Chapter 4: Stress Response

Cortisol, a hormone in the stress response, caused the elevation in glucose levels

A blood sample shows elevation of Jennifer's blood glucose. Which of the following most likely explains this elevation?

Hypothalamus - post pituitary - adrenal gland

A group of nursing students has created a flowchart to learn the hormones of the stress response. Which of the following show a mistake has been made on the flowchart?

- Increased blood pressure - Increased heart rate - Elevated white blood cells

A nurse has received a series of laboratory values and vital signs for a patient who recently experienced a traumatic accident. The laboratory values were taken when the patient was in the alarm stage of the stress response. Which of the following laboratory values and vital signs does the nurse expect to see? Select all that apply

- Nervous - Endocrine

A nurse is educating a patient about the stress response because the patient wants to know why the stress response is so strong. The nurse responds that several systems are the initial primary responders to stress. Which systems was the nurse speaking about? Select all that apply.

- Increased blood pressure - Pupil dilation - Cool, clammy extremities

A nurse rushes up to a trauma victim. Which of the following signs and symptoms is the nurse expecting to encounter? Select all that apply.

The adrenal cortex produces epinephrine and norepinephrine

A nursing educator overhears some students speaking about how amazing the adrenal glands are for the stress response. Which of the following comments indicate the students need help?

- Increased epinephrine - Increased cortisol release

A patient arrives at the emergency department having come from the scene of a motor vehicle accident. Initial blood laboratory values indicate elevated blood glucose levels. Which of the following are likely explanations? Select all that apply.

Reduced corticotropin releasing factor (CRF)

A patient has developed a tumor of the hypothalamus disrupting hypothalamic hormone production. As the nurse scans the laboratory report, which finding most directly supports this conclusion?

Eat a balanced, nutritious diet

A patient is speaking to a nurse about the patient's stressful life. Which of the following recommendations may the nurse make?

Exhaustion

A patient presents with the following characteristics: reduced white blood cell (WBC) levels, immunosuppression, a sense of being rundown and unable to cope, and suppressed hormone levels. Which stage of the stress response may the patient be experiencing?

Inform the patient of the different effects of cortisol on the immune system, whether the cortisol is present for a short duration or long term

A patient with rheumatoid arthritis, an autoimmune condition, is upset because she has been prescribed corticosteroids to suppress the immune system. The patient feels this is wrong, as she has learned that cortisol activates the immune response. Which of the following would be an appropriate response by the nurse?

Lower than expected cortisol levels

If Jennifer's adrenal cortex had been damaged by the accident, which hormonal response may appear on a blood laboratory sample?

Epinephrine

In addition to sympathetic nervous system activation, the adrenal glands also produce hormones to assist in the stress response. If a blood sample were taken from Jennifer, which of the following would indicate increased activity by the adrenal medulla in response to the car accident? Select all that apply.

- Epinephrine - Blood glucose - Acute immune response

In order to make studying easier, some nursing students have decided to group together items that increase during the stress response. Which of the following should be included on the students' list? Select all that apply.

Increased WBC response

In response to her accident, Jennifer's cortisol levels increased significantly. What effect will this initial increase in cortisol cause?

Increased heart rate

In response to the car accident, Jennifer's sympathetic nervous system was activated. Which of the following clinical signs may the clinician expect to observe in Jennifer based on activation of this system? Select all that apply.

Antidiuretic hormone

Jennifer has a catheter inserted. Urine output for Jennifer is significantly reduced. Which hormone works directly on the kidneys to reduce urine output during stress?

Jenifer's sympathetic nervous system has been activated, as indicated by the increased heart rate. However, blood pressure is still lower than normal due to possible internal bleeding.

Jennifer's vital signs include a heart rate of 130 bpm and a blood pressure of 96/58 mm Hg. Which of the following explains this response?

Allostatic load

While taking a patient's history, the nursing student learns that the patient has been under extreme stress at school and has suffered repeated infections of the common cold. The nursing student knows that prolonged stress may produce wear and tear on the body's systems. What term describes the nursing student's understanding?

Alarm

After a traumatic car accident, Jennifer, a 22-year-old college student, was rushed to the emergency department by ambulance transport. In addition to multiple shallow lacerations and broken bones, you are worried that Jennifer may be experiencing internal hemorrhaging and have her rushed into surgery. When the car accident initially occurred, which stage of the stress response did Jennifer experience?

- Poorer ability to adapt - Longer duration stress response

Some individuals appear to suffer from stress to a greater degree than others. Which of the following may account for a more pronounced stress response? Select all that apply.

Alarm, Resistance, Exhaustion

Which of the following choices shows the correct sequence for Hans Selye's stress response?

Adrenocorticotropic hormone

The response to a stressor such as Jennifer experienced involves a number of tissues. The elevation in cortisol that Jennifer likely experienced is the results of which signal from anterior pituitary?

- Migraines - Hypertension - Myocardial infarctions - Peptic ulcer disease

Which of the following are conditions associated with chronic stress? Select all that apply.