ch10

Which interventions will the nurse include in the plan of care of a patient diagnosed with generalized anxiety syndrome (GAS) resulting from stress? Select all that apply. Correct 1 Going to sleep 30 minutes earlier than usual. 2 Getting up 30 minutes later each morning. Correct 3 Including 30 minutes of exercise into your daily routine three days a week. 4 Including some form of exercise about 30 minutes before going to bed. Correct 5 Listening to soothing music to increase relaxation.

1 Going to sleep 30 minutes earlier than usual. 3 Including 30 minutes of exercise into your daily routine three days a week. 5 Listening to soothing music to increase relaxation.

The difference in how various individuals rate their stress may be explained by which concept? 1 Projection 2 Denial 3 Perception 4 Repression

3 Perception

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

A. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed

The relaxation response calls upon A. sympathetic activation. B. parasympathetic activation. C. brainstem deactivation. D. increased cortisol production by the adrenals.

B. parasympathetic activation.

Over a five-year period, an adult experienced liver failure. A liver transplant was performed. During the immediate postoperative period, which intervention could the nurse recommend to enhance healing and reduce the harmful effects of stress? 1 Aerobic exercise Correct 2 Listening to music 3 Attending a support group 4 Occasional chocolate treats

Correct 2 Listening to music

A nursing student learns that corticosteroids are released in response to stress. What are the consequences of increased levels of corticosteroids in the body? Correct 1 Increase in muscle endurance 2 Increase in digestive process 3 Increase in immunity level 4 Increase in reproductive function

1 Increase in muscle endurance

A nurse is caring for a patient diagnosed with tension headaches. Which technique does the nurse teach the patient to relieve tension headaches? Correct 1 Progressive muscle relaxation 2 Relaxation response 3 Cognitive reframing 4 Deep breathing exercise

1 Progressive muscle relaxation

Which patient is illustrating eustress? 1 A college student who fails an exam 2 A bride who is planning for her wedding 3 A man who is laid off from his job 4 An adolescent who gets into a fight at school

2 A bride who is planning for her wedding

A patient is extremely depressed after ending a relationship with a partner. The nurse is teaching cognitive reframing techniques to this patient as a means to counteract depression. Which response given by the patient indicates effective teaching by the nurse? 1 "I will never think about my partner again in my life." 2 "I was destined to face this situation in my life." 3 "I have many friends who love and care for me." 4 "'My partner will realize that I was not wrong."

3 "I have many friends who love and care for me."

Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex, and over the long term it can result in A. insulin resistance. B. a high resting heart rate. C. digestive problems. D. chronic muscle tension.

A. insulin resistance.

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

B. "I can be successful if I do all the things required to learn the job."

Stress reduction is not likely to result in A. reduced pain. B. lower blood pressure. C. decreased cognitive functions. D. decreased gastrointestinal problems.

C. decreased cognitive functions.

A nurse assesses a survivor of a devastating category 5 tornado. Which comment best indicates this survivor can maintain a sense of control, an intact self-concept, and competency in the face of this stress? 1 "I believe I was destined to experience this loss." 2 "The tornado was not in my control but I should have found a safer place to hide." Correct 3 "I have three close friends I can talk to about this experience. They are always there when I need them." 4 "I lost my home but I suppose I could go live with my parents temporarily. I can tolerate it for a little while."

"I have three close friends I can talk to about this experience. They are always there when I need them."

Which scenario presents an example of eustress? 1 A senior nursing student addresses invitations to graduation. 2 On her honeymoon, a new bride questions whether she made the right decision to marry. 3 An adult anticipates a coronary artery bypass graft (CABG) to open three occluded vessels. 4 After a diagnostic test, an adult listens as the health care provider says, "I'm afraid I have some bad news."

1 A senior nursing student addresses invitations to graduation.

A nurse who works in a stress management clinic finds that the female patients are more vulnerable to stress- related disorders. What is the most likely reason for this observation? 1 Females are more sensitive to corticotropin-releasing factor. 2 Females have few friends and weak support systems. 3 Females have more stress as compared to male counterparts. 4 Females do not share their problems with others.

1 Females are more sensitive to corticotropin-releasing factor.

Which fact concerning meditation would a nurse include in a discussion with a patient experiencing moderate anxiety and stress? Select all that apply. Correct 1 The strategy helps a person to create personal calmness. Correct 2 The practice quiets the sympathetic nervous system. 3 Meditation is a technique that is learned easily and requires little practice. Correct 4 A visual object, a sound, or even one's own breathing can be the focus. Correct 5 Meditation can be practiced anyplace and at anytime.

1 The strategy helps a person to create personal calmness. 2 The practice quiets the sympathetic nervous system. 4 A visual object, a sound, or even one's own breathing can be the focus. 5 Meditation can be practiced anyplace and at anytime.

The nurse is performing stress assessments in outpatients by using Recent Life Changes Questionnaire. Which important point should the nurse keep in mind for obtaining effective results from the questionnaire? 1 The patients experience the same level of stress for all the situations in their lives. 2 Cultural differences of the patients do not influence the level of stress in a given situation. 3 Every patient has a different threshold beyond which disruption occurs for a given situation. 4 The questionnaire does not have variance in scoring with the changes in the stress level.

3 Every patient has a different threshold beyond which disruption occurs for a given situation.

A nurse is performing a physical examination of a patient who was fired from work a week ago. Which signs and symptoms would suggest a sympathetic response to the stress? Select all that apply. 1 Decreased blood pressure 2 Decreased heart rate 3 Increased respiratory rate 4 Dry mouth 5 Dilated pupils

3 Increased respiratory rate 4 Dry mouth 5 Dilated pupils

A nurse advises a patient who is stressed to exercise daily to relieve stress. What is the reason for the nurse to consider exercise as a stress-buster? Select all that apply. 1 It increases muscle tension. 2 It decreases endorphin levels. Correct 3 It decreases chronic and acute stress. Correct 4 It decreases levels of anxiety. Correct 5 It decreases sensitivity to stress.

3 It decreases chronic and acute stress. 4 It decreases levels of anxiety. 5 It decreases sensitivity to stress.

A Hispanic woman has been in an abusive relationship for three years. Which comment by this patient is most likely? 1 "I need help with preparing an escape plan." 2 "I feel so depressed about the failure of my marriage." 3 "He is not a good man. His father and brother are also abusive." Correct 4 "I have very bad headaches that make it hard for me to care for my children."

4 "I have very bad headaches that make it hard for me to care for my children."

For the past five months, an adult has been experiencing conflict with a supervisor at work. Which comment by this person reflects adaptive coping related to this stressor? 1 "I've been in trouble at work before. If I keep my head down, it will all blow over." 2 "I keep hoping my supervisor will resign. If that happened, I would be happy at work." 3 "I've always been very opinionated. I think that's the reason for all my troubles with my supervisor." Correct 4 "I'm lucky to have a job but I think it's in my best interest to begin looking at some other opportunities."

4 "I'm lucky to have a job but I think it's in my best interest to begin looking at some other opportunities."

A nurse is educating a patient with anxiety about the stress-relieving technique of mindfulness. Which statement made by the patient indicates effective teaching? 1 "Mindfulness involves progressively tensing then relaxing body muscles." 2 "Mindfulness is a memory system to assist me in short-term memory recall." 3 "Mindfulness involves focusing on an object and repeating a phrase while deep breathing." Correct 4 "Mindfulness involves focusing and paying attention to what is going on around me."

4 "Mindfulness involves focusing and paying attention to what is going on around me."

A woman, whose friend recently committed suicide, asks the nurse to identify some ways she could cope with her stress regarding the event. Which option would be appropriate to discuss? 1 Isolation for a short time so that the pain isn't reinforced by explaining her feelings over and over 2 Antianxiety medication to help her relax 3 Starting a hobby to keep her mind off the troubling event 4 Talking with friends and attending a loss support group

4 Talking with friends and attending a loss support group

Myla, a 29-year-old patient admitted with anxiety, states, "my counselor keeps talking about my stressors. What exactly are stressors?" Your best response to the patient would be: A. "Stressors are events that happen that threaten your current functioning and require you to adapt." B. "Stressors are complicated neuro stimuli that cause mental illness." C. "It's best if you ask questions like that of your provider for a complete answer." D. "Instead of focusing on what stressors are, let's explore your coping skills."

A. "Stressors are events that happen that threaten your current functioning and require you to adapt."

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

A. The individual's perception of the event

A client 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 A. biofeedback. B. guided imagery. C. therapeutic touch. D. assertiveness training.

A. biofeedback.

Self-help groups are useful for reducing stress because they provide the individual with the stress mediator identified as A. social support. B. cultural support. C. life satisfaction. D. cognitive reframing.

A. social support.

The physiologic basis for the success of guided imagery is A. β-endorphin release raises the pain threshold. B. imagery raises the body level of cortisol and epinephrine. C. the sympathetic nervous system is stimulated to produce a quiet state. D. brain catecholamines are less available to transmit pain impulses.

A. β-endorphin release raises the pain threshold.

Which of the following examples illustrates eustress? A. A college student fails an exam. B. A bride is planning for her wedding. C. A man is laid off from his job. D. An adolescent gets into a fight at school.

B. A bride is planning for her wedding.

The first stage of the general adaptation syndrome can be characterized as A. eustress. B. adaptive. C. maladaptive. D. psychological.

B. adaptive.

A nurse teaches a client a technique for examining negative thoughts and restating them in positive ways. This technique is called A. guided imagery. B. cognitive reframing. C. wishful thinking. D. confrontational assertion.

B. cognitive reframing.

An Asian client would be most likely to respond to stress by the subjective experience of A. anxiety. B. somatic complaints. C. memory deficiencies. D. sensory perceptual alterations.

B. somatic complaints.

Which statement made by a teenager indicates an increased risk for poor stress management as a result of a psychosocial factor? Correct 1 "I couldn't survive if my boyfriend left me." 2 "My father tried to kill himself when I was 10 years old." 3 "Our religion does not accept homosexuality as a lifestyle choice." 4 "In my culture mental illness is thought of as a punishment, not a sickness."

Correct 1 "I couldn't survive if my boyfriend left me."

A nurse is caring for a patient who is experiencing a crisis. Which symptoms would indicate that the patient is in the stage of alarm? Correct 1 Dry mouth 2 Constricted pupils 3 Decrease in heart rate 4 Drop in blood pressure

Correct 1 Dry mouth

An effective stress-reduction technique a nurse might teach an individual with performance anxiety is A. assertiveness. B. journal keeping. C. diaphragmatic breathing. D. restructuring and setting priorities.

C. diaphragmatic breathing.

One effect of stress can be attributed to the stimulation of the hypothalamus-pituitaryadrenal cortex, causing a short-term increase in A. the heart rate. B. triglycerides. C. gluconeogenesis. D. brain norepinephrine.

C. gluconeogenesis.

Jacob is a college student whose friend recently committed suicide. Jacob rates his stress as low. Melissa was also friends 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: A. projection. B. denial. C. perception. D. repression.

C. perception.

Meditation is successful in promoting stress reduction because it A. prevents endorphin release. B. changes the client's energy field. C. quiets the sympathetic nervous system. D. activates the parasympathetic nervous system.

C. quiets the sympathetic nervous system.

What would a patient experience during a progressive relaxation session? Correct 1 Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed 2 Being attached to a machine that monitors a physical parameter and receiving audible feedback about the state of that parameter 3 Having a nurse enter the patient's energy field to rebalance it and bring harmony 4 Being led into a positive imaginary sensory experience

Correct 1 Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed

Which statement by an older adult who recently has had hip replacement surgery supports that his or her positive attitude is contributing to mental health wellness? 1 "I know I can't go hiking like I did but I really miss it so much." Correct 2 "I can't go hiking but I still enjoy walking in the park in the afternoon." 3 "If I work really hard in rehabilitation, I think I'll be able to hike again next spring." 4 "Hiking gave me such pleasure but if I can't hike, I'll just have to get used to it."

Correct 2 "I can't go hiking but I still enjoy walking in the park in the afternoon."

A client who is experiencing great stress associated with a disturbing new diagnosis asks the nurse, "Do you think saying a prayer would help?" The answer the nurse should give is A. "Of course you may pray if you wish. I'll leave you alone." B. "At the moment we should continue the stress assessment." C. "Shall I call the chaplain for you?" D. "If you find comfort in prayer, I'd encourage you to pray."

D. "If you find comfort in prayer, I'd encourage you to pray."

Which approach to reducing client stress is most effective in people with low to moderatehypnotic ability? A. Meditation B. Breathing exercises C. Journal keeping D. Biofeedback

D. Biofeedback

What tool might be useful in assessing the amount of stress a client has experienced in the past year? A. NANDA Handbook B. DSM-IV-TR C. Quick Mental Status Assessment D. Life-Changing Event Questionnaire

D. Life-Changing Event Questionnaire

Melissa, whose friend recently committed suicide, asks you some ways she could cope with her stress regarding the event. Which of the following options would be appropriate to discuss with Melissa? A. Isolation for a short time so that the pain isn't reinforced by explaining her feelings over and over B. Antianxiety medication to help her relax C. Starting a hobby to keep her mind off the troubling event D. Talking with friends and attending a loss support group

D. Talking with friends and attending a loss support group

An advantage of the Holmes and Rahe updated life event and social readjustment scale is that it A. focuses on the presenting symptoms. B. identifies the client's perception of events. C. considers the client's various mediating factors. D. assesses stress threshold and potential for future illness.

D. assesses stress threshold and potential for future illness.

The individual initially thinks, "I'll never get through this huge assignment," but then amends the thought to "I can get through the assignment by breaking it into small portions and doing them one by one." This thought process is an example of A. rationalization. B. wishful thinking. C. simple assertion. D. cognitive reframing.

D. cognitive reframing.

High-quality social support relationships have attributes that include A. constructive criticism. B. minor conflict. C. continuous feedback. D. reciprocal closeness.

D. reciprocal closeness