Chapter 42 PrepU Questions - Stress and Adaptation

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? A. Anticipatory guidance B. Guided imagery C. Relaxation D. Normalization

A. Anticipatory guidance

Which behaviors represent effective coping mechanisms? Select all that apply. A. setting limits with family members who upset you B. learning relaxation techniques C. taking a vacation D. sleeping 14 hours a night E. sleeping 3 hours a night F. denying responsibility for a DUI conviction

A. setting limits with family members who upset you B. learning relaxation techniques C. taking a vacation

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? A. "It eases tense muscles by clearing the mind of stressful thoughts." B. "It alters a negative physiologic response through the power of suggestion." C. "It uses the mind to visualize calming, pleasurable, and positive experiences." D. "It reduces physical and emotional tension through postural changes and focused concentration."

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

In human beings, the physiologic response to a stressor includes the: A. sympathetic nervous system slowing the heart rate. B. hypothalamus secreting adrenocorticotropic hormone. C. hypothalamus secreting thyroid-stimulating hormone. D. epinephrine increasing the blood-glucose level.

D. epinephrine increasing the blood-glucose level.

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? A. "I can't seem to calm down. I keep seeing those faces and hearing their words every time I close my eyes." B. "I get so tired from working long hours at the site." C. "I need to get back to work here at home. That will get me back into a routine." D. "I guess the smoke in the air brought out my mental addiction to cigarettes."

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

A mother tells the school nurse that her 5-year-old is refusing to go to school and won't accept a "school night" bedtime. The school nurse knows the mother will need more instruction when the mother makes which statement? A. "I don't know why he is acting like this. He hasn't had anyone to play with but his little brother all summer." B. "I am bringing him to the orientation so he can meet his teacher and some classmates." C. "It's so hard to get them into a routine after summer break. I go through this every year with all my kids." D. "We've all been talking to him about what school will be like; his brother had the same teacher and really liked her."

A. "I don't know why he is acting like this. He hasn't had anyone to play with but his little brother all summer."

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: A. 7 years B. 15 years C. 3 years D. 21 years

A. 7 years

The nurse is caring for four clients. Which client does the nurse identify as the highest risk for social readjustment concerns? A. 77-year-old whose spouse just died B. 54-year-old who is undergoing marital separation C. 32-year-old who has recently been incarcerated D. 40-year-old who was fired from work last month

A. 77-year-old whose spouse just died

Which client is experiencing the panic level of anxiety? A. A client loses control and expresses irrational thinking. B. A client experiences increased alertness and motivated learning. C. A client focuses narrowly on specific detail. D. A client displays a narrow perception field.

A. A client loses control and expresses irrational thinking.

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? A. Advocate for the client's choice. B. Explain that meditation and prayer are not curative. C. Arrange for a chaplain to visit with the client. D. Prepare to administer chemotherapy as ordered.

A. Advocate for the client's choice.

Which statement correctly explains a person's interactions with basic human needs? A. As a person strives to meet basic human needs at each level, stress can serve as either a stimulus or barrier. B. Basic human needs and responses to stress are generalized. C. Basic human needs and responses to stress are unaffected by sociocultural backgrounds, priorities, and past experiences. D. Stress affects all people in their attainment of basic human needs in the same manner.

A. As a person strives to meet basic human needs at each level, stress can serve as either a stimulus or barrier.

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. A. Mother's increased cortisol levels lead to increased anxiety and decreased attachment. B. The inability to hold and touch can lead to delay in bonding between mother and infant. C. Excessive noise and lights can increase cortisol levels in the neonate. D. The mother's cesarean section will impair her ability to hold and bond. E. Stress does not affect the newborn

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

A client asks about general adaptation syndrome (GAS). Which details provided by the nurse are correct? Select all that apply. A. The alarm stage of GAS can last from minutes to hours. B. It can be a response to physiologic or psychological stress. C. There are three stages to GAS. D. GAS requires psychological hospitalization for treatment.

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

In contrast to anxiety, fear is characterized by: A. a cognitive response to a known threat. B. the creation of an action plan to deal with a perceived threat. C. a real, rather than perceived, threat. D. short-term resolution.

A. a cognitive response to a known threat.

A client informs the nurse that headaches started when marital problems began. The client reports that each time they have a fight, a headache develops and loss of appetite occurs for several days. What does the nurse identify as the physiologic symptoms? A. a somatic disorder B. anxiety C. fear D. a coping mechanism

A. a somatic disorder

Which response to long-term stress may present itself in clients? Select all that apply. A. alcoholism B. peritonitis C. hypertension D. bulimia E. diplopia

A. alcoholism C. hypertension D. bulimia

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: A. avoidance coping. B. buffering. C. chronic stress. D. adaptation.

A. avoidance coping.

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: A. clear identification of the relevant problem. B. presentation of clear, achievable, and evidence-based solutions. C. careful and objective analysis of different proposed options. D. comparison of the family's situation to other similar situations.

A. clear identification of the relevant problem.

The nurse involved in coordinating a support group for spinal cord injury clients learns that one of the participants in the support group was a college athlete prior to his diving accident. The client informs the group that he earned a scholarship based upon his athletic abilities and not his academic performance, and after the injury, he focused his energies on his studies. He has been on the dean's list for two semesters. What defense mechanism is illustrated in this scenario? A. compensation B. sublimation C. projection D. reaction formation

A. compensation

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: A. determining if the outcome has been achieved. B. outlining several solutions to the crisis with the client. C. asking the client, "What would happen if you did this solution?" D. having the client select an acceptable solution to her problem.

A. determining if the outcome has been achieved.

A nurse is teaching a client regarding effective coping strategies. Which teaching will the nurse include? Select all that apply. A. making an appointment with a counselor B. writing a list of pros and cons C. sleeping during the day D. avoiding crowds and social activity E. practicing yoga and relaxation F. turning to a higher power

A. making an appointment with a counselor B. writing a list of pros and cons E. practicing yoga and relaxation F. turning to a higher power

A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention? A. provide care transition at discharge for speech therapy B. assess blood pressure every 4 hours C. conduct mental status assessment every 2 hours D. discuss family history of hypertension

A. provide care transition at discharge for speech therapy

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? A. sympathetic nervous system B. parasympathetic nervous system C. endocrine system D. respiratory system

A. sympathetic nervous system

The nurse is making preparations for a group of clients who have been experiencing some stressful events in their lives. Which nursing strategies should the nurse use to assist these clients? Select all that apply. A. ignoring the stressors B. preventing additional stressors C. assessing the client's response to stress D. implementing stress management techniques E. assisting in maintaining a network of social support

B. preventing additional stressors C. assessing the client's response to stress D. implementing stress management techniques E. assisting in maintaining a network of social support

Which client is handling stress by using the defense mechanism termed displacement? A. An athlete who doesn't make the team concentrates on body-building instead. B. A man with symptoms of prostate cancer refuses to see a doctor. C. A mother who is angry at her husband shouts at the kids to "keep quiet." D. A man who forgets his medication blames his wife for putting it away.

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

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? A. Alarm reaction B. Exhaustion C. Resistance D. Reflex pain response

C. Resistance

The client asks the nurse to explain stress and its effect on the body. Which information will the nurse include? Select all that apply. A. Stress begins in children at about age 2. B. All stress has a negative effect on the human body in some form. C. Stress begins in utero. D. Stress is ever-present. E. Some forms of stress are positive events.

C. Stress begins in utero. D. Stress is ever-present. E. Some forms of stress are positive events.

The nurse is describing the effect of stress on the body to a group of health practitioners. Which statements accurately describe the role of stress on the health and illness of clients? Select all that apply. A. Stress has a negative impact on a person as he strives to meet basic human needs at each level. B. People react to stress in a consistent and predictable manner. C. The health-illness continuum is affected by stress. D. The effects of stress on a sick or injured person are usually positive. E. As the duration, intensity, or number of stressors increases, a person's ability to adapt is lessened. F. Recovery from illness and return to normal function are compromised by prolonged stress.

C. The health-illness continuum is affected by stress. E. As the duration, intensity, or number of stressors increases, a person's ability to adapt is lessened. F. Recovery from illness and return to normal function are compromised by prolonged stress.

A nurse is assisting a neurologist, who is assessing the norepinephrine (noradrenaline) level of a client who is reporting stress. Which function does norepinephrine (noradrenaline) perform? A. stabilizes mood and regulates temperature B. promotes coordinated movement C. heightens arousal and increases energy D. transmits sensation of pain

C. heightens arousal and increases energy

A recently retired client reports that he has been able to sleep only 3 hours a night and that he has nausea, frequent urination, and headaches. He is asking the nurse what she thinks is going on with his health. What is the most probable cause of his symptoms? A. type 2 diabetes B. obstructive sleep apnea C. moderate anxiety D. herniated lumbar disc

C. moderate anxiety

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? A. alarm stage B. exhaustion stage C. resistance stage D. primary stage

C. resistance stage

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? A. perform meditation to relax B. tense and relax muscle groups systematically C. seek assistance from family and friends D. keep the home environment noise-free

C. seek assistance from family and friends

A client with persistent nausea is diagnosed with somatization. What is the appropriate nursing action when the client reports nausea? A. Immediately administer an antiemetic. B. contact the primary care provider C. sit with the client and ask them about their feelings D. explain that the physical symptoms are all in their head

C. sit with the client and ask them about their feelings

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? A. a quiet environment B. an open attitude C. soft music D. a focus of attention

C. soft music

A withdrawn and isolated client is most likely suffering from what type of stressors on basic human needs? A. Physiologic needs B. Safety and security needs C. Self-esteem needs D. Love and belonging needs

D. Love and belonging needs

A nurse is meeting with a young woman who has recently lost her mother, lost her job, and moved with her husband to a new city. She is reporting acute anxiety and depression. What does the nurse know about stress that would be helpful with this client's situation? A. Adaptation often fails during stressful events and results in homeostasis. B. Stress is a part of our lives and eventually this young woman will adapt. C. Acute anxiety and depression are seldom associated with stress. D. Sometimes too many stressors disrupt homeostasis, and if adaptation fails, the result is disease.

D. Sometimes too many stressors disrupt homeostasis, and if adaptation fails, the result is disease.

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? A. cocaine use B. projection C. exercise D. alcohol use

D. alcohol use

The nurse is caring for a client who is exhibiting signs of stress. Which cognitive symptom associated with stress does the nurse recognize? A. angry outbursts B. lack of interest in sex C. difficulty falling asleep D. impaired concentration

D. impaired concentration

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: A. thyroid production. B. adrenal function. C. estrogen levels. D. cortisol. E. glucose.

C. estrogen levels.

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? A. reaction formation B. rationalization C. repression D. regression

C. repression

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? A. beneficial B. maladaptive C. generational D. cultural

B. maladaptive

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? A. Families operate in a collectivistic manner. B. Families operate in an individualistic manner. C. Family is the only thing that is important. D. Older adults never change their eating patterns.

B. Families operate in an individualistic 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? A. Self-Esteem Disturbance B. Ineffective Individual Coping C. Altered Family Process D. Chronic Confusion

B. Ineffective Individual Coping

A toilet-trained toddler was admitted to the hospital for dehydration. Upon returning 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? A. This behavior is sublimation. B. This behavior is called regression. C. This behavior is known as repression. D. This behavior is reaction formation.

B. This behavior is called regression.

A client is admitted to the emergency department with a urinary tract infection and is experiencing a stress response from hospitalization. The client does not speak any of the dominant language. What is the priority nursing intervention? A. begin taking a client history B. contact a translator C. collect a urine specimen D. administer a broad-spectrum antibiotic

B. contact a translator

A client who responds to bad news concerning laboratory results by crying uncontrollably is handling stress by using: A. adaptation technique. B. coping mechanism. C. withdrawal behavior. D. defense mechanism.

B. coping mechanism.

A client with diabetes mellitus is experiencing acute stress. The nurse identifies that the client will be secreting excess levels of cortisol. What should the nurse monitor the client for related to the increased levels of cortisol? A. depression B. elevated glucose levels C. elevated potassium levels D. cardiac dysrhythmias

B. elevated glucose levels

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate? A. tell the family they are causing too much stress B. limit the family visits to once daily C. explain that family visits and support are important D. do not intervene and allow the client to work out the family issue

B. limit the family visits to once daily