Chapter 6: Individual and Family Homeostasis, Stress, and Adaptation

The nurse is teaching a community group about emotions experienced with stress. What emotions will the nurse include in the teaching? Select all that apply

helplessness anxiety inadequacy Explanation: The nurse will need to teach that people with stress often feel helpless, inadequate, anxious, angry, and powerless. Happiness and power are not seen with people experiencing stress.

Which of the following would a nurse least likely assess in a client experiencing anxiety?

Positive self-talk Explanation: Anxiety would be manifested by negative self-talk, sleeping difficulties, irritability, and muscle tension.

The patient wants to be prescribed an anti-infective drug for the flu. The nurse understands that anti-infective medications would not be useful against which biologic agents?

Viruses Explanation: Viruses are among the smallest living organisms known and survive as parasites of the living cells they invade. Viruses infect specific cells. Through a complex mechanism, viruses replicate within cells and then invade other cells, where they continue to replicate. As the body mounts an immune response to eliminate the viruses, cells harboring the viruses can be injured in the process. Typically, an inflammatory response and immune reaction are the body's physiologic responses to viral infection. Anti-infective medications are not typically effective against viruses.

After teaching nursing students about substance abuse and its effects on individuals and families, the instructor determines that additional teaching is necessary when the students state which of the following?

"Individuals frequently engage in substance use and abuse to enhance their decision-making ability." Explanation: Substance abuse refers to the use of alcohol and illegally obtained, prescribed, or over-the-counter drugs alone or combined in ineffective attempts to cope with the pressures, strains, and burdens of life. Thus, individuals with substance abuse often have difficulty identifying and implementing adaptive behaviors. Substance abuse occurs in all settings. Individuals who abuse substances are unable to make healthy decisions and to solve problems effectively.

The nurse has been talking to a client who has had difficulty coping with a new situation. The nurse has met with the client a number of times but each time the client is reluctant to talk about the situation or the feelings associated with it. Which statement by the nurse would be MOST helpful to the client in this situation?

"Many people who have difficulty talking about a situation are able to write about it. I would suggest spending some time each day writing about your feelings." Explanation: It is the role of the nure to assist the client in identifying positive strategies to deal with stress. If a client has difficulty verbalizing feelings, it is helpful to suggest that the client write about them in a journal. It is not helpful to the client for the nurse to walk away from the situation. Deep breathing can be an effective coping mechanism but the issue is that the client is unable to talk about the situation. Walking 5-10 minutes each day can be helpful and then working up to more vigorous exercise. Telling a client to run for 30 minutes is too strenuous.

A client with a foodborne illness is concerned his gastrointestinal tract will never be the same again. Which of the following would be an appropriate response from the nurse?

"New gastrointestinal cells replace damaged ones constantly." Explanation: Labile cells multiply constantly to replace worn-out cells. Epithelial cells of the gastrointestinal tract are labile and will constantly regenerate.

A 12-year-old boy taken to the emergency department after a soccer injury cries out, "Look, my leg is bigger now!" How will the nurse respond to the boy?

"Swelling is a normal response from your body to prepare for healing." Explanation: Inflammation is a defensive reaction after injury that helps to prepare the site for repair. At the age of 12 years, children should be given age-appropriate responses for better understanding of what is happening to them. The correct choice is the best therapeutic communication response.

A pregnant patient is experiencing changes in her breast and asks the nurse if this should be cause for concern. What is the nurse's best response about the cellular adaptation to stress in the pregnant woman?

"This is hyperplasia, which refers to an increase in cells because of the hormones from pregnancy." Explanation: Hyperplasia is an increase in the number of new cells in an organ or tissue. As cells multiply and are subjected to increased stimulation, the tissue mass enlarges. This mitotic response (a change occurring with mitosis) is reversible when the stimulus is removed. This mechanism distinguishes hyperplasia from neoplasia or malignant growth, which continues after the stimulus is removed. Hyperplasia may be hormonally induced. An example is the increased size of the thyroid gland caused by thyroid-stimulating hormone (secreted from the pituitary gland) when a deficit in thyroid hormone occurs.

While interviewing the wife of a patient with multiple health problems, the spouse states, "I'm not the one who is ill, but I feel like I'm getting sick all the time." Which response by the nurse would be most appropriate?

"When one family member becomes ill, other members are affected." Explanation: When a family member becomes ill, injured, or disabled, all members of the family are affected. Depending on the nature of the health problem, family members may need to modify existing lifestyles or even restructure their lives. Thus, informing the wife of this addresses her concerns. The statement about catching something from the husband is inappropriate and focuses more on the wife feeling ill than on the underlying message of the statement. Telling the wife to focus on how well she is coping and suggesting that they talk with the doctor are inappropriate, because these responses do not address the wife's concern.

Brain cell death may occur in as little as:

3 minutes Explanation: The length of time that different tissues can survive without oxygen varies. Brain cells may succumb in 3 to 6 minutes, depending on the situation.

The physician tells a client, "You are lucky. This episode of chest pain is a warning sign." How can the nurse explain to the client what the physician means?

A decrease in blood supply to the heart causes stress to cells through the perception of pain. Explanation: Ischemia means that blood supply to an organ is deficient. In the case of the heart, the decreased blood supply results in chest pain. The chest pain warns the client that ischemia is occurring in the heart and that the client needs to seek medical attention.

After teaching a group of cancer survivors about loss and grief, the nurse determines that the teaching was successful when the group identifies loss as which of the following?

A part of the life cycle in the form of change, growth, and transition Explanation: Loss is part of the life cycle and occurs in the form of change, growth, and transition. Grief refers to the universal response to any loss. It is experienced by anyone suffering any type of loss. Spirituality refers to the feeling of connectedness with self, others, a life force, or God that allows people to find meaning in life. Anxiety refers to feelings of apprehension or worry in response to or about a situation.

A nurse is teaching a group of families who have members experiencing addiction about this problem. Which of the following, if stated by the families, indicates that the teaching was successful?

Addiction is not a result of a person having moral faults. Explanation: Addiction is not a defect in character or a moral fault. It results from a combination of factors, such as values, beliefs, family and personal norms, spiritual convictions, and conditions of the current social environment. Even with treatment, relapse, which is considered part of the illness process, can occur.

A nurse has developed a plan of care for a patient with a nursing diagnosis of "risk for spiritual distress." Which interventions would the plan most likely include? Select all that apply.

Actively listen to the patient. Demonstrate acceptance of the patient. Encourage the patient to talk about his or her faith. Explanation: Interventions that foster spiritual growth and reconciliation include being fully present; listening actively; conveying a sense of caring, respect, and acceptance; using therapeutic communication to encourage expression; suggesting the use of prayer, meditation, or imagery; and facilitating contact with spiritual leaders or performance of spiritual rituals. Being present indicates that the nurse is available to the patient and does not limit the amount of time spent.

The nurse is developing a plan of care to assist a patient in coping with a below-the-knee amputation (BKA) on the right leg. Which intervention should the nurse include?

Allow client to verbalize feelings of loss Explanation: Nursing interventions to enhance client's ability to cope with stressful events include allowing the client to verbalize feelings of loss, such as those associated with the loss of a lower extremity. The nurse should also encourage objective, not subjective, appraisal of the event by the client, and assist the client in establishing mutual client nursing goals, not nurse-determined goals. If the client desires, the nurse should assist the client to use other forms of alternative therapy such as meditation, music therapy, etc.

A client has an abnormal result on a Papanicolaou test. The client asks the nurse what dysplasia means. Which definition should the nurse provide?

Alteration in the size, shape, and organization of differentiated cells Explanation: The nurse should explain that dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. The presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin is called anaplasia. An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found is called metaplasia.

A nurse identifies a nursing diagnosis of spiritual distress for a patient based on assessment of which of the following? Select all that apply.

Anger Ambivalence Despair Explanation: Spiritually distressed patients may show despair, discouragement, ambivalence, detachment, anger, resentment, or fear. They may question the meaning of suffering or life and express a sense of emptiness.

The nurse is discussing health care goals with a client. What intervention will a nurse perform when assisting a client to achieve health care goals?

Appreciate the client's beliefs about the cause of illness. Explanation: A nurse may disagree with a client's beliefs about their health or illness. However, a nurse must appreciate these beliefs when assisting a client to achieve health care goals. Appraisal and coping are affected by internal characteristics such as health, energy, personal belief systems, commitments, life goals, self-esteem, control, mastery, knowledge, problem-solving skills, and social skills. Learning to speak a second language and modifying unsafe practices performed by the client help to develop a growing expertise in culturally sensitive nursing care.

The nurse is caring for a client with diabetes who has an infection. The nurse creates a plan of care for the client based on a knowledge of the hypothalamic-pituitary response to stress by including which nursing intervention in the plan of care?

Assessment for hyperglycemia Explanation: The hypothalamic-pituitary response to stress includes stimulation of the adrenal cortex to produce glucocorticoids that inhibit glucose uptake. This increases need for insulin in a client with diabetes and the need for the nurse to assess for hyperglycemia. Restriction of dietary protein is contraindicated because the hypothalamic-pituitary response includes catabolism of body protein. Measurement of intake/output is not indicated in this case. Although the client's insulin dosage will most likely need to be increased, this is not a nursing action and requires a physician's order.

Cells in which organ are unable to regenerate?

Brain Explanation: Brain cells are not able to regenerate. Stable cells in some organ systems have a latent ability to regenerate under normal physiologic processes. Examples of regenerative cells include functional cells of the kidney, liver, and pancreas.

A client is experiencing difficulty speaking and numbness on his right side. His wife calls a neighbor who is a nurse for help. Upon arrival at the scene, the nurse calls 911 immediately. Which of the following displays the nurse's critical clinical judgment?

Brain cells without oxygen die in approximately 3 to 6 minutes. Explanation: Ischemia results from intravascular clots that interfere with blood supply, which is what happens in a stroke. Brain cells need a constant supply of blood and will die within 3 to 6 minutes without blood. Therefore, it is necessary to seek health care immediately.

A nurse is working with a family that is under stress. Which trait would the nurse emphasize in the plan of care as being most useful to the family's coping?

Communication skills Explanation: Communication skills and spirituality have been identified as the most useful traits that enhance family members' coping. Other helpful traits include cognitive abilities, emotional strengths, individual strengths and talents, relationship capabilities, and willingness to use community resources.

The nurse is working with a client who is in a stressful situation. The nurse evaluates the client's resiliency by assessing the client's ability to do what?

Continue to function well Explanation: Resilience has been defined by researchers as the ability of a person to function well in stressful situations. It is demonstrated by controlling strong emotional reactions, using appropriate communication and problem-solving skills, and knowing when to take action, when to rely on others, and when to nurture the self.

The nurse is performing an assessment to determine the patient's social support systems. What question is important for the nurse to ask?

Does the patient belong to a group that is mutually dependent and communicative? Explanation: The nature of social support and its influence on coping have been studied extensively. Social support has been demonstrated to be an effective moderator of life stress. Such support has been found to provide people with several different types of emotional information. The first type of information leads people to believe that they are cared for and loved. This emotional support appears most often in a relationship between two people in which mutual trust and attachment are expressed by helping one another meet their emotional needs. The second type of information leads people to believe that they are esteemed and valued. This is most effective when there is recognition demonstrating a person's favorable position in the group. Known as esteem support, this elevates the person's sense of self-worth. The third type of information leads people to feel that they belong to a network of communication and mutual obligation. Members of this network share information and make goods and services available to the members as needed.

The nurse is caring for a client with a possible psychobiologic illness and knows that which neurotransmitter is responsible for integrating thoughts and helps to enhance judgment?

Dopamine Explanation: Dopamine is a neurotransmitter that integrates thoughts, promotes movement in concert with ACH, stimulates the hypothalamic endocrine activity and enhances judgment.

The nurse is caring for a client diagnosed with Parkinson's disease. The nurse is most correct to correlate the client's uncontrolled tremors as a physical characteristic of a lack of which neurotransmitter?

Dopamine Explanation: Parkinson's disease is a neurodegenerative disorder and the most common movement disorder. It is characterized by progressive loss of muscle control, which leads to trembling of the limbs and head while at rest, stiffness, slowness, and imbalance. Low levels of the neurotransmitter dopamine have been linked to the uncontrollable tremors.

A deep vein thrombosis (DVT) results in vascular vasodilation, local tissue congestion, and increased capillary permeability. The nurse would expect to see which of the following body responses in a client with a DVT?

Erythema and pain Explanation: Inflammation occurs with a DVT and prepares the site for repair. The inflammatory response is a sequence of events that involves changes in the microcirculation, as identified in the question. As these changes take place, five cardinal signs of inflammation are produced: erythema, warmth, edema, pain, and impaired functioning.

Which of the following would be the priority when providing care to a client with posttraumatic stress disorder (PTSD)?

Establishing a trusting nurse-client relationship Explanation: The first step in caring for a client with PTSD is to develop a trusting nurse-client relationship because the patient is physically compromised and struggling emotionally with a situation that is outside the norm. Once the relationship is established, the nurse can help the client address and work through the trauma experience and teach the client appropriate coping skills needed for recovery and self-care.

A nurse is working with a client to integrate effective coping skills into the client's life. What activities will the nurse suggest to the client? Select all that apply.

Explore coping strategies the client has found helpful in the past and encourage their continued use. Re-establish priorities to strike a healthy balance between work and play. Cultivate relationships with family and friends who are supportive. Explanation: Activities to enhance coping include exploring the coping strategies the client has found helpful in the past and encouraging their continued use, encouraging clients to reestablish priorities and to strike a healthy balance between work and play, and suggesting cultivating relationships with family and friends who are supportive. The client needs to develop both long- and short-term goals. The client should not focus on anger management, but needs to have anger management outlets.

When providing care to a patient with anxiety, which intervention would be the highest priority?

Exploring appropriate coping strategies Explanation: For the patient with anxiety, the priorities of care include teaching and promoting effective coping abilities and use of relaxation techniques. Improving sleeping patterns, ensuring adequate nutrition, and administering prescribed medications would also be important, but these would not be considered most important.

Which of the following factors are implicated in the development of heart disease?

Frequent activation of the sympathetic nervous system Explanation: Frequent activation of the sympathetic nervous system in persons prone to anger and hostility is a factor implicated in the development of heart disease. Brain pathology is seen as the major factor contributing to mental illnesses called psychobiologic disorders. Results of excess levels of dopamine imply disorganized thought patterns and bizarre behaviors of schizophrenia. Results of imbalances in serotonin imply depression, eating disorders, sleep disturbances, and obsessive-compulsive disorders.

Cellular injury alters the ability of the cell to maintain homeostasis. Which agent can cause fluid and electrolyte imbalance?

Glucose Explanation: Injury is defined as a disorder in steady-state regulation. Any stressor can lead to injury. Large amounts of glucose can cause osmotic shifts. The shift can affect fluid and electrolyte balance.

A client who has had a traumatic experience states that he has no lasting effects from this experience. His wife disagrees. Which of the following will the nurse assess if the wife is correct about the lasting stress?

High blood pressure, palpitations Explanation: Stressors exist in many forms and categories. Stressors are classified as (1 day-to-day frustrations, (2) major complex occurrences involving large groups, and (3) less frequent stressors involving fewer people. The second group influences larger groups, even nations. These include events of history such as terrorism. High blood pressure and palpitations are physiologic responses of stress.

Which term best describes an increase in the number of new cells in an organ or tissue that is reversible when the stimulus for production of new cells is removed?

Hyperplasia Explanation: Hyperplasia is an increase in the number of new cells and occurs as cells multiply and are subjected to increased stimulation resulting in tissue mass enlargement. Hypertrophy is an increase in size and bulk of tissue that does not result from an increased number of cells. Atrophy refers to reduction in the size of a structure after it has achieved full maturity. With neoplasia, the increase in the number of new cells in an organ or tissue continues after the stimulus is removed.

What is the term for an adaptation to environmental stress that occurs when tissue mass enlarges due to cell multiplication and increased stimulation?

Hyperplasia Explanation: Hyperplasia is an increase in the number of new cells in an organ or a tissue. Atrophy is shrinkage in the size of a cell, leading to a decrease in organ size. Dysplasia is a change in the appearance of cells after they have been subjected to chronic irritation. Metaplasia is a cell transformation in which highly specialized cells change to less specialized cells.

A patient has a hemoglobin level of 7 g/dL. What should the nurse be alert to assess for?

Hypoxia Explanation: Inadequate cellular oxygenation (hypoxia) interferes with the cell's ability to transform energy. Hypoxia may be caused by a decrease in blood supply to an area, a decrease in the oxygen- carrying capacity of the blood (decreased hemoglobin), a ventilation-perfusion or respiratory problem that reduces the amount of arterial oxygen available, or a problem in the cell's enzyme system that makes it unable to use oxygen.

The nurse conducting a community educational program on stress is including Lazarus's cognitive appraisal theory. The nurse evaluates that the participants understand the teaching when they state that during primary appraisal, which action occurs?

Identification of the event as stressful Explanation: During primary appraisal, the event is evaluated with respect to what is at stake and results in the situation being identified as either nonstressful or stressful. Evaluation of what might be done occurs during secondary appraisal

When approaching health care holistically, which of the following would the nurse do?

Include physical, emotional, and social elements Explanation: Holistic care involves the promotion of the total health of mind, body, and spirit. This approach integrates the client's physical, emotional, and social elements of health. Complementary and alternative practices are included with holistic health but are not the primary focus. Active participation and capitalizing on the client's personal strengths are part of holistic health. Holistic health includes a balance and integration of traditional medicine and advanced technology in conjunction with the influence of the mind and spirit on healing.

A client has gastroenteritis. He not only has diarrhea and dehydration but also complains of feeling very warm. What systemic response may the client experience with this inflammatory infection?

Increased body temperature Explanation: A systemic reaction occurs throughout the body. Fever is the most common sign of a systemic response to injury. It is caused by the release of pyrogens from neutrophils. This substance influences the hypothalamus and produces a fever

Which condition is a sympathetic-adrenal medullary response to stress?

Increased heart rate Explanation: Increased heart rate is a sympathetic-adrenal-medullary response to stress. Mental confusion, decreased blood glucose levels, and constricted pupils do not occur as part of this response.

A patient comes to the health center reporting headache, backache, and abdominal pain. Further assessment leads the nurse to suspect that the patient has depression based on an understanding of which of the following?

Most patients experiencing depression seek treatment for somatic problems. Explanation: Many people experience depression but seek treatments for somatic complaints such as headache, backache, abdominal pain, fatigue, malaise, anxiety, and decreased desire or problems with sexual functioning. Estimates are that depression is undiagnosed in approximately 50% of cases and masquerades as physical health problems. The patient's reports do not meet the criteria for a diagnosis of depression. Research has not demonstrated a scientific link between depression and pain. Although research has shown links involving neurotransmitters and brain functioning with mental health disorders, this is not the reason for suspecting depression.

A patient with diabetes is admitted to the hospital with a blood sugar level of 320 mg/dL. Why should the nurse monitor fluid intake and output for this patient?

Polyuria results from osmotic diuresis, which is compensatory to hyperglycemia. Explanation: Large amounts of glucose can cause osmotic shifts, affecting the fluid and electrolyte balance and leading to polyuria, or increased urination.

Which of the following would least suggest emotional health?

Realistic sense of hopelessness Explanation: Emotional health is manifested by maintaining a realistic sense of hope as well as by the achievement of personal goals, ability to manage every day challenges and problems, and an acceptance of reality.

Which type of healing occurs when the edges are not approximated and the wound fills with granulation tissue?

Second intention Explanation: In second-intention healing, the edges are not approximated, and the wound fills with granulation tissue. Scar tissue may form, with loss of specialized function. In first-intention healing, the wound edges are approximated as in a surgical wound. In third-intention healing, the wound edges are not approximated, and healing is delayed. Cellular necrosis is part of the inflammatory process

When a person thinks about whether it is possible to do something about a situation, they are exhibiting what type of appraisal?

Secondary Explanation: Secondary appraisal is an evaluation of what might and can be done about a situation. Primary appraisal evaluates a situation with respect to what is at stake. Reappraisal is a change of opinion based on new information. Hardiness is the name given to a general quality that comes from having rich, varied, and rewarding experiences.

The nurse is teaching the Benson relaxation response to a client as a stress reduction technique. What will the nurse teach the client to do?

Select a focus word. Explanation: The nurse should instruct the patient to select a focus word and maintain a passive demeanor. Thinking of a comforting scene is a part of guided imagery. The Benson technique is best used on an empty stomach.

During a family assessment, the mother states, "When I was a child, we always had a special dinner on Christmas Eve, that my mother had when she was a child. Now our family follows the same tradition." The nurse interprets this statement as indicating which family function?

Socialization Explanation: The socialization function involves the family's transmission of culture and acceptable behaviors to perform adequately in the home and the world. The management function of a family involves the use of power, decision-making about resources, establishment of rules, provision of finances, and future planning. Boundary setting makes clear distinctions between the generations and roles of the adults and children. Communication is reflected by the interaction among members. Education and support involves modeling skills for living a physically, emotionally, and socially healthy life; support is indicated by family members feeling cared about and loved.

When assessing a client for manifestations of posttraumatic stress disorder (PTSD), which of the following would the nurse expect to assess? Select all that apply.

Strong startle response Lack of impulse control Nightmares Explanation: Assessment findings associated with PTSD include strong startle response, lack of impulse control, inability to concentrate, heightened vigilance, generalized anxiety, societal withdrawal, nightmares or flashbacks, phobic avoidance reaction (avoidance of activities that arouse recollection of the traumatic event), muscle tension or soreness, and dry mouth.

When caring for a family who is coping with a crisis illness situation, which family function would the nurse identify as being most crucial?

Support Explanation: Family functions include management, boundary setting, communication, education and support, and socialization. Of these functions, support is considered a critical factor in coping with crises and illness situations.

The nurse is caring for a client with hypoxia. What is the nurse's consideration with regard to the client experiencing brain cell death?

The client may have brain cell death in 3 to 6 minutes. Explanation: The length of time that different tissues can survive without oxygen varies. Brain cells may succumb in 3 to 6 minutes, depending on the situation.

An instructor is preparing for a class discussion on family health and the effects of illness on it. Which of the following would the instructor incorporate into the discussion?

The health of the family often affects the family's ability to function. Explanation: Health problems often affect the family's ability to function. Each family responds to illness and crisis in different ways depending on the nature of the health problem, the family structure and usual functioning, developmental stages and coping abilities. The primary focus of care is to maintain and improve the client's present level of health and to prevent physical and emotional deterioration. Then the nurse would intervene in the cycle that the illness creates. Therapeutic interaction, education, positive role modeling, direct care provision and teaching are all important elements to help families deal with the numerous stressors facing them.

A nurse is giving discharge instructions to a client who came to the emergency department following an ankle sprain. The client asks "Why does this hurt so much?" Which response would be most appropriate from the nurse?

The nerves are being stimulated by the pressure from the swelling at the sprain." Explanation: A sprain injury causes a cellular response. The inflammatory response causes pain. The pain that occurs is attributed to the pressure of swelling on nerve endings and to the irritation of nerve endings by chemical release.

The nurse is assessing a postoperative client's surgical incision site. The nurse anticipates which finding?

Wound edge approximated Explanation: Surgical sites heal by first intention. In first-intentional healing, the wound edges are approximated, little scar formation occurs, and the wound heals without granulation tissue. In addition, in first-intentional healing, cell functionality is preserved.

During assessment, a client states, "I don't know why God is punishing me like this." What coping strategy will the nurse offer the client?

a telephone call to a spiritual leader Explanation: Spiritual distress is typically manifested by despair, discouragement, ambivalence, detachment, anger, resentment, or fear. Therefore, the statement about God punishing the client suggests spiritual distress. A telephone call to a spiritual leader is the best response to this sort of statement. A warm shower and offering television are relaxation strategies. A discussion of current events does not meet the needs for spiritual help.

A nurse correctly instructs a client with peripheral vascular disease that stress-reduction techniques:

are helpful because stress stimulates the release of vasoconstricting catecholamines. Explanation: The stress-induced release of vasoactive catecholamines such as epinephrine causes vasoconstriction, which directly aggravates peripheral vascular disease by intensifying the ischemic burden of the affected tissues. Vasoconstriction also indirectly aggravates atherogenesis by inducing hypertension. Stress-reduction techniques make it easier for clients to give up bad habits such as smoking; however, this isn't the only reason they're useful. Client's shouldn't ignore claudication, which is a symptom of muscle ischemia.

The immune system and the brain communicate with each other through the chemical messenger system using neurotransmitters and immunopeptides. Stress impacts the immune system in what way?

can lower the number of white blood cells, the immune system's disease fighters Explanation: Stress can lower the number of white blood cells, the immune system's disease fighters.

A client who is going to have surgery is slightly nervous. What nursing intervention is most important for the nurse to perform?

provide education Explanation: Goals for preoperative teaching include reducing stress and improving the client's coping ability. Giving information reduces the emotional response so clients can concentrate and solve problems more effectively. All the options are appropriate for stress reduction, but educating the client about the surgery is most important at this time.

What is the function of the cerebrum? Select all that apply.

sensory perception memory abstract thought Explanation: The cerebrum is the brain's largest component. It is the basis for abstract thought, which occurs primarily in the frontal lobe; sensory perception, which occurs primarily in the parietal lobe; and memory, which occurs primarily in the occipital lobe. Respiration is controlled in the brain stem.

The nurse is using progressive muscle relaxation with a client to reduce stress. What will the nurse teach the client to do?

tense and relax specific muscles Explanation: During progressive muscle relaxation, the client lies in a quiet room and tenses the muscles of the body one at a time. The client holds the tension and then relaxes. Using weights or bending at the waist does not relax muscles. Imaging a pleasant scene is part of guided imagery.

The nurse is completing a client assessment. What is an effect of the sympathetic division of the autonomic nervous system?

vasoconstriction Explanation: Vasoconstriction is an effect of the sympathetic division of the ANS. It causes increased gastric motility, relaxation of the urinary bladder muscles, and decreased intestinal peristalsis. Increased coagulability of blood occurs with sympathetic division of the ANS.