Stress and Adaptation Prep U

Which client statement, after a presentation about drug use, indicates to the nurse a correct understanding of the information presented?

"Mixing alcohol and tranquilizers may cause physical impairment and drug dependency."

Prior to the client's scheduled bone marrow biopsy, the nurse has devoted time to educating him about the rationale and the specific details of the procedure. The nurse's actions constitute what stress management technique?

Anticipatory guidance

A client asks about general adaptation syndrome (GAS). Which details provided by the nurse are correct? Select all that apply.

The alarm stage of GAS can last from minutes to hours. It can be a response to physiologic or psychological stress. There are three stages to GAS.

An adolescent describes a dysfunctional home life to the nurse and reports smoking marijuana to help cope with the situation. How will the nurse identify this form of coping?

maladaptive

A Red Cross volunteer has recently returned from assisting families in the Northwest who survived a devastating forest fire. She is having trouble sleeping and has taken up smoking again. Which statement by her leads the nurse to suspect a nursing diagnosis of Caregiver Role Strain related to stress from disaster volunteer activities?

"I can't seem to calm down. I keep seeing those faces and hearing their words every time I close my eyes."

The nurse teaches a client about the use of yoga as a stress management intervention. Which client statement indicates to the nurse that learning has taken place?

"It reduces physical and emotional tension through postural changes and focused concentration."

A client presents with a flare of lupus. Which statement made by the client would cause the nurse to suspect a stress reaction?

"I just had a baby 3 weeks ago."

A client is admitted to the oncology unit with a diagnosis of leukemia. Her sister comes to visit. The healthy sibling tells the nurse that her sister is sick because "I got mad at her and wished she would go away." Based on this information, the nurse would estimate the sister's age to be:

7 years

A nurse is working with a 67-year-old Asian American woman on diet changes to help with weight loss. She is explaining her role in the family as the one who prepares the meats for the family, while her daughter is responsible for preparing vegetables. Based on the nurse's knowledge of traditional Asian cultures, the nurse knows what to be true?

Families operate in a collectivistic manner.

A 35-year-old woman comes to the local health center with a large mass is her right breast. She has felt the lump for about a year but was afraid come to the clinic because she was sure it was cancer. What is the most appropriate nursing diagnosis for this client?

Ineffective Individual Coping

A withdrawn and isolated client is most likely suffering from what type of stressors on basic human needs?

Love and belonging needs

A 2-day-old, 28-week gestation preterm infant is being cared for in the neonatal intensive care unit. The mother is recovering from a cesarean section and comes in to visit for the first time today. Determining that stress can affect infant development., what situation does the nurse identify can develop? Select all that apply.

Mother's increased cortisol levels lead to increased anxiety and decreased attachment. The inability to hold and touch can lead to delay in bonding between mother and infant. Excessive noise and lights can increase cortisol levels in the neonate.

A nurse is making a follow-up phone call to a client who reported being raped. The client answers the phone and states, "I don't know what you are talking about. I have never been raped." What action should the nurse take?

Offer support, recognizing that the client may be using repression as a defense mechanism

A client with cancer has recovered from tumor removal surgery and is now stable while undergoing a chemotherapy treatment schedule. She is not having any symptoms at this time and is continuing to work and enjoy social events. What stage of the general adaptation syndrome (GAS) would the nurse place her in?

Resistance

In contrast to anxiety, fear is characterized by:

a cognitive response to a known threat.

A 56-year-old construction worker is in for his annual physical. As the nurse takes his vital signs, he tells her that his blood pressure may be a little off this morning. He tells the nurse that he is recently unemployed, is quite stressed, and is having a hard time coping. He feels like he needs to numb the pain. What is the nurse most concerned about regarding this client?

alcohol use

The nurse is caring for a client who is a teacher in a high school and states that there have been several issues with violence. What clinical manifestations during the client assessment would indicate that the client is experiencing physical manifestations of stress? Select all that apply.

an extra heart sound every fourth to sixth beat report of frequent evening headaches relieved by sleep reports of nausea

Family conflict around the care of a recently hospitalized woman has escalated to the point that crisis intervention may be required. This process should begin with:

clear identification of the relevant problem.

A nurse working on an oncology floor often sits with her clients in a calm, quiet, dimly lit environment and describes a walk along the ocean's shore. The nurse provides details of the walk and verbally paints a picture for the client. What best defines this form of stress management?

guided imagery

A client's body uses physiologic mechanisms from within to respond to internal changes and maintain an essential balance.This process is known as:

homeostasis

The nurse is caring for a client who is exhibiting signs of stress. Which cognitive symptom associated with stress does the nurse recognize?

impaired concentration

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate?

limit the family visits to once daily

Which situations are threats to psychological homeostasis in a client? Select all that apply.

loss of job a parent being diagnosed with dementia

A nurse is teaching a client regarding effective coping strategies. Which teaching will the nurse include? Select all that apply.

making an appointment with a counselor writing a list of pros and cons practicing yoga and relaxation praying

During a counseling session a client states, "I just try to forget about my spouse hitting me." Which coping mechanism should the nurse document on the basis of this client's statement?

repression

A nurse has been caring for a client who experienced a physical assault a year ago. The client now describes being "totally recovered from it." Which stage of stress is the client currently experiencing?

resistance stage

Which behaviors represent effective coping mechanisms? Select all that apply.

setting limits with family members who upset you learning relaxation techniques taking a vacation

A client with persistent nausea is diagnosed with somatization. What is the appropriate nursing action when the client reports nausea?

sit with the client and ask them about their feelings

A nurse is assessing a client with stress-related problems. Which factor influences responses to stressors?

social support

A client is refusing to get out of bed the day after hip surgery. The nurse knows that for the intervention to be safe, therapeutic, and nonthreatening, she will need to not only enlist the client's cooperation, but also her willing participation. Which stress reduction technique does the nurse acknowledge as the best choice in this situation?

Anticipatory guidance

A group of nursing students is learning about the body's response to stress. Which system is responsible for initiating the fight-or-flight response to stress?

sympathetic nervous system

The nurse is caring for four clients. Which client does the nurse identify as the highest risk for social readjustment concerns?

77-year-old whose spouse just died

An example of a long-term coping strategy is:

walking briskly three times a week for 20 minutes.

Which emotional clinical manifestations of stress should the nurse anticipate when providing care to an adolescent client?

withdrawal, depression, and angry outbursts

A teen is worried that her boyfriend is under "a lot of stress" with his home life, classes, clubs, community service, and part-time work. She asks the nurse what medication he should take to "calm down." Which response would be best?

"Do you think he would be willing to sit down and talk with me? I'd like to get to know him better so I can suggest some healthy alternatives."

The nurse is explaining to a group of high school students how the nervous system helps regulate homeostasis. Which statements by the nurse are correct? Select all that apply.

"The sympathetic nervous system is responsible for the flight-or-fight response." "The parasympathetic nervous system increases peristalsis."

Which client is experiencing the panic level of anxiety?

A client loses control and expresses irrational thinking.

Which nurse is most likely to experience the greatest amount of stress related to his or her position as a nurse?

A graduate nurse working on a telemetry unit

Which client is handling stress by using the defense mechanism termed displacement?

A mother who is angry at her husband shouts at the kids to "keep quiet."

The nurse is caring for a client diagnosed with terminal cancer who wishes to use meditation and prayer to be cured. What is the appropriate nursing action?

Advocate for the client's choice.

When nurses become overwhelmed in their jobs and develop symptoms of anxiety and stress, they are experiencing what condition?

Burnout

A school nurse is talking with teen related to school and home situations. The teen states, "I can't focus when I study, can't eat or sleep, and I feel like I'm going to pass out sometimes." The nurse believes the teen is experiencing which disorder?

Moderate anxiety response

The nurse is caring for a 72-year-old female who is recovering from abdominal surgery on the medical-surgical unit. The surgery was very stressful and prolonged. The nurse notes on the chart that the client's blood sugars are elevated, yet the client has not been diagnosed with diabetes. To what does the nurse attribute this elevation in blood sugars?

The blood sugars are probably a result of the "fight-or-flight" reaction

A toilet trained toddler was admitted to the hospital for dehydration. Upon returing home, the toddler becomes incontinent of urine and stool. The parent is concerned regarding this return to previous behavior and calls the pediatric clinic. What is the nurse's best response to the parent?

This behavior is called regression.

Many families are sheltering in the local middle school gymnasium during a severe tornado outbreak. Many homes have been destroyed and lives lost. The community health nurse expects to see negative stress reactions to the crisis, such as:

a young wife asking everyone repeatedly if they know where her husband is

A client is discussing stressors with the nurse and is describing how she feels better when she takes a brisk walk. The client's action is an example of:

adaptation

The nurse is preparing to administer an injection to an adult client and states, "Try to stay as still as possible." Which stage of the General Adaptation Syndrome (GAS) is the nurse addressing by making this statement?

alarm

A teenage girl is discussing her recent breakup with her boyfriend. She tells the nurse she just stays in bed all day and cannot seem to feel any better. She says she is only relieved of the pain while sleeping. The nurse identifies this coping strategy as:

avoidance coping

Which stressor collected during the assessment process for an adult client requires priority intervention by the nurse?

being laid off from a job

A Spanish-speaking client is admitted to the emergency department with a urinary tract infection and is experiencing a stress response from hospitalization. What is the priority nursing intervention?

contact a translator

A client who responds to bad news concerning his lab reports by crying uncontrollably is handling stress by using:

coping mechanism.

The client is a single mother of two children who attends college and works full time. She is seeing the college nurse due to a crying outburst in class. The last step of crisis intervention that the nurse employs is:

determining if the outcome has been achieved.

A client has experienced the loss of a loved one and is in the grieving process. The grief following this stressful event may be documented as what type of event?

distress

In human beings, the physiologic response to a stressor includes the:

epinephrine increasing the blood-glucose level.

A young woman, who has recently suffered acute stress, asks the nurse why she seems to be more sensitive to stress than her husband. The nurse explains that a contributor to this phenomenon is:

estrogen levels

The nurse is caring for a client who is a doctor in a general hospital. He complains about the stressful condition of his job. Lately, he has become increasingly susceptible to colds, headaches, muscular tension, excessive tiredness, and many other symptoms. At what stage of stress is the client?

exhaustion stage

A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention?

provide care transition at discharge for speech therapy

A client is experiencing major life changes including graduating from medical school, an internship, and a wedding all within 2 months of graduation. What conditions does the nurse identify that the client is at risk for?

psoriasis rheumatoid arthritis Asthma

After failing a nursing exam, the nursing student states, "That exam was written terribly." What coping strategy would the nursing instructor identify?

rationalization

A nurse is assessing a client who has recently lost her husband. During the interview the nurse realizes that the client is unable to cope with the loss. The client finds it difficult to organize daily tasks or solve problems effectively. Which suggestion would be most appropriate for the nurse to suggest as a crisis intervention?

seek assistance from family and friends

A client is on a stress management program. She states that she is open to trying a guided meditation class. When helping her get started, a nurse tells her that which of the following is not important?

soft music

A high school student comes to the nurse's office to discuss her anxiety regarding an upcoming test. Her test-taking anxiety is a (an):

stressor

A middle-age woman's father has passed away, and her mother requires physical and emotional help due to disabilities. The woman is married and raising two children, along with working full time. All of the factors described are:

stressors

The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve?

the mindful use of a word, phrase, or visual image that allows oneself to be distracted and temporarily escape from stressful situations