Deck 12: Stress Adaptation
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Deck 12: Stress Adaptation
1
A client demonstrates a cognitive response to stress.What observation caused the nurse to make this clinical decision?
A) Skipping meals
B) Avoiding talking with others
C) Sleeping late into the morning
D) Forgetting where medications are stored
A) Skipping meals
B) Avoiding talking with others
C) Sleeping late into the morning
D) Forgetting where medications are stored
Forgetting where medications are stored
2
The nurse suspects that a client is overusing a defense mechanism.What behavior did the client demonstrate to the nurse?
A) Criticized spouse for health problems
B) Requested strategies to prevent overeating
C) Asked for information about a prescribed medication
D) Discussed ways to react when an adolescent daughter acts out
A) Criticized spouse for health problems
B) Requested strategies to prevent overeating
C) Asked for information about a prescribed medication
D) Discussed ways to react when an adolescent daughter acts out
Criticized spouse for health problems
3
The nurse is caring for a patient with unresolved anger.For which associated complication should the nurse assess?
A) Depression
B) Hypochondriasis
C) Somatization
D) Malingering
A) Depression
B) Hypochondriasis
C) Somatization
D) Malingering
Depression
4
A patient is in crisis.After assessing the situation,what should the nurse do first?
A) Determine the imminent cause of the crisis.
B) Intervene to relieve the patient's anxiety.
C) Decide on the type of help the patient needs.
D) Ensure the safety of both the nurse and patient.
A) Determine the imminent cause of the crisis.
B) Intervene to relieve the patient's anxiety.
C) Decide on the type of help the patient needs.
D) Ensure the safety of both the nurse and patient.
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5
Before entering the room of a patient who is angry and yelling,the nurse removes her stethoscope from around her neck.Why did the nurse perform this action?
A) Could be used by the patient to hurt her
B) Might cause the patient not to trust her
C) Would distract her from focusing on the patient
D) Will function as another stressor for the patient
A) Could be used by the patient to hurt her
B) Might cause the patient not to trust her
C) Would distract her from focusing on the patient
D) Will function as another stressor for the patient
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6
A client becomes verbally abusive to the nurse after having an argument with the spouse.Which coping mechanism is this client exhibiting?
A) Reaction formation
B) Displacement
C) Denial
D) Conversion
A) Reaction formation
B) Displacement
C) Denial
D) Conversion
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7
A patient who has been diagnosed with breast cancer decides on a treatment plan and feels positive about her prognosis.Assuming the cancer diagnosis represents a crisis,this patient is most likely experiencing which phase of crisis?
A) Precrisis
B) Impact
C) Crisis
D) Adaptive
A) Precrisis
B) Impact
C) Crisis
D) Adaptive
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8
After sustaining injuries in a motor vehicle accident,a patient experiences a decrease in blood pressure and an increase in heart rate and respiratory rate despite surgical intervention and fluid resuscitation.Which stage of the general adaptation syndrome is the patient most likely experiencing?
A) Alarm
B) Resistance
C) Exhaustion
D) Recovery
A) Alarm
B) Resistance
C) Exhaustion
D) Recovery
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9
The nurse cares for a patient who suddenly experiences a cardiac arrest.As the nurse responds to the emergency,which substance in the nurse's body will be secreted in large amounts to help the nurse react in this situation?
A) Epinephrine
B) Corticotrophin-releasing hormone
C) Aldosterone
D) Antidiuretic hormone
A) Epinephrine
B) Corticotrophin-releasing hormone
C) Aldosterone
D) Antidiuretic hormone
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10
At the end of an imagery session,which physical assessment finding suggests that the relaxation technique was successful?
A) Decreased blood pressure
B) Decreased peripheral skin temperature
C) Increased heart rate
D) Increased respiratory rate
A) Decreased blood pressure
B) Decreased peripheral skin temperature
C) Increased heart rate
D) Increased respiratory rate
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11
A patient who has been hospitalized for weeks becomes angry and says,"I hate this place; nobody knows how to take care of me or I'd be home by now." Which response by the nurse is best in this situation?
A) "You seem angry; what's going on that makes you hate this place?"
B) "I'm sorry that we aren't caring for you according to your expectations."
C) "You were very sick; don't be angry; you're lucky to be alive."
D) "You shouldn't be angry with us; we're trying to help you."
A) "You seem angry; what's going on that makes you hate this place?"
B) "I'm sorry that we aren't caring for you according to your expectations."
C) "You were very sick; don't be angry; you're lucky to be alive."
D) "You shouldn't be angry with us; we're trying to help you."
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12
A patient complains of a vague,uneasy feeling of dread,and has an elevated heart rate.Which nursing diagnosis is most appropriate for this patient?
A) Anger
B) Fear
C) Anxiety
D) Hopelessness
A) Anger
B) Fear
C) Anxiety
D) Hopelessness
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13
When released in response to alarm,which substance promotes a sense of well-being?
A) Aldosterone
B) Thyroid-stimulating hormone
C) Endorphins
D) Adrenocorticotropic hormone
A) Aldosterone
B) Thyroid-stimulating hormone
C) Endorphins
D) Adrenocorticotropic hormone
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14
During an assessment,the nurse suspects that a client utilizes maladaptive coping methods to handle stress.What did the nurse assess in this client?
A) Drinks with friends after work
B) Attends a poetry class at the library
C) Runs in the park several times a week
D) Tends a vegetable garden in the summer
A) Drinks with friends after work
B) Attends a poetry class at the library
C) Runs in the park several times a week
D) Tends a vegetable garden in the summer
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15
A patient sustains a laceration of the thigh in an industrial accident.Which step in the inflammatory process will the patient experience first?
A) Cellular inflammation
B) Exudate formation
C) Tissue regeneration
D) Vascular response
A) Cellular inflammation
B) Exudate formation
C) Tissue regeneration
D) Vascular response
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16
What is the function of antidiuretic hormone when released in the alarm stage of the general adaptation syndrome?
A) Promotes fluid retention by increasing the reabsorption of water by kidney tubules
B) Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle
C) Increases the use of fats and proteins for energy and conserves glucose for use by the brain
D) Promotes fluid retention by causing the kidneys to reabsorb more sodium
A) Promotes fluid retention by increasing the reabsorption of water by kidney tubules
B) Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle
C) Increases the use of fats and proteins for energy and conserves glucose for use by the brain
D) Promotes fluid retention by causing the kidneys to reabsorb more sodium
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17
The nurse suspects that a client is experiencing stress.What finding did the nurse use to make this clinical determination?
A) Works a full-time job
B) Goes to the gym three times a week to work out
C) Spouse takes care of the children when grocery shopping
D) Expresses a lack of time to waste at a healthcare appointment
A) Works a full-time job
B) Goes to the gym three times a week to work out
C) Spouse takes care of the children when grocery shopping
D) Expresses a lack of time to waste at a healthcare appointment
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18
When counseling a patient about behaviors to reduce stress,which goal should the nurse put on the care plan?
A) "The patient will limit his intake of fat to no more than 15% of the daily calories consumed."
B) "The patient will eat three meals per day at approximately the same time each day."
C) "The patient will limit his intake of sugar and salt,as well as sweet and salty foods."
D) "The patient will consume no more than three alcoholic beverages a day."
A) "The patient will limit his intake of fat to no more than 15% of the daily calories consumed."
B) "The patient will eat three meals per day at approximately the same time each day."
C) "The patient will limit his intake of sugar and salt,as well as sweet and salty foods."
D) "The patient will consume no more than three alcoholic beverages a day."
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19
The nurse identifies the nursing diagnosis Diarrhea related to stress for a patient.Which nursing intervention should be included in the nursing care plan to help the patient relieve the cause of the diarrhea?
A) Monitor and record the frequency of stools on the graphic record.
B) Administer prescribed antidiarrheal medications as needed.
C) Encourage the patient to verbalize about stressors and anxiety.
D) Provide oral fluids on a regular schedule.
A) Monitor and record the frequency of stools on the graphic record.
B) Administer prescribed antidiarrheal medications as needed.
C) Encourage the patient to verbalize about stressors and anxiety.
D) Provide oral fluids on a regular schedule.
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20
The family member of a client with numerous physiological complaints tells the nurse that the client is pretending to be sick to avoid going to work.Which somatoform disorder is this patient most likely experiencing?
A) Hypochondriasis
B) Somatization
C) Somatoform pain disorder
D) Malingering
A) Hypochondriasis
B) Somatization
C) Somatoform pain disorder
D) Malingering
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21
During the alarm stage of the general adaptation syndrome,which metabolic change occurs? Select all that apply.
A) Rate of metabolism decreases.
B) Liver converts more glycogen to glucose.
C) Use of amino acids decreases.
D) Amino acids and fats are more available for energy.
E) The brain uses more glucose for energy.
A) Rate of metabolism decreases.
B) Liver converts more glycogen to glucose.
C) Use of amino acids decreases.
D) Amino acids and fats are more available for energy.
E) The brain uses more glucose for energy.
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22
A client complains about not having enough time to complete work responsibilities and take care of family activities.What should the nurse suggest to this client? Select all that apply.
A) Set boundaries
B) Learn to say no
C) Make a to-do list
D) Delegate responsibilities
E) Schedule time for exercise
F) None of the above
A) Set boundaries
B) Learn to say no
C) Make a to-do list
D) Delegate responsibilities
E) Schedule time for exercise
F) None of the above
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23
Two days after a patient undergoes abdominal surgery,the surgical incision is red and slightly edematous; it is oozing a small amount of serosanguineous (pink-tinged serous)fluid.On the basis of these data,what can the nurse conclude? Select all that apply.
A) The wound is most likely infected.
B) This is a vascular response to inflammation.
C) Damaged cells are being regenerated.
D) Exudate formation is occurring.
E) The wound is beginning the repair process.
A) The wound is most likely infected.
B) This is a vascular response to inflammation.
C) Damaged cells are being regenerated.
D) Exudate formation is occurring.
E) The wound is beginning the repair process.
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24
After an assessment,the nurse realizes that a client demonstrates cognitive responses to stress.What behaviors did the client demonstrate for the nurse to make this clinical determination? Select all that apply.
A) Angry
B) Lethargic
C) Irritable
D) Preoccupied
E) Decreased attention to detail
A) Angry
B) Lethargic
C) Irritable
D) Preoccupied
E) Decreased attention to detail
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25
An older patient is tearful,shaky,and withdrawn and admits to worrying about losing her aging spouse.Why should the nurse recognize this patient's reaction as being Anxiety instead of Fear? Select all that apply.
A) It concerns future or anticipated events.
B) It concerns anticipation of danger rather than a present danger.
C) There is no shakiness or tearfulness present.
D) There is a psychological rather than a physical threat.
E) The source can be identified.
A) It concerns future or anticipated events.
B) It concerns anticipation of danger rather than a present danger.
C) There is no shakiness or tearfulness present.
D) There is a psychological rather than a physical threat.
E) The source can be identified.
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