Deck 4: Stress and Adaptation

Question 1

Which statement by a patient indicates to the nurse that more teaching about the effects of stress is needed?

A) "Stress is a psychological and physiological response."
B) "Stress can lead to poor health."
C) "Coping strategies help a person adapt to stress."
D) "Smoking is a useful coping strategy."

Answer 1

"Smoking is a useful coping strategy."

Question 2

When planning care for a trauma patient, which statement does the nurse understand best describes the body's response to stress?

A) The stress response is the result of stimulation of the sympathetic nervous system.
B) The stress response boosts the adaptive immune response.
C) The stress response suppresses the hypothalamic-pituitary-adrenal axis.
D) The stress response has a negative effect on the endogenous opioid pathway.

Answer 2

The stress response is the result of stimulation of the sympathetic nervous system.

Question 3

Which manifestations is the nurse likely to assess in a patient with stimulating effects of acute stress?

A) Dry skin, reduced respiratory rate
B) Increased blood glucose levels, pupil dilation
C) Hypotension, reduced visual perception
D) Decreased urine production, hypoglycemia

Answer 3

Increased blood glucose levels, pupil dilation

Question 4

The patient with chronic stress is likely to exhibit which immune response?

A) Increased leukocyte mobilization to the skin
B) Suppressed delayed-type hypersensitivity responses
C) Enhanced production of chemokines
D) Enhanced production of cytokines

Question 5

When describing the state of homeostasis to nursing students, the nurse explains that:

A) it is a state of internal stability.
B) it is a state of positive feedback.
C) it is a state of flux and change.
D) it is a state the drives the body away from its resting or set point.

Question 6

The nurse is assessing a patient who was recently divorced and is now living in a temporary shelter after losing her home in a hurricane. Which finding indicates that the patient is experiencing allostatic load?

A) The patient is in a state of exhaustion.
B) The patient is using available resources to respond to stress.
C) The patient is making healthy lifestyle choices.
D) The patient is in an internal state of balance.

Question 7

The nurse in the student health center is counseling a college student who reports high levels of stress before each exam, causing his heart to race and affecting his ability to concentrate. The nurse assesses that this student is in which stage of the general adaptation syndrome during an exam?

A) Stage of alarm
B) Stage of resistance
C) Stage of exhaustion
D) Stage of resolution

Question 8

Using a transactional approach to stress, the nurse recognizes that a person's response to stress depends on:

A) the nature of the environmental threat that requires a response.
B) a physiological response to stress
C) the person's perceived meaning of the stressful event.
D) the fight-or-flight response.

Question 9

Which of the following concepts should guide a nurse's plan of care for a pregnant woman who has just lost her home due to a forest fire?

A) The symptoms of acute stress disorder (ASD) develop more than one month after the traumatic event
B) Pathologic stress responses can affect the encoding and retrieval of memories
C) The release of dopamine in the medulla oblongata contributes to the development of posttraumatic stress disorder (PTSD)
D) Elevated stress levels during pregnancy are not associated with adverse fetal outcomes.

Question 10

While teaching a prenatal class, a participant asks about the effects of stress on the fetus. Which response should the nurse make?

A) "The placenta protects the baby from maternal stress."
B) "High levels of stress can lead to preterm birth."
C) "Heightened stress can lead to a higher fetal birth weight."
D) "The baby is not affected by maternal stress."

Question 11

The nurse should expect to observe which behavior in a patient with posttraumatic stress disorder?

A) Normal memory recall
B) Hyporeflexia
C) Euphoria
D) Hypervigilance

Question 12

Which response by a patient indicates an understanding of the effects of stress on her asthma?

A) "Stress decreases my rate of breathing and makes my breathing easier."
B) "Stress decreases the amount of oxygen I need and helps my breathing."
C) "Stress dilates my airways, allowing me to get more oxygen."
D) "Stress causes inflammation of the airways which can trigger asthma attacks."

Question 13

When reviewing the medical history of a patient with multiple sclerosis (MS), the nurse is most likely to observe which of the following?

A) Elevated IL-12
B) Decreased interferon gamma
C) Elevated IL-10
D) Decreased tumor necrosis factor alpha

Question 14

Which concept of stress should the nurse apply when planning care for the patient with inflammatory bowel disease?

A) Stress may cause increased gastric emptying time.
B) Stress may increase catecholamine production.
C) Stress may reduce sympathetic responsiveness.
D) Stress exacerbates the hypothalamic-pituitary-adrenal (HPA) response.

Question 15

A 38-year-old woman, with no history of diabetes, has an elevated blood glucose level on the first postoperative day following an elective hysterectomy. Which response should the nurse give the patient?

A) "This means that you are at risk for developing diabetes."
B) "You probably have diabetes but did not know it."
C) "This is a normal stress response following surgery."
D) "Do you have a family history of diabetes?"

Question 16

Which laboratory value would the nurse expect in a patient with chronic stress and a reduced cell-mediated immune response to viral infection?

A) Increased natural killer cell activity
B) Reduced CD8+ activity
C) Increased cytotoxic T lymphocyte activity
D) Increased B lymphocyte (CD19+) activity

Question 17

Which information should the nurse include in a teaching plan about cortisol for a patient who is HIV-positive?

A) Chronically high levels of cortisol accelerate immune decline.
B) Cortisol levels that are lowest in the morning boost the immune response.
C) A flattened cortisol circadian pattern indicates a healthy immune system.
D) Low cortisol levels are associated with the development of AIDS.

Question 18

The nurse recommends the influenza vaccination to a 72-year-old woman who is the primary caregiver of her elderly mother who has Alzheimer's disease. Which instruction should the nurse include in the teaching plan for this vaccine?

A) The vaccine is not needed because chronic stress boosts the immune response.
B) Older adult caregivers have an accentuated immune response to influenza vaccine.
C) Chronic stress may blunt the efficacy of the influenza vaccine in older adults.
D) The effects of chronic stress on the immune system improve immediately when the stress is removed.

Question 19

The nurse is teaching a community class on risk factors for heart disease. Which fact should be included about the effects of stress on the heart?

A) Hostility and anxiety are risk factors for heart disease.
B) Psychosocial stress has a protective effect on the heart.
C) A positive emotional state is a risk factor for heart disease.
D) Psychosocial stress is not a risk factor for acute myocardial infarction.

Question 20

Which statement by a patient would the nurse not expect to find with a diagnosis of posttraumatic stress disorder (PTSD) as a result of a motor vehicle accident?

A) "I keep seeing the accident in my dreams."
B) "I find that I am avoiding riding in cars."
C) "I startle easily with loud noises."
D) "I find myself emotionally expressive."