Adult Nursing - Chapter 6: Individual and Family Homeostasis, Stress, and Adaptation - PrepU
Which of the following would least suggest emotional health?
- Realistic sense of hopelessness
Which type of healing occurs when the edges are not approximated and the wound fills with granulation tissue?
- Second-intention
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."
A nurse is interviewing a client for possible depression. What client statement will most likely reflect clinical depression?
- "My life is worthless, and I don't know why I'm here."
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."
The nurse is instructing a community education class on stress. The nurse asks the participants, "Is all stress bad for you?" Which answer by the participants is most accurate?
- "No, the right amount of stress can be motivating to accomplish goals."
A client with diabetes whose husband recently died reports elevated blood glucose levels. She admits she is barely eating anything; she does not feel hungry. How will the nurse best respond to this client?
- "Often with stress, glucose level increases because the body needs more energy."
A nurse is assessing a patient who has been diagnosed with post-traumatic stress disorder (PTSD). Which statements would the nurse identify as supporting this diagnosis? Select all that apply.
- "Sometimes I feel like I'm looking from outside my body." - "I jump when I hear any loud noise, like a bang." - "I don't understand why I'm still alive when so many others died." - "I keep having nightmares about the incident."
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."
For a person to be clinically depressed, signs of a depressed mood or depressed interest in pleasurable activities must occur for at least
- 2 weeks.
Which of the following responses is most helpful to the client when in an emergency situation?
- A response by the sympathetic nervous system
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.
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.
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 - Despair - Ambivalence
The nurse is caring for a client with an infected surgical incision. Which signs demonstrating systemic inflammatory response does the nurse observe? Select all that apply.
- Anorexia, malaise, and weakness - Loss of appetite and complaints of aching - A febrile state caused by the release of pyrogens
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 judgement?
- Brain cells without oxygen die in approximately 3 to 6 minutes.
A nursing instructor is discussing death and dying with a group of students as part of a clinical conference. Which of the following would the instructor identify as the current cause of most deaths?
- Chronic illness
A nurse assesses that a patient is at increased risk for depression based on which of the following?
- Co-existing medical problems
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
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
Nursing students are reviewing information about depression. The students demonstrate understanding of the information when they state which of the following?
- Depression is commonly underdiagnosed and undertreated.
Which of the following conditions triggers the general adaptation syndrome?
- Distress
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?
Impaired balance and uncontrolled tremors of Parkinson's disease is correlated with which neurotransmitter?
- Dopamine
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
A nurse is developing a plan of care for a patient diagnosed with post-traumatic stress disorder (PTSD). Which of the following would be the priority?
- Establishing a trusting nurse-patient relationship
The nurse is conducting a community education program on stress. The nurse includes which information?
- Excessive stress response increases susceptibility to illness.
Which of the following factors are implicated in the development of heart disease?
- Frequent activation of the sympathetic nervous system
What is the term for an adaptation to environmental stress that occurs when tissue mass enlarges due to cell multiplication and increased stimulation?
- Hyperplasia
When approaching health care holistically, which of the following would the nurse do?
- Include physical, emotional, and social elements
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
After educating a class about depression, the instructor determines that additional class time is needed for teaching when the class identifies which of the following as an indicator of depression?
- Increased concentration
Which condition is a sympathetic-adrenal medullary response to stress?
- Increased heart rate
The nurse is caring for a patient with a fever. Care for this patient should be based on what body responses? (Select all that apply.)
- Increased nutrient catabolism, which influences the body's caloric needs - Increased heart rate, which helps to meet increased metabolic demands - Diaphoresis, which is a compensatory mechanism that cools the body
A nurse is assessing a patient with posttraumatic stress disorder (PTSD) who is exhibiting physiologic manifestations. The nurse interprets these manifestations as being the result of which of the following?
- Increased sympathetic activity
Students are reviewing information about substance abuse and its effects on individuals and families. The students demonstrate understanding of this topic when they identify which of the following?
- Individuals with substance abuse often have difficulty using adaptive behaviors.
Which nursing intervention is required when caring for a client with alcoholism who is diagnosed with Imbalanced Nutrition: Less than Body Requirements?
- Obtain a baseline weight
Which of the following would a nurse least likely assess in a client experiencing anxiety?
- Positive self-talk
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
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
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.
When describing the term "grief" to a group of students, which of the following would the instructor include?
- The response experienced by anyone who has suffered a loss
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
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
A nurse correctly instructs a client with peripheral vascular disease that stress-reduction techniques:
- are helpful because stress stimulates the release of vasoconstricting catecholamines.
What physiologic events may happen in the alarm phase of General Adaptation Syndrome?
- increased sympathetic nervous system stimulation
A client who is going to have surgery is slightly nervous. What nursing intervention is most important for the nurse to perform?
- provide education
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