ATI Stress and Coping Module Assessment
A nurse is caring for a client who has delivered a healthy newborn. The client is tense, refuses to hold the baby, and tells the nurse, "I have no idea how to handle having a baby. I wish this pregnancy had never happened." Which of the following statements should the nurse make? - "Becoming a parent is a new experience for you. Let's talk about your concerns." - "You should be thrilled about having a healthy newborn. I would be." - "Why don't you hold the baby? I'm sure it will make you feel better." - "How can you think that way? This is a joyous occasion and should be celebrated."
"Becoming a parent is a new experience for you. Let's talk about your concerns." An individual's perceptions of and responses to the stressor determine whether the stressor is positive (eustress) or negative (distress). By using therapeutic communication skills, the nurse creates a safe environment for the client to express thoughts and feelings.
A nurse is caring for a client who is in crisis following the breakup of a long-term relationship. The client tells the nurse, "I might as well just die. My life is over." Which of the following actions should the nurse take first? - Explore past positive coping strategies. - Establish a follow-up plan of care. - Conduct a suicidal risk evaluation. - Display a neutral attitude.
Conduct a suicidal risk evaluation. The greatest risk to this client is injury to self or others; therefore, the first action the nurse should take is to conduct a suicidal and homicidal risk evaluation.
A nurse is caring for a college student admitted for acute intoxication. The client reports feeling overwhelmed and expresses and inability to cope with stressors at school. Which of the following statements should the nurse make? - "Drinking too much alcohol is not the best choice. I suggest you stop drinking." - "I can see why you're using alcohol to cope; you've got a lot going on." - "Let's talk about the coping methods that have worked for you in the past." - "I've been stressed before too, but I tell myself that I can handle it."
"Let's talk about the coping methods that have worked for you in the past." The nurse is using therapeutic communication techniques and building on the client's strengths to improve coping skills. Nurses use several therapeutic communication techniques to build a trusting relationship including active listening, asking open-ended questions, seeking clarification, and offering observations.
A nurse is interviewing a client who is in distress and tells the nurse, "My ex-partner is suing for full custody of my children. I am so worried and don't know what to do." Which of the following questions should the nurse ask to evaluate the client's coping skills? - "Can you describe your relationship with your ex-partner?" - "What happens when you feel worried like this?" - "What do you believe was your contribution to the relationship breakup?" - "What strategies have you used in the past to deal with stress?"
"What strategies have you used in the past to deal with stress?" This question is appropriate because it focuses on investigating the client's ability to cope with and manage stressful situations.
A nurse is caring for a client sho has migraine headaches and reports that they are "getting worse." Which of the following questions should the nurse ask the client to determine if the headaches are a stress-related disorder? SATA - "What is the intensity of your migraine headaches?" - "How often do the migraine headaches occur?" - "Are you eligible for workers' compensation due to the migraine headaches?" - "What type of support is available to you when you have a migraine headache?" - "What coping strategies do you use when you experience a migraine headache?"
- "What is the intensity of your migraine headaches?" - "How often do the migraine headaches occur?" - "What type of support is available to you when you have a migraine headache?" - "What coping strategies do you use when you experience a migraine headache?"
A nurse is caring for a client whose partner was recently hospitalized with COVID-19. The client is experiencing manifestations related to the alarm stage of general adaptation syndrome (GAS). For which of the following manifestations should the nurse monitor? - Hypertension - Dilated pupils - Increased state of arousal - Bradycardia - Lethargy
- Hypertension - Dilated pupils - Increased state of arousal
A nurse is assessing a client who was sexually assaulted 6 months ago and has been diagnosed with post-traumatic stress disorder (PTSD). Which of the following manifestations should the nurse expect? SATA - Intrusive memories of the event - Flashbacks of the event - Poor work relationships - Exaggerated startle response when reminded of the event - Frequent episodes of diarrhea
- Intrusive memories of the event - Flashbacks of the event - Exaggerated startle response when reminded of the event
A nurse is providing discharge teaching about health promotion to a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following instructions should the nurse include? SATA - Practice mindful breathing. - Start each day with a to-do list. - Include simple carbohydrates in the diet. - Develop habits to mitigate stress. - Preserve energy by reducing physical activity.
- Practice mindful breathing. - Start each day with a to-do list. - Develop habits to mitigate stress. - The nurse should instruct the client to practice mindful breathing. Health promotion includes practicing mindfulness activities that build resilience. Mindful breathing includes clearing the mind and relaxing while taking in slow, deep breaths. - The nurse should instruct the client to start each day with a to-do list. Health promotion includes prioritizing daily tasks from high to low to help lower stress levels. - The nurse should instruct the client to develop habits to mitigate stress. Health promotion includes building resilience to bounce back from life's various challenges.
A nurse in a community clinic is interviewing a client who is distressed and reports being unable to sleep following a neighborhood fire several days ago. The client has hypertension, tachycardia, and is diaphoretic. The nurse should identify that the client is experiencing which of the following types of stress? - Acute stress - Post-traumatic stress disorder (PTSD) - Episodic acute stress - Chronic stress
Acute stress The nurse should identify that the client is experiencing acute stress. Most episodes of acute stress do not have lingering health effects; however, if an individual experiences severe or prolonged stress levels, this condition could lead to mental health issues.
A nurse is interviewing a client who recently experienced an act of workplace violence when an armed person held the workers at gunpoint before police intervened. The client now reports being anxious and fears the gunman might return. The nurse should identify that the client is experiencing which of the following crisis? - Situational - Cultural - Maturational - Adventitious
Adventitious Adventitious crises occur from natural disasters such as floods, hurricanes, or fire; or from acts of war, criminal activity, or terrorism.
A nurse in a health clinic is interviewing a client who is upset and reports that their stress "is too much to handle." The client is unemployed, a single guardian to young children, and has periodic asthma attacks. Which of the following stress-related conditions is the client experiencing? - Post-traumatic stress disorder (PTSD) - Allostatic load - Chronic illness - Alarm stage
Allostatic load Chronic exposure to elevated or fluctuating endocrine or neural responses causes excessive wear and tear on the body organs, resulting in allostatic load. The nurse should identify that the client's constant stress may be manifesting itself in physical ailments such as periodic asthma attacks.
A nurse is caring for a client who has pancreatic cancer that is unresponsive to treatment. The client is experiencing significant weight loss and fatigue, but when the nurse asks how they are feeling, the they respond with, "Great! I'm going to beat this cancer." Which of the following defense mechanism is the client using? - Regression - Projection - Repression - Denial
Denial Denial refers to the refusal to acknowledge or accept reality about a situation, despite what might be obvious to others, to avoid the emotional impact.
A nurse is caring for an older adult client who reports being stressed about their health status due to problems with short-term memory, slower reaction times when driving, and urinary frequency. The nurse should recognize that the client is experiencing which of the following types of stressor? - Developmental stressors - Situational stressors - Adventitious stressors - Socioeconomic stressors
Developmental stressors Developmental, or maturational, stressors vary throughout the lifespan and occur as individuals move through the stages of life. Older adults may experience stressors related to health problems and changes in mobility and cognition.
A nurse is caring for a client who has delivered a healthy newborn. The client tells the nurse that while they are somewhat stressed about being a new parent, they are thrilled by the birth of their child. The nurse should identify that the client is experiencing which of the following types of stress? - Allostatic load - Distress - Eustress - Fight-or-flight response
Eustress Positive stress, or eustress, is often associated with accomplishment or achievement and generally produces feelings of well-being, inspiration, and motivation.
A nurse is conducting an educational session for clients who report experiencing stress-related disorders. A client asks the nurse which part of the body activates the stress response. Which of the following responses should the nurse provide? - Sympathetic nervous system (SNS) - Adrenal glands - Hypothalamus - Adrenocorticotropic hormone
Hypothalamus The hypothalamus activates the stress response. When a stress response is triggered, the hypothalamus sends signals to the pituitary and adrenal glands.
A nurse is assessing a client who is working at home due to COVID-19 restrictions. The client reports abdominal cramping and bloating with diarrhea and states, "I am completely stressed out from working at home." The nurse should identify that the client is experiencing manifestations of which of the following stress-related conditions? - Irritable bowel syndrome - Food poisoning - Panic disorder - Major depressive disorder
Irritable bowel syndrome Irritable bowel syndrome is a condition often triggered by stress and characterized by abdominal discomfort, cramping, bloating, and diarrhea.
A nurse is talking about implementing self-care strategies to cope with the stress of caregiving with the partner of a client who has dementia. Which of the following strategies reported by the partner should the nurse identify as an example of effective coping? - Practicing deep breathing while sitting outside - Sitting by the client's bedside and drinking coffee - Going out onto the patio to smoke a cigarette when feeling stressed - Drinking a glass of wine every night before falling asleep
Practicing deep breathing while sitting outside Eating nutritious meals, participating in active exercise, and engaging in mindfulness activities such as deep breathing are examples of healthy coping.
A nurse is caring for a client who has been charged with partner violence against their spouse. The client is angry, pacing, and yells out, "I wouldn't lose my temper if my spouse would just leave me alone. It's their fault." The nurse should identify the client is displaying which of the following defense mechanism? - Projection - Compartmentalization - Repression - Regression
Projection Projection involves attributing negative or uncomfortable thoughts, feelings, or motives onto another individual to avoid dealing with them as one's own.
A nurse is caring for a client who reports experiencing stress over an upcoming surgical procedure. Which of the following statements describes the characteristics of stress? - Stress is an easily defined phenomenon regardless of viewpoint and discipline. - Stress is a condition in which the body responds to physical, emotional, or environmental changes affecting one's state of equilibrium. - Stress only affects the individual and does not affect the person's family, friends, or other associates. - The lack of definition regarding stress does not pose a problem for the client or the nurse.
Stress is a condition in which the body responds to physical, emotional, or environmental changes affecting one's state of equilibrium. Stress can be caused by physical, emotional, environmental, or mental changes, which can be positive or negative depending on the person's perception or appraisal of the stressor.
A nurse is planning care for a client who is recently divorced with two young children. The client reports difficulty sleeping, feeling hopeless, and being estranged from family. The nurse should plan to monitor the client for which of the following potential manifestations of chronic illness. - Systemic infection - Exaggerated startle response - Recurring nightmares - Suicide
Suicide Chronic stress can cause or exacerbate serious health problems such as depression, anxiety, cancer, and suicide.
