2200 - Stress

Which question would be helpful in eliciting data about the effects of stress during a health history?

"How does your body feel when you are upset?"

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

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

An adolescent client is brought to the clinic by the parents, who inform the nurse that they are concerned that the adolescent is using maladaptive coping mechanisms to deal with a bullying issue at school. Which statement(s) by the parents should the nurse report to the health care provider as correlating with the use of maladaptive coping mechanisms? Select all that apply.

"Our adolescent is sleeping a lot more than usual." "We have tried to discuss the issues so we can find a solution but are met with anger and hostility." "We have found evidence of drug use, which is very unlike our adolescent."

The emergency department nurse suspects that an older adult client who fell and broke her hip is using a defense mechanism when the client states:

"They must have given me the wrong medication at the drug store. I don't have trouble with my eyesight."

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

7 years

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

Anticipatory guidance

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

Anticipatory guidance

Which illness has been associated with long-term stress?

Cardiovascular disease

Which outcome(s) will the nurse include in the plan of care for a client experiencing caregiver role strain? Select all that apply.

Client will demonstrate appropriate coping strategies. Client will identify support mechanisms to help with stress. Client will identify one or two stressors to eliminate.

If a nurse assessed the vital signs of a person who was in the initial alarm reaction stage (shock phase) of the general adaptation syndrome, what would be the expected findings?

hypertension

A nurse assigned to a newly admitted client realizes that the client finds the facility environment extremely stressful. What would be most appropriate for the nurse to do to decrease sensory stimulation of the client?

Keep down the conversational noise in the hallway.

An individual steps into a tub of very hot water and immediately jumps out again. What mechanism caused this response?

Reflex pain response

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

Resistance

A friend has lost her job and is becoming increasingly anxious to the point of crisis. What type of crisis is she experiencing?

Situational

A client has been brought to the health care facility with accident-related injuries. During the initial interview, the client becomes agitated and upset and is unable to answer any more of the nurse's questions. What does the nurse conclude about the condition of the client?

The client's mind is preparing for a fight-or-flight response as he relates the incident.

The nurse is caring for two clients on the same unit. One client states that cold temperatures and loud noises are stressors. The other client says the temperature is fine and the noises do not bother him. What is the difference between the two clients related to these stressors?

The perception and effects of stressors are highly individualized.

Which scenario describes an example of developmental stress?

a middle adult accepting signs of aging

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

alcohol use

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

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

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?

compensation

A group of nursing students is reviewing Lazarus's scale of everyday hassles. The students demonstrate understanding by ranking the items below from most stressful to least stressful. Place the items as the students would rank them.

concern about weight worry about rising cost of living losing things worry about crime concern about physical appearance

A young mother tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior?

coping mechanism

A client who responds to bad news concerning laboratory results by crying uncontrollably is handling stress by using:

coping mechanism.

The client is under immediate stress. The nurse assesses which sign as an effect of the sympathetic system?

heart rate of 102 bpm

A 65-year-old client has experienced the death of a parent and a family pet in the span of 1 month. Which action is a coping mechanism that demonstrates adaptation?

joining the local garden club

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

limit the family visits to once daily

In evaluating the therapeutic outcome of using biofeedback to help a client work through a stressful situation, the nurse would expect the client to:

maintain vital signs within normal limits.

A client who is a drug addict visits a health care facility for treatment. During counseling, he discloses that he took to drugs because it helped him deal with stressful situations. The nurse explains that he is not using the correct coping strategy to overcome his stress-related problems. What kind of strategy has the client used in this case?

nontherapeutic coping strategy

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

provide care transition at discharge for speech therapy

A new graduate is having difficulty coping with the role transition from student to registered nurse (RN). Which defense mechanism is being exhibited when the nurse states, "I hate going in to work on weekends. The aides are lazy, the clients are all complaining, and the families are all crazy!"

reaction formation

The client is a child age 5 years hospitalized for a surgical procedure. The client is bedwetting. The parents report this is a new behavior and their child is toilet trained. The nurse assesses the client is exhibiting the defense mechanism of:

regression.

A nurse teaches a client deep-breathing exercises to help control his anxiety. This is considered what type of stress management technique?

relaxation

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

repression

A client visits a health care facility reporting work-related stress that alters his mood when he comes home. The nurse suggests that the client make changes to his home décor to include vibrant colors and bright lighting, and listen to soothing music when he returns home. Which stress-reducing technique is the nurse following in this case?

sensory manipulation technique

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

sit with the client and ask them about their feelings

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

social support

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

sympathetic nervous system

Which group of terms best describes anxiety?

unknown cause, emotional, apprehensive