Stress Questions

7. Which patient response identified by the nurse is unrelated to clinically depressed older adults? 1. Fatigue 2. Disturbed sleep 3. Stress incontinence 4. Activity intolerance

3

A client will be discharged soon after having surgery. After a visit with their spouse and children, the client exhibits signs of regression in their therapy and begins to experience excessive pain and fatigue, stating they don't think they're ready to go home. What should the nurse assess for in this client? 1. Hypochondriasis 2. Pain disorder 3. Malingering 4. Somatization

3

The nurse is caring for a client diagnosed with severe depression. Which statement made by the client should alert the nurse of an increased risk for suicide? 1. "I don't understand why my spouse wants a divorce." 2. "I am going to cancel my plans this weekend." 3. "I have outlived my friends and spouse. There is nothing left for me in life." 4. "I am so unhappy in my life. I have lost my job and my family due to gambling."

3

A newly divorced father of two children reports working full-time and returning to school to obtain a higher degree. He says it is difficult to meet the demands of life. Which role performance difficulty is this client experiencing? 1. Role strain 2. Interrole conflict 3. Role expectations 4. Interpersonal role conflict

1

An older client with a history of congestive heart failure was just admitted to the hospital for chest pain. The patient asks a nurse, "Why did the chest pain begin after I thought someone was trying to break into my house?" What is the nurse's best response? 1. "Fear causes an increase of the body's heart rate and blood pressure, which can place additional stress on your damaged heart and cause chest pain." 2. "Fear causes the parasympathetic system to use all available adrenaline, leaving you so tired that you developed chest pain." 3. "The decrease in the need for oxygen during the fight-or-flight response experienced with fear is most likely the reason that you developed chest pain." 4. "Fear causes an increase in glucose levels, which limits blood flow and causes chest pain."

1

At the end of a meditation session, which physical assessment finding would suggest that the relaxation technique was successful? 1. Decreased blood pressure 2. Decreased peripheral skin temperature 3. Increased respiratory rate 4. Increased bowel motility

1

Evelyn is a 47-year-old who recently lost her husband in a tragic accident. In addition, she is responsible for the daily care of her elderly mother who is suffering with Alzheimer's disease and failing health. Evelyn is in the office experiencing chest pain, extreme fatigue, and shortness of breath. It is discovered she has gained about 10 pounds in a short period of time and has started smoking again after 25 years. What action should the nurse take first? 1. Explore other possible maladaptive coping mechanisms. 2. Determine what is disrupting her mother's health and recommend interventions to help relieve stress. 3. Provide a psychiatric referral to help cope with the death of her spouse. 4. Evaluate Evelyn's past health history to determine if symptoms are typical for her.

1

The nurse is caring for a client who is in the alarm stage of a stress response. Which clinical finding corresponds to the production of aldosterone, antidiuretic hormone, and renin? 1. Decreased urine output 2. Hyperglycemia 3. Decreased peristalsis 4. Increased tidal volume

1

The nurse is working in a mental health clinic and a client states, "My coworker did not do well on our team presentation, and that's why I got fired!" As the nurse documents the findings, what defense mechanism is this client using? 1. Projection 2. Minimization 3. Rationalization 4. Intellectualization

1

The nurse recognizes that a coworker has been working extra shifts and has had several clients die recently. The coworker has made several mistakes when administering medications and is fatigued, forgetful, and preoccupied. What should the nurse do to help prevent burnout in the coworker? 1. Offer support to help with tasks or with their feelings and suggest speaking with a supervisor. 2. Be proactive about the things you can change and accept the things that you cannot change. 3. Join and support professional organizations that address workplace issues. 4. Seek help from others; don't be afraid to ask for help.

1

What is a CAM (complementary and alternative medicine) therapy a nurse can teach the client that involves a heightened awareness of the mind, body, and spirit? 1. Meditation 2. Mindfulness 3. Biofeedback 4. Visualization

1

A client who experienced a traumatic sexual assault is expressing feelings of guilt, embarrassment, and self-blame. What nursing actions would be appropriate for this client? Select all that apply. 1. Establish trust and rapport. 2. Provide strict confidentiality. 3. Do not use judgmental language and tone. 4. Encourage verbalization. 5. Leave alone to process details of event.

1, 2, 3, 4

A client who experienced a traumatic sexual assault is expressing feelings of guilt, embarrassment, fear, and self-blame. What nursing outcomes would be appropriate for this client? Select all that apply. 1. Client will have a resolution of embarrassment, self-blame, guilt, and fear. 2. Client will state the results of the physical examination completed in the emergency department. 3. Client will discuss the need for follow-up crisis counseling and other supports. 4. Nurse will approach the client in a nonjudgmental manner. 5. Nurse will arrange for crisis counseling.

1, 2, 3

A client who has a strong spiritual belief in healing is in the adaptation stage of stress. What practices might this client engage in to reduce stress? Select all that apply. 1. Practice meditation 2. Pray 3. Meet with clergy 4. Get angry and bargain with God 5. Exhibit hostile behavior

1, 2, 3

The school nurse is preparing a presentation to a group of teenagers about how cognitive understanding affects body image. Which norms influence cognitive understanding? Select all that apply. 1. Social 2. Family 3. Cultural 4. Genetic 5. Gender

1, 2, 3

Which are issues a nurse should be aware of when assessing anxiety and ego defense mechanisms? Select all that apply. 1. When used sparingly, defense mechanisms can be helpful. 2. When overused, defense mechanisms become habits that appear as if we are coping. 3. If defense mechanisms are inadequate to diminish perceived threats and restore equilibrium, anxiety disorders may develop. 4. When stressors cannot be controlled, an individual may become apprehensive and respond with anger. 5. If left without intervention, hostility can develop along with destructive behavior.

1, 2, 3

Which disorders place the client at a higher risk for abusing substances? Select all that apply. 1. Mood 2. Conduct 3. Anxiety 4. Neurological 5. Gastrointestinal

1, 2, 3

27. A patient who is withdrawn says, "When I have the opportunity, I am going to commit suicide." What is the best response by the nurse? 1. "You have a lovely family. They need you." 2. "You must feel overwhelmed to want to kill yourself." 3. "Let's explore the reasons you have for wanting to live." 4. "Suicide does not solve problems. Tell me what is wrong."

2

32. Which is the best way for the nurse to support patients' self-esteem needs across the life span? 1. Employing a positive mental attitude 2. Providing a nonjudgmental environment 3. Encouraging social interaction with others 4. Supporting the use of defense mechanisms

2

5. What is an important concept to consider about anxiety to provide appropriate nursing care? 1. Panic attacks generally have a slow onset that can be prevented if identified early 2. One can conceptualize anxiety as being similar to the health-illness continuum 3. People who lead healthy lifestyles rarely experience anxiety 4. Anxiety is an abnormal reaction to realistic danger

2

6. Which word reflects the ability of a person to perceive another person's emotions accurately? 1. Trust 2. Empathy 3. Sympathy 4. Autonomy

2

8. When considering the concepts regarding the defense mechanism of projection, the nurse identifies that the person who fears being taken advantage of usually is: 1. In denial 2. An opportunist 3. Depersonalizing 4. Eager to please others

2

9. A client becomes verbally abusive to the nurse after having an argument with the spouse. Which coping mechanism is this client exhibiting? 1) Reaction formation 2) Displacement 3) Denial 4) Conversion

2

The nurse is caring for an elderly client who is suddenly confused and disoriented. The client is usually alert and oriented to time, place, person, and situation. Which factors should the nurse assess for in the client's health record that could cause this change in mental status? Select all that apply. 1. Age 2. Infections 3. Dehydration 4. Medications 5. Recent loss of a spouse

2, 3, 4

The nurse is preparing to interview a client who reports having problems at work. Which skills should the nurse incorporate into the interview to promote open communication? Select all that apply. 1. Allowing emotions to show 2. Maintaining the focus on the client 3. Incorporating open-ended questions 4. Being respectful of cultural details 5. Being cognizant of self-imposed biases 6. Permitting the client to control the interview direction

2, 3, 4, 5

Which behaviors would the nurse expect to find in a client with dementia? Select all that apply. 1. Inability to concentrate 2. Sleeping a lot during the day 3. Difficulty finding correct words 4. Slow to respond to verbal stimuli 5. Answers questions inappropriately

2, 3, 5

The nurse is working with a client who is working to improve their self-concept. What are the four interrelated components of the process? Select all that apply. 1. Gender 2. Body image 3. Role performance 4. Locus of control 5. Personality 6. Self-esteem

2, 3, 5, 6

When researching the correlation between depression and health-related issues in older adults, what will the nurse find? Select all that apply. 1. Older adults with depression have increased longevity. 2. Older adults with depression report higher rates of physical ailments. 3. Older adults with depression present with greater functional impairments. 4. Older adults with depression have lower suicide rates than younger adults. 5. Older adults with depression tend to use healthcare services more frequently.

2, 3, 6

Which factors work together to form a client's self-concept? Select all that apply. 1. Phobias 2. Beliefs and values 3. Sexual performance 4. Physical appearance 5. Intellectual abilities 6. Problem-solving abilities

3, 4, 5, 6

The nurse is conducting a stress assessment for a client experiencing some life changes. Which questions best determine the client's coping methods? Select all that apply. 1. "What is causing the most stress in your life?" 2. "How long have you been under this stress?" 3. "Tell me how you have handled stressful situations in the past." 4. "Do you have difficulty sleeping?" 5. "What have you been doing to cope with the current situation?"

3, 5

38. A woman with diabetes does not follow her prescribed diet and states, "Everyone with diabetes cheats on their diet." Which defense mechanism does the nurse identify this patient has used? 1. Rationalization 2. Sublimation 3. Undoing 4. Denial

1

1. A patient with a terminal illness tells the nurse, "I have lived a long life. I am ready to go." What is the nurse's best response? 1. Sit quietly by the bedside 2. Offer the patient a back rub 3. Tell the family about the patient's statement 4. Initiate a discussion of how dying is part of the life cycle

1

11. Which defense mechanism is being used when a patient who has just been diagnosed with terminal cancer calmly says to the nurse, "I'll have to get on the Internet to assess my options?" 1. Intellectualization 2. Introjection 3. Depression 4. Denial

1

13. At the end of an imagery session, which physical assessment finding suggests that the relaxation technique was successful? 1) Decreased blood pressure 2) Decreased peripheral skin temperature 3) Increased heart rate 4) Increased respiratory rate

1

14. The nurse identifies which defense mechanism is being used when an adolescent who is a poor student excels in sports? 1. Projection 2. Sublimation 3. Displacement 4. Compensation

1

20. A patient strongly states the desire to go to the hospital coffee shop for lunch regardless of hospital policy. What does the nurse conclude that this behavior most likely reflects? 1. The need to regain some measure of control 2. Anger with the policies of the hospital 3. Disappointment with hospital food 4. A desire for a change of scenery

1

22. The physician informs a patient that the diagnosis is inoperable cancer and the prognosis is poor. After the physician leaves the room, the patient begins to cry. What should the nurse do? 1. Touch the patient's hand to provide support 2. Leave the room to give the patient privacy to cry 3. Telephone the patient's family to inform them of the diagnosis 4. Ask the patient questions to encourage a ventilation of feelings

1

3. A man with a heart condition continues to perform strenuous sports against medical advice. Which defense mechanism does the nurse identify the patient is using? 1. Denial 2. Repression 3. Introjection 4. Dissociation

1

33. The nurse identifies that a patient is mildly anxious. The nurse understands that when a patient is mildly anxious the patient may appear: 1. Alert 2. Fearful 3. Forgetful 4. Preoccupied

1

4. What is the function of antidiuretic hormone when released in the alarm stage of the general adaptation syndrome? 1) Promotes fluid retention by increasing the reabsorption of water by kidney tubules 2) Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle 3) Increases the use of fats and proteins for energy and conserves glucose for use by the brain 4) Promotes fluid retention by causing the kidneys to reabsorb more sodium

1

7. A patient who has been hospitalized for weeks becomes angry and says, "I hate this place; nobody knows how to take care of me or I'd be home by now." Which response by the nurse is best in this situation? 1) "You seem angry; what's going on that makes you hate this place?" 2) "I'm sorry that we aren't caring for you according to your expectations." 3) "You were very sick; don't be angry; you're lucky to be alive." 4) "You shouldn't be angry with us; we're trying to help you."

1

Which is an effect of vascular response in inflammation? Select all that apply. 1. Hyperemia 2. Edema 3. Release of kinin 4. Exudate formation 5. Leukocytes move to the area

1, 2, 5

9. What is the consequence when the nurse denies a patient the use of a defense mechanism? 1. Damages the Id 2. Causes more anxiety 3. Facilitates effective coping 4. Encourages emotional growth

2

A client states, "I am so angry that my father gave me depression. It's all his fault that I am in the hospital right now." The nurse knows which theory is related to this statement?

Physiological theory

A nurse admitted a client diagnosed with depression and suicidal ideation 2 days ago. Which new finding is the greatest concern?

The client becomes happy and wants to be discharged as soon as possible.

A client is admitted to the hospital after suffering a stroke. They have been able to manage their home and self-care independently but now are unable to speak clearly, are paralyzed, and become frustrated as they attempt to communicate their needs. What stressor is most concerning for them as they enter the hospital? 1. Loss of privacy and control 2. Possible loss of family support while an inpatient 3. Fear of other clients in the hospital 4. Loneliness

1

Which localized physiological response would the nurse anticipate a client may experience during an intravenous insertion? 1. Reflex pain response 2. Inflammatory response 3. Fight-or-flight response 4. General adaptation syndrome

1

What can a nurse do during the assessment process to help a client focus who is experiencing post-traumatic stress disorder? Select all that apply. 1. Ask short, direct questions. 2. Ask open-ended questions as client begins to give more detail. 3. Demonstrate empathy and develop a rapport. 4. Recognize and relieve the immediate stressor. 5. Recognize future stressors through assessment.

1, 2, 3, 4

25. A client complains about not having enough time to complete work responsibilities and take care of family activities. What should the nurse suggest to this client? Select all that apply. 1) Set boundaries 2) Learn to say no 3) Make a to-do list 4) Delegate responsibilities 5) Schedule time for exercise

1, 2, 3, 4, 5

23. An older patient is tearful, shaky, and withdrawn and admits to worrying about losing her aging spouse. Why should the nurse recognize this patient's reaction as being Anxiety instead of Fear? Select all that apply. 1) It concerns future or anticipated events. 2) It concerns anticipation of danger rather than a present danger. 3) There is no shakiness or tearfulness present. 4) There is a psychological rather than a physical threat. 5) The source can be identified.

1, 2, 4

A 44-year-old female client who was just admitted states, "I must be under too much stress at work and home. I just do not feel well." Which physical findings are consistent with the client's statement? Select all that apply 1. Blood pressure is 178/96 mm Hg. 2. Palms of her hands are sweaty. 3. Pupils are constricted and reactive to light. 4. Legs are continually moving in the bed. 5. Mucous membranes are dry.

1, 2, 4, 5

An older adult is tearful, shaky, withdrawn, tachycardic, and sleepless. She tells you that she is "worrying herself to death" about losing her aging husband and being "all alone." Which statement can be made about this anxiety reaction? Select all that apply. 1. It concerns future or anticipated events. 2. It concerns anticipation of danger rather than a present danger. 3. Her symptoms are emotional and not physical. 4. There is a psychological rather than a physical threat. 5. She lacks adaptive coping mechanisms.

1, 2, 4, 5

A nurse is differentiating between the physiological and psychological responses to anxiety. Which statements by the client indicate a physiological reaction? Select all that apply. 1. Number of Options 2. "My heart feels like it's racing all the time." 3. "I don't know why my speech is so rapid." 4. "I wish I could have something for this diarrhea." 5. "My wife complains how irritable I am all the time." 6. "When I drive in the car, I start to hyperventilate." 7. "I have a difficult time falling asleep."

1, 2, 4, 6, 7

The nurse is conducting an educational session on stress with a group of business administrators. Which type of stressors would most likely be problems for this population? Select all that apply. 1. Time stressors 2. Home-life stressors 3. Situational stressors 4. Anticipatory stressors 5. Physiological stressors

1, 3, 4

What does the nurse know is true about depression? Select all that apply. 1. Depression is more common in women. 2. Once depression is cured, it does not return. 3. Depression is associated with low socioeconomic status. 4. Medication is the answer for those with depression. 5. Spiritual anguish has been noted in clients with depression.

1, 3, 5

40. Anxiety can progress through levels of severity from mild to panic. The patient's level of anxiety will influence how the nurse approaches the patient situation. Place these patient statements in order as anxiety progresses from mild, to moderate, to severe, and finally to panic. 1. "I want to know more about the surgery I am having tomorrow." 2. "I don't think I am going to make it through the surgery tomorrow." 3. "I can't concentrate and all I think about is the pain I may have tomorrow." 4. "I get butterflies in my stomach when I think about the surgery tomorrow."

1, 4, 3, 2

39. When the nurse analyzes a patient's statements, which statements best reflect the dimensions of self-esteem? Select all that apply. 1. _____ "I really like the me that I see." 2. _____ "What do I want to achieve?" 3. _____ "How do I appear to others?" 4. _____ "I like to do things my way." 5. _____ "I'm OK, you're OK."

1, 5

13. A patient is told that surgery is necessary and the patient begins to experience elevations in pulse, respirations, and blood pressure. What stage of anxiety is indicated by these nursing assessments? 1. Mild 2. Moderate 3. Severe 4. Panic

2

21. The nurse is teaching a patient about the positive effects of exercise to reduce anxiety. The nurse evaluates that the information is understood when the patient says, "Exercise reduces anxiety by: 1. Interfering with the ability to concentrate." 2. Stimulating the production of endorphins." 3. Reducing the metabolism of adrenaline." 4. Decreasing the acidity of blood."

2

29. After being hospitalized for a surgical procedure, a patient who was impressed with the care received from the nurses decides to change careers and become a nurse. What is this an example of? 1. Fantasy 2. Projection 3. Identification 4. Intellectualization

3

30. The nurse is caring for several patients with emotional needs. What is the most common cause of anxiety that the nurse should consider when collecting information from these patients? 1. Identifiable fears 2. Unexpected events 3. Threats to ego integrity 4. Anticipated dependence

3

37. When assessing a patient for anxiety, the nurse determines that anxiety is a: 1. Reaction triggered by a known stressor 2. Response that is avoidable 3. Universal experience 4. Threat to the id

3

14. The nurse is caring for a patient with unresolved anger. For which associated complication should the nurse assess? 1) Depression 2) Hypochondriasis 3) Somatization 4) Malingering

1

15. Before entering the room of a patient who is angry and yelling, the nurse removes her stethoscope from around her neck. Why did the nurse perform this action? 1) Could be used by the patient to hurt her 2) Might cause the patient not to trust her 3) Would distract her from focusing on the patient 4) Will function as another stressor for the patient

1

18. During an assessment, the nurse suspects that a client utilizes maladaptive coping methods to handle stress. What did the nurse assess in this client? 1) Drinks with friends after work 2) Attends a poetry class at the library 3) Runs in the park several times a week 4) Tends a vegetable garden in the summer

1

20. The nurse suspects that a client is overusing a defense mechanism. What behavior did the client demonstrate to the nurse? 1) Criticized spouse for health problems 2) Requested strategies to prevent overeating 3) Asked for information about a prescribed medication 4) Discussed ways to react when an adolescent daughter acts out

1

3. The nurse cares for a patient who suddenly experiences a cardiac arrest. As the nurse responds to the emergency, which substance in the nurse's body will be secreted in large amounts to help the nurse react in this situation? 1) Epinephrine 2) Corticotrophin-releasing hormone 3) Aldosterone 4) Antidiuretic hormone

1

35. The nurse is assessing a patient who is fearful. Fear is most commonly experienced when the precipitating cause is: 1. Life-threatening 2. Unexpected 3. Recurrent 4. Unknown

1

36. A patient expresses a sense of hopelessness. Which concern identified by the nurse is the priority? 1. Risk for self-harm 2. Inability to cope 3. Powerlessness 4. Fatigue

1

6. A patient complains of a vague, uneasy feeling of dread, and has an elevated heart rate. Which nursing diagnosis is most appropriate for this patient? 1) Anger 2) Fear 3) Anxiety 4) Hopelessness

3

26. Which is the most appropriate inference made by the nurse when a patient says, "I'm the same age as my father when he died. Am I going to die of my cancer?" What is the patient experiencing? 1. Grieving associated with perceived impending death 2. Fear associated with perceived threat to biological integrity 3. Powerlessness associated with feelings of being out of control 4. Impaired coping associated with inadequate psychological resources

2

A client begins experiencing chest pain off and on for a few days and continues to work without seeking medical attention. Which response to stress is this client demonstrating? 1. Altering the stressor 2. Avoiding the stressor 3. Analyzing the stressor 4. Adapting to the stressor

2

A client has just learned of the loss of a close friend. She tells others that she is fine when asked and everything will be all right. Which phase of crisis is she experiencing? 1. Adaptive 2. Precrisis 3. Impact 4. Crisis

2

A client in a group setting begins to kick a trash can and yell at other clients. Which behavior would the nurse note in the client's medical record? 1. Anger 2. Hostility 3. Depression 4. Defense mechanisms

2

A client is discussing an extended family-related conflict with the nurse and states they are tired of the problem and do not participate in family get-togethers because of it. Which ego defense mechanism will the nurse document that the client is using? 1. Denial 2. Avoidance 3. Projection 4. Displacement

2

A nurse is reviewing the various theories of depression. What are the causes of psychodynamic depression? 1. Biochemical, hormonal, and genetics 2. Loss, abandonment, and emotional detachment 3. Negative thinking 4. Poor family relationships and socioeconomic factors

2

The nurse is caring for a client with severe anxiety. When assessing the client, what should the nurse do when asking questions? 1. Ask open-ended questions. 2. Ask simple and direct questions. 3. Avoid asking questions until the anxiety subsides. 4. Postpone questions until the client can offer information

2

Which client is using conversion as a defense mechanism? 1. A client who wishes to be a singer but becomes a football player 2. A client who is overwhelmed with stress and experiences nausea and vomiting 3. A client who lost a spouse and states they know the spouse is in a better place and no longer in any pain 4. A client who has always wanted to be a police officer but cannot pass the test and becomes a security guard

2

22. Two days after a patient undergoes abdominal surgery, the surgical incision is red and slightly edematous; it is oozing a small amount of serosanguineous (pink-tinged serous) fluid. On the basis of these data, what can the nurse conclude? Select all that apply. 1) The wound is most likely infected. 2) This is a vascular response to inflammation. 3) Damaged cells are being regenerated. 4) Exudate formation is occurring. 5) The wound is beginning the repair process.

2, 4

21. During the alarm stage of the general adaptation syndrome, which metabolic change occurs? Select all that apply. 1) Rate of metabolism decreases. 2) Liver converts more glycogen to glucose. 3) Use of amino acids decreases. 4) Amino acids and fats are more available for energy. 5) The brain uses more glucose for energy.

2, 4, 5

1. When released in response to alarm, which substance promotes a sense of well-being? 1) Aldosterone 2) Thyroid-stimulating hormone 3) Endorphins 4)Adrenocorticotropic hormone

3

11. The nurse identifies the nursing diagnosis Diarrhea related to stress for a patient. Which nursing intervention should be included in the nursing care plan to help the patient relieve the cause of the diarrhea? 1) Monitor and record the frequency of stools on the graphic record. 2) Administer prescribed antidiarrheal medications as needed. 3) Encourage the patient to verbalize about stressors and anxiety. 4) Provide oral fluids on a regular schedule.

3

12. A person addicted to alcohol says to the nurse, "I just drink a little to help me relax after a hard day at work." Which defense mechanism is the patient using? 1. Substitution 2. Suppression 3. Rationalization 4. Intellectualization

3

12. When counseling a patient about behaviors to reduce stress, which goal should the nurse put on the care plan? 1) "The patient will limit his intake of fat to no more than 15% of the daily calories consumed." 2) "The patient will eat three meals per day at approximately the same time each day." 3) "The patient will limit his intake of sugar and salt, as well as sweet and salty foods." 4) "The patient will consume no more than three alcoholic beverages a day."

3

17. To provide the most effective psychosocial support, which data are the most helpful to the nurse? 1. Progress notes 2. Medical history 3. Patient concerns 4. Family contributions

3

18. A preoperative patient is anxious about pending elective surgery. Which is the best way for the nurse to help the patient reduce the anxiety? 1. Involve significant others 2. Use distraction techniques 3. Foster verbalization of feelings 4. Use progressive desensitization strategies

3

19. The nurse concludes that a woman is remembering only the good times after the death of her husband. What defense mechanism is the woman using? 1. Compensation 2. Minimization 3. Repression 4. Regression

3

2. After sustaining injuries in a motor vehicle accident, a patient experiences a decrease in blood pressure and an increase in heart rate and respiratory rate despite surgical intervention and fluid resuscitation. Which stage of the general adaptation syndrome is the patient most likely experiencing? 1) Alarm 2) Resistance 3) Exhaustion 4) Recovery

3

2. Which word reflects a concept that is nonessential for the nurse to establish a therapeutic relationship? 1. Trust 2. Caring 3. Control 4. Empathy

3

28. A dying patient is withdrawn and depressed. Which nursing action is most therapeutic? 1. Assisting the patient to focus on positive thoughts daily 2. Explaining that the patient still can accomplish goals 3. Accepting the patient's behavioral adaptation 4. Offering the patient advice when appropriate

3

The nurse is presenting a workshop on stress and adaptation to a group of teenagers. A teenager approaches the nurse and says, "Sometimes I feel stressed when I have to take a test. I feel my heart is going faster and I have a hard time focusing. I'm scared I'm going to fail. Do you think that is normal?" What is the most appropriate response by the nurse? 1. "As long as you are getting through the test, I think you will be just fine." 2. "A little stress is not necessarily a bad thing. It can help you to focus." 3. "You may need to develop some additional stress-reducing activities." 4. "I think you should talk to your teacher about getting accommodations for testing."

3

10. A patient who has been diagnosed with breast cancer decides on a treatment plan and feels positive about her prognosis. Assuming the cancer diagnosis represents a crisis, this patient is most likely experiencing which phase of crisis? 1) Precrisis 2) Impact 3) Crisis 4)Adaptive

4

10. Which nursing intervention best supports a patient's sense of self? 1. Referring to counseling services 2. Exploring maladaptive responses 3. Verbalizing realistic expectations 4. Maintaining respectful interactions

4

15. Which nursing action best demonstrates support of human dignity in the practice of nursing? 1. Maintaining confidentiality of information about clients 2. Supporting the rights of others to refuse treatment 3. Obtaining sufficient data to make inferences 4. Staying at the scene of an accident

4

16. A patient is in crisis. After assessing the situation, what should the nurse do first? 1) Determine the imminent cause of the crisis. 2) Intervene to relieve the patient's anxiety. 3) Decide on the type of help the patient needs. 4) Ensure the safety of both the nurse and patient.

4

16. The nurse identifies that a patient who has diabetes continues to eat foods with a high glycemic index. What defense mechanism is being used by the patient? 1. Intellectualization 2. Introjection 3. Regression 4. Denial

4

17. The nurse suspects that a client is experiencing stress. What finding did the nurse use to make this clinical determination? 1) Works a full-time job 2) Goes to the gym three times a week to work out 3) Spouse takes care of the children when grocery shopping 4) Expresses a lack of time to waste at a healthcare appointment

4

19. A client demonstrates a cognitive response to stress. What observation caused the nurse to make this clinical decision? 1) Skipping meals 2) Avoiding talking with others 3) Sleeping late into the morning 4) Forgetting where medications are stored

4

23. Which might a patient be at risk for in the psychosocial domain when the nursing assessment indicates that the patient is almost completely paralyzed? 1. Infection 2. Self-harm 3. Constipation 4. Powerlessness

4

24. The nurse determines that the situation that stimulates the greatest anxiety for most people is: 1. Accepting assistance from nonfamily members 2. Arranging for home care before discharge 3. Carrying out self-care activities when ill 4. Managing uncertainty about an illness

4

25. The nurse is caring for a patient who is scheduled for intravenous chemotherapy for cancer. Which defense mechanism is being used when the patient says to the daughter, "Be brave"? 1. Rationalization 2. Minimization 3. Substitution 4. Projection

4

31. Which situation identified by the nurse reflects the defense mechanism of displacement? 1. A woman is very nice to her mother-in-law whom she secretly dislikes 2. A man says that he is not so bad, so don't believe what they say about him 3. An adolescent puts a poor grade on a test out of her mind when at her after-school job 4. An older man gets angry with friends after family members attempt to talk with him about his illness

4

34. What is the underlying basis of all the defense mechanisms? 1. Compensation 2. Suppression 3. Regression 4. Repression

4

4. The nurse is caring for a patient with a comprehension deficit. What should the nurse do to best support this patient? 1. Ask that unclear words be repeated 2. Speak directly in front of the patient 3. Make a referral for a hearing evaluation 4. Establish structured activities of daily living

4

5. A patient sustains a laceration of the thigh in an industrial accident. Which step in the inflammatory process will the patient experience first? 1) Cellular inflammation 2) Exudate formation 3) Tissue regeneration 4) Vascular response

4

8. The family member of a client with numerous physiological complaints tells the nurse that the client is pretending to be sick to avoid going to work. Which somatoform disorder is this patient most likely experiencing? 1) Hypochondriasis 2) Somatization 3) Somatoform pain disorder 4) Malingering

4

A client states, "I am so angry that my father gave me depression. It's all his fault that I am in the hospital right now." The nurse knows which theory is related to this statement? 1. Psychodynamic theory 2. Cognitive theory 3. Social/environmental theory 4. Physiological theory

4

Which is an example of abnormal anxiety? 1. Being startled by a snake when gardening 2. Being scared of driving across a high bridge 3. Feeling nervous before meeting new people 4. Choosing to drive long distances due to fear of a plane crash

4

Which somatoform disorder would the nurse expect to find in the medical record of a client who is constantly fearful of becoming ill? 1. Malingering 2. Pain disorder 3. Somatization 4. Hypochondriasis

4

Which stage of general adaptive syndrome (GAS) would a client be in if they were failing to adapt to the point where exhaustion will occur if left unresolved? 1. Alarm 2. Recovery 3. Adaptive 4. Resistance

4

24. After an assessment, the nurse realizes that a client demonstrates cognitive responses to stress. What behaviors did the client demonstrate for the nurse to make this clinical determination? Select all that apply. 1) Angry 2) Lethargic 3) Irritable 4) Preoccupied 5) Decreased attention to detail

4, 5

Hide A client is in the ICU and has been diagnosed with delirium. What priority action should the nurse take?

Provide adequate nutrition and hydration