Ch.42 Stress and Adaptation PrepU

A client asks about general adaptation syndrome (GAS). Which details provided by the nurse are correct? Select all that apply. A) The alarm stage of GAS can last from minutes to hours. B) It can be a response to physiologic or psychological stress. C) There are three stages to GAS. D) GAS requires psychological hospitalization for treatment. E) The resistance stage usually lasts for less than a day.

A) The alarm stage of GAS can last from minutes to hours. B) It can be a response to physiologic or psychological stress. C) There are three stages to GAS.

The client tells the nurse she has never "gotten over" the loss of her husband 2 years ago. The client states she is drinking alcohol to excess every day and has started smoking, saying both help her cope. What is the best response by the nurse? A)"It may be time for you to consider a comprehensive treatment program." B) "As you learn to better cope, you will see a decrease in your need for these substances." C)"This is the way you are coping with the stress. Everyone copes in their own way." D)"You need to decrease your alcohol consumption and stop smoking for your overall health."

A)"It may be time for you to consider a comprehensive treatment program."

Which response to stressors results from the activation of the local adaptation syndrome (LAS)? A)A girl quickly withdraws her hand from a stream of hot tap water. B)A man is experiencing moderate anxiety before meeting with an important client. C)A woman's impending job interview has prompted the activation of her fight-or-flight response. D)A man has a sudden urge for a bowel movement before undergoing thoracentesis.

A)A girl quickly withdraws her hand from a stream of hot tap water.

Which outcome(s) will the nurse include in the plan of care for a client experiencing caregiver role strain? Select all that apply. A)Client will identify support mechanisms to help with stress. B)Client will confront those responsible for additional stress. C)Client will identify one or two stressors to eliminate. D)Client will demonstrate appropriate coping strategies. E)Client will eliminate all stress in a period of 6 months.

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

A withdrawn and isolated client is most likely suffering from what type of stressors on basic human needs? A)Love and belonging needs B)Self-esteem needs C)Physiologic needs D)Safety and security needs

A)Love and belonging needs

Many families are sheltering in the local middle school gymnasium during a severe tornado outbreak. Many homes have been destroyed and lives lost. The community health nurse expects to see negative stress reactions to the crisis, such as: A)a young wife asking everyone repeatedly if they know where her husband is. B)a man enlisting others to help him look for lost pets. C)an older adult couple staying near each other constantly. D)a young boy asking everyone if they need some water or food.

A)a young wife asking everyone repeatedly if they know where her husband is.

An adolescent girl is discussing her recent breakup with her boyfriend. She tells the nurse she just stays in bed all day and cannot seem to feel any better. She says she is only relieved of the pain while sleeping. The nurse identifies this coping strategy as: A)avoidance coping. B)chronic stress. C)buffering. D)adaptation.

A)avoidance coping.

A client is being admitted to a health care facility for abdominal pain of undetermined origin. The client states, "I have never been hospitalized before. What is going to happen to me?" The nurse notes the client's respirations are 28 breaths/minute, heart rate is 102 beats/minute, and blood pressure is 120/86 mm Hg. The client's muscles are tense. What action(s) will the nurse take to reduce the client's anxiety? Select all that apply. A)introduce self to client by name and title B)provide information about diet, activity, and diagnostic tests C)ask the client about available support systems and enlist his or her support D)hold information about policies and routines until the client's anxiety is reduced E)discuss past experiences involving the health care system with the client

A)introduce self to client by name and title B)provide information about diet, activity, and diagnostic tests C)ask the client about available support systems and enlist his or her support E)discuss past experiences involving the health care system with the client

Which behaviors represent effective coping mechanisms? Select all that apply. A)learning relaxation techniques B)sleeping 14 hours a night C)denying responsibility for a DUI conviction D)taking a vacation E)sleeping 3 hours a night F)setting limits with family members who upset you

A)learning relaxation techniques D)taking a vacation F)setting limits with family members who upset you

A mother tells the school nurse that her 5-year-old is refusing to go to school and won't accept a "school night" bedtime. The school nurse knows the mother will need more instruction when the mother makes which statement? A)"I am bringing him to the orientation so he can meet his teacher and some classmates." B) "I don't know why he is acting like this. He hasn't had anyone to play with but his little brother all summer." C) "It's so hard to get them into a routine after summer break. I go through this every year with all my kids." D) "We've all been talking to him about what school will be like; his brother had the same teacher and really liked her."

B) "I don't know why he is acting like this. He hasn't had anyone to play with but his little brother all summer."

Question 7 of 10 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: A) 15 years B) 7 years C) 21 years D) 3 years

B) 7 years

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? A) Exhaustion B) Resistance C) Reflex pain response D) Alarm reaction

B) Resistance

A freshman college student comes to the health clinic reporting insomnia and difficulty concentrating in class. The student has three red, scaly patches of skin on his arms and chest. The nurse believes the primary nursing diagnosis for this client is: A)Disturbed Thought Processes related to increased scholastic workload. B)Anxiety related to stress of achievement in school. C)Impaired Skin Integrity related to psoriasis. D)Sleep Deprivation related to change in living arrangements.

B)Anxiety related to stress of achievement in school.

A nurse hears a client yelling for help from the room. Upon arriving the nurse notes tachypnea and a sense of panic. On further evaluation, the client's heart rate is increased as well as oxygen needs. Which step would the nurse take first to address this client's needs? A)Administer an antianxiety medication and report to the health care provider B)Attempt to calm the client and administer oxygen C)Place the client in the semi-Fowler position and have the client explain what happened to cause this reaction D)Offer a distraction by asking about the client's family or interests and continue to monitor vitals

B)Attempt to calm the client and administer oxygen

When nurses become overwhelmed in their jobs and develop symptoms of anxiety and stress, they are experiencing what condition? A)Culture shock B)Burnout C)Ineffective coping D)Adaptation syndrome

B)Burnout

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? A)sublimation B)compensation C)projection D)reaction formation

B)compensation

A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention? A)discuss family history of hypertension B)provide care transition at discharge for speech therapy C)assess blood pressure every 4 hours D)conduct mental status assessment every 2 hours

B)provide care transition at discharge for speech therapy

A nurse has been caring for a client who experienced a physical assault a year ago. The client now describes being "totally recovered from it." Which stage of stress is the client currently experiencing? A)exhaustion stage B)resistance stage C)alarm stage D)primary stage

B)resistance stage

A client with persistent nausea is diagnosed with somatization. What is the appropriate nursing action when the client reports nausea? A)explain that the physical symptoms are all in their head B)sit with the client and ask them about their feelings C)Immediately administer an antiemetic. D)contact the primary care provider

B)sit with the client and ask them about their feelings

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. A)"Friends come over frequently to watch television or play video games." B)"The school counselor is seeing our adolescent once a week to check in and see how things are going in school." C) "We have found evidence of drug use, which is very unlike our adolescent." D)"We have tried to discuss the issues so we can find a solution but are met with anger and hostility." E)"Our adolescent is sleeping a lot more than usual."

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

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? A) Biofeedback B) Meditation C) Anticipatory guidance D) Guided imagery

C) Anticipatory guidance

Which are considered internal stressors? Select all that apply. A) loud noises B) pollution C) illness D) hormonal change E) fear

C) illness D) hormonal change E) fear

The nurse is caring for a client who is exhibiting signs of stress. Which cognitive symptom associated with stress does the nurse recognize? A) angry outbursts B) lack of interest in sex C) impaired concentration D) difficulty falling asleep

C) impaired concentration

Which nurse is most likely to experience the greatest amount of stress related to his or her position as a nurse? A)A nurse with 10 years of experience working as a nurse educator B)A nurse who is an editor of a nursing journal C)A graduate nurse working on a telemetry unit D)A nurse with 2 years of experience working on an oncology unit

C)A graduate nurse working on a telemetry unit

Which client is handling stress by using the defense mechanism termed displacement? A)A man with symptoms of prostate cancer refuses to see a doctor. B)A man who forgets his medication blames his wife for putting it away. C)A mother who is angry at her husband shouts at the kids to "keep quiet." D)An athlete who doesn't make the team concentrates on body-building instead.

C)A mother who is angry at her husband shouts at the kids to "keep quiet."

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? A)Relaxation B)Guided imagery C)Anticipatory guidance D)Normalization

C)Anticipatory guidance

A toilet trained toddler was admitted to the hospital for dehydration. Upon returning home, the toddler becomes incontinent of urine and stool. The parent is concerned regarding this return to previous behavior and calls the pediatric clinic. What is the nurse's best response to the parent? A)This behavior is sublimation. B)This behavior is known as repression. C)This behavior is called regression. D)This behavior is reaction formation.

C)This behavior is called regression.

An intensive care unit (ICU) nurse with 11 years of experience has been frequently absent or late for shifts, has been verbally abusive with coworkers she feels are unskilled at the technological tasks of the job, and cursed under her breath at a distraught family member today. The nurse manager is threatening to suspend her if it happens again. The ICU nurse may be experiencing: A)sleep deprivation. B)repression. C)burnout. D)allostatic load.

C)burnout

A client who responds to bad news concerning laboratory results by crying uncontrollably is handling stress by using: A)adaptation technique. B)defense mechanism. C)coping mechanism. D)withdrawal behavior.

C)coping mechanism.

The nurse is providing care to the following clients. The nurse assesses the client exhibiting maladaptive behavior as the client who is: A)participating in a smoking cessation program after her father was diagnosed with lung cancer. B)84 years old with multiple health problems and requesting to see an end-of-life care specialist. C)experiencing a terminal illness and states, "If I pray to God and go to church each week, I will live." D)overweight, consumes 1,600 calories/day, and exercises 30 minutes a day 5 times each week.

C)experiencing a terminal illness and states, "If I pray to God and go to church each week, I will live."

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate? A)tell the family they are causing too much stress B)do not intervene and allow the client to work out the family issue C)limit the family visits to once daily D)explain that family visits and support are important

C)limit the family visits to once daily

A nurse is assessing a client with stress-related problems. Which factor influences responses to stressors? A)economic status B)personal hygiene C)social support D)eating habits

C)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? A)endocrine system B)parasympathetic nervous system C)sympathetic nervous system D)respiratory system

C)sympathetic nervous system

Which clients does the nurse identify that are at the greatest risk for situational stress? Select all that apply. A. a toddler learning to control elimination B. a school-age child attending her first party C. a man getting married to his high school sweetheart D. a woman recovering from a car accident E. a teenager being offered a cigarette by a friend F. a high school graduate enrolling in the armed services

C. a man getting married to his high school sweetheart D. a woman recovering from a car accident F. a high school graduate enrolling in the armed services

A client presents with a flare of lupus. Which statement made by the client would cause the nurse to suspect a stress reaction? A) "My joints hurt more with this flare." B)"My lupus typically flares twice a year." C)"I have a fever with this flare." D) "I just had an infant 3 weeks ago."

D) "I just had an infant 3 weeks ago."

An adolescent describes a dysfunctional home life to the nurse and reports smoking marijuana to help cope with the situation. How will the nurse identify this form of coping? A) generational B) beneficial C) cultural D) maladaptive

D) maladaptive

A nursing instructor is discussing burnout with a group of graduating nursing students. Which statement might lead the instructor to believe that the particular student has not developed needed coping mechanisms for nursing practice? A)"There's so much to learn. I have to find a way to balance these new challenges with settling back into my regular life." B)"I hope I get a good preceptor. I know that will help me get used to this transition." C) "I know that I am not prepared to take on a leadership role right now since I am new and need to learn." D)"I can handle absolutely any situation now. You teachers have trained us well."

D)"I can handle absolutely any situation now. You teachers have trained us well."

A nurse has accepted numerous overtime shifts over the past several months. Which behavior indicates the nurse is experiencing burnout? A)Telling the manager staffing numbers are unsafe B)Taking smoke breaks during the shift C)Beginning a rigorous exercise program D)Dozing at the desk during downtime

D)Dozing at the desk during downtime

A recently retired client reports that he has been able to sleep only 3 hours a night and that he has nausea, frequent urination, and headaches. He is asking the nurse what she thinks is going on with his health. What is the most probable cause of his symptoms? A)type 2 diabetes B)herniated lumbar disc C)obstructive sleep apnea D)moderate anxiety

D)moderate anxiety

A nurse is assessing a client who has recently lost her husband. During the interview the nurse realizes that the client is unable to cope with the loss. The client finds it difficult to organize daily tasks or solve problems effectively. Which suggestion would be most appropriate for the nurse to suggest as a crisis intervention? A)tense and relax muscle groups systematically B)perform meditation to relax C)keep the home environment noise free D)seek assistance from family and friends

D)seek assistance from family and friends

Family conflict around the care of a recently hospitalized woman has escalated to the point that crisis intervention may be required. This process should begin with:

clear identification of the relevant problem.

What is the general adaptation syndrome? and what are the three stages?

the body's response to stress Three stages: alarm resistence exhaustion