Ch 10 - Stress Responses and Stress Management

Which statement by a patient who has been taught cognitive reframing indicates that the teaching was successful? a. "I can be successful if I do all the things required to learn the job." b. "I can never learn all there is to know for the job." c. "I do not have the ability to handle that job." d. "I may be fired from the job but eventually I will find something else to do with my life."

"It can be successful if I do all the things required to learn the job." Cognitive reframing changes the individual's perceptions of stress by reassessing a situation and replacing irrational beliefs with more positive self-statements. The other options are all negative cognitive distortions that would prevent the individual from success.

Which assessment monitors the effect of stress attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex? a. Blood glucose levels b. Brain norepinephrine c. Triglycerides d. Heart rate

Blood glucose levels An increase in gluconeogenesis, stimulated by the release of cortisol, ensures that increased amounts of glucose are available to the individual. Increased glucose levels heighten and maintain energy levels to meet the demands of a crisis or stressor. None of the other options are as directly associated with the hypothalamus-pituitary-adrenal cortex.

The first stage of the general adaptation syndrome (GAS) can be characterized by which response? Fight or flight Exhaustion Eustress Resistance

Fight or flight The initial adaptive response of the general adaptation syndrome prepares the individual to fight or flee in the face of acute stress. None of the other options are associated with the initial stage of GAS.

Which approach to reducing client stress is most effective for children experiencing postoperative pain? Guided Imagery Meditation Breathing exercises Journal keeping

Guided Imagery With guided imagery people are taught to focus on pleasant images to replace negative or stressful feelings. This focus diverts a person from less positive thoughts or obsessions, resulting in a refreshed outlook. It is especially useful for children experiencing pain and anxiety. The other options may be too complicated for a child to master effectively.

What tool should the nurse use in assessing the amount of stress a client has experienced in the past year? Life-Changing Event Questionnaire NANDA Handbook DSM-IV-TR Quick Mental Status Assessment

Life-Changing Event Questionnaire This questionnaire calls for the client to review events of the past year and score each. This is the only tool listed that assesses stress.

Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex. Which assessment finding would confirm the long-term effects of such stress? (Select all that apply.) Chronic muscle tension Obesity Insulin resistance Digestive problems A high resting heart rate

Obesity and insulin resistance Insulin resistance and obesity are considered long-term sequelae of the high blood glucose levels incurred when the body responds to stress. None of the other options are related to the hypothalamus-pituitary-adrenal cortex.

The relaxation response calls upon the initiation of what process? Increased cortisol production by the adrenals Brainstem deactivation Parasympathetic activation Sympathetic activation

Parasympathetic activation Sympathetic activation prepares the individual for the fight-or-flight response. Parasympathetic activation has the opposite effect. None of the other options would bring about relaxation.

Self-help groups are useful for reducing stress because they provide the individual with the stress mediator that take what form? Cognitive reframing Cultural support Social support Life satisfaction

Social support Self-help groups often provide a high level of social support. Members meet and are encouraged and sustained by others who share the same problem. None of the other options are expected to be provided by the self-help group format.

What factor exerts the greatest influence on the degree to which various life events upset a specific individual? a. The effect of the individual's health-sustaining behaviors b. The individual's degree of spirituality c. The individual's perception of the event d. The amount of social support available to the individual

The individual's perception of the event Researchers have looked at the degree to which various life events upset specific individuals. They have found that the perception of a recent life event determines the person's emotional and psychological reactions to it. While the other options may be factors none contribute to the degree of stress than one's perception of the stressor.

What are the physiologic responses associated with successful guided imagery? Select all that apply. a. Reduction of obsessive thoughts b. Reduction of anxiety c. Increase in appetite d. Improved sleep patterns e. Reduction of muscle pain

a. Reduction of obsessive thoughts b. Reduction of anxiety d. Improved sleep patterns With guided imagery people are taught to focus on pleasant images to replace negative or stressful feelings. This focus diverts a person from less positive thoughts or obsessions and decreases anxiety or insomnia. Patients have successfully used progressive muscle relaxation to reduce pain-related distress. Guided imagery is not known to directly increase appetite.

A patient admitted with anxiety asks, "What exactly are stressors?" What is the nurse's best response to the patient's question? a. "Instead of focusing on what stressors are, let's explore your coping skills." b. "Stressors are events that happen that threaten your current functioning and require you to adapt." c. "Stressors are complicated neuro stimuli that cause mental illness." d. "It's best if you ask questions like that of your provider for a complete answer."

b. "Stressors are events that happen that threaten your current functioning and require you to adapt." Stressors are psychological or physical stimuli that are incompatible with current functioning and require adaptation. Stressors are not complicated neuro stimuli; telling the patient to address these questions to her provider fails to educate the patient, which is the nurse's responsibility. Exploring coping skills would be a good intervention at a later time but does not address the patient's question and changes the subject.

Which client behavior illustrates eustress? a. A man is laid off from his job. b. A bride is planning for her wedding. c. An adolescent gets into a fight at school. d. A college student fails an exam.

b. A bride is planning for her wedding. Eustress is the result of a positive perception toward a stressor, such as having a baby, planning a wedding, or getting a new job. The other options all describe distress, or a negative energy.

What would a client experience during a progressive relaxation session? a. Having a nurse enter the client's energy field to rebalance it and bring harmony b. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed c. Being attached to a machine that monitors a physical parameter and receiving audible feedback about the state of that parameter d. Being led into a positive imaginary sensory experience

b. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed Instruction on sequential tensing and relaxing muscles provides a description of Benson's method of progressive relaxation. Being attached to a machine that uses sound describes biofeedback. Rebalancing an energy field describes therapeutic touch. Positive imaging describes a component of guided imagery.

A client, whose friend recently committed suicide, asks the nurse about some ways to help cope with the stress regarding the event. Which option should the nurse discuss with the client? a. Isolation for a short time so that the pain isn't reinforced by explaining her feelings over and over b. Talking with friends and attending a loss support group c. Starting a hobby to keep her mind off the troubling event d. Antianxiety medication to help her relax

b. Talking with friends and attending a loss support group

A client diagnosed with hypertension uses an automatic cycling blood pressure cuff with audible changing tones. The client uses relaxation techniques to lower her blood pressure and is informed of her ongoing success by the tone. This process describes this technique? guided imagery. therapeutic touch. biofeedback. assertiveness training.

biofeedback. Biofeedback is a technique for gaining conscious control over unconscious processes. The scenario describes one method that might accomplish this.

Jacob, a college student whose friend recently committed suicide, rates his stress as low. Melissa was also friend with the person who committed suicide, but she rates her stress as high. The difference in how Jacob and Melissa rate their stress may be explained by which coping mechanism? a. Projection b. Denial c. Perception d. Repression

c. Perception Perception, which is influenced by gender, culture, age, and life experience, plays a part in how someone will respond to a stress. The perception of a stressor determines the person's emotional and psychological reactions to it. The other options are all defense mechanisms that do not explain the difference in reactions to a stressor.

A nurse teaches a client a technique for examining negative thoughts and restating them in positive ways. What term is used to identify this technique? cognitive reframing Guided imagery wishful thinking confrontational assertion

cognitive reframing Cognitive reframing calls for changing the viewpoint of a situation and replacing it with another viewpoint that fits the facts but is less negative. That description does not apply to any of the other options.

What stress-reduction technique should a nurse teach an individual experiencing severe performance anxiety? deep breathing. journal keeping. restructuring and setting priorities. assertiveness.

deep breathing. Changing the breathing pattern can be highly effective in aborting or mitigating the high anxiety level associated with performance anxiety. None of the other options are typically associated with anxiety management.

Meditation is successful in promoting stress reduction because it brings about which outcome? Prevents endorphin release quiets the sympathetic nervous system changes the client's energy field activates the parasympathetic nervous system

quiets the sympathetic nervous system Sympathetic nervous system stimulation prepares the body for fight or flight in response to stress. Meditation reduces this state of alert by eliciting a relaxation response by creating a hypometabolic state of quieting the sympathetic nervous system. None of the other options accurately describe the process.