimise the stress and anxiety of hospitalisation?

A) Explain all procedures in detail before performing them.
B) Control the environment of healing.
C) Demonstrate staff competence by using multiple nurses for care.
D) Let the client make the majority of decisions about the plan of care.

Question 13

Match the human needs to the negative effect of stress.
1. Safety
2. Physiological
3. Self-esteem
4. Belonging
5. Self-actualisation
A. Blames others for own problems
B. Shows lack of control
C. Change in appetite or sleep
D. Draws attention to self
E. Focus is only on the stressor

Question 14

A client has been admitted to the hospital with severe chest pain and has been medically diagnosed with myocardial infarction. The client 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 defence mechanism is this client exhibiting?

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

Question 15

The parents of a 16-year-old who has a history of depression are concerned because the physician has prescribed an SSRI antidepressant for their child. What information should the nurse use to formulate a response to these parents' concerns?

A) The management of any SSRI use with young people should include careful monitoring for the emergence of suicidal ideation and behaviour.
B) These medications are addictive and difficult to discontinue when the depressive incident is past.
C) It is difficult for teenagers to manage the dosage regimen for many of these drugs because they must be taken with a full meal.
D) Most of the SSRI antidepressant medications will deliver a marked improvement in depression within three to four days of the first dose.

Question 16

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

A) Differentiate between "have to do" and "nice to do" at work.
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) Spend the lunch hour completing documentation while eating a sandwich.

Question 17

Short-term strategies to reduce stress to a tolerable level temporarily, but may be harmful, include:

A) change in lifestyle patterns to promote balance in work and leisure.
B) learning problem-solving techniques in decision making.
C) daydreaming and fantasising that everything will be all right.
D) using exercise routines to work the energy out of anger.

Question 18

If a stressor is prolonged and continual, the body will reach the:

A) alarm stage.
B) shock stage.
C) resistance stage.
D) exhaustion stage.

Question 19

The clinical nurse consultant (CNC) who is the unit manager of a busy emergency department is concerned about burnout in the nursing staff. The CNC has overheard nurses complaining about their job, absenteeism has increased, and the nurses look tired and anxious. What action, planned by the CNC, would best serve to alleviate this burnout?

A) Ask administration to require 30 minutes of exercise at the end of each shift.
B) Ask the medical staff to take over some of the nursing roles as part of inter-professional practice.
C) Assign each nurse to spend 30 minutes with the hospital clinical psychologist daily.
D) Encourage the nurses to debrief and try not to be all things to all people.

Question 20

The client tells the nurse that she does not wish to see her mother-in-law during this hospitalisation because she does not like her. When the client's husband and her mother-in-law visit, the client is very cordial and acts happy to see both visitors. The nurse recognises that this client may be using which defence mechanism?

A) Reparation.
B) Rationalisation.
C) Reaction formation.
D) Regression.