Chapter 10

Which nursing comments are likely to help a patient to cope by addressing the mediators of stress? Select all that apply. a. A divorce, while stressful, can be the beginning of a new, better phase of life. b. You said you used to jog; getting back to aerobic exercise could be helpful. c. Journaling often promotes awareness of how experiences have affected people. d. Slowing your breathing by counting to three between breaths will calm you. e. Would a short-term loan make your finances less stressful? f. There is a support group for newly divorced persons in your neighborhood.

a. A divorce, while stressful, can be the beginning of a new, better phase of life. c. Journaling often promotes awareness of how experiences have affected people. e. Would a short-term loan make your finances less stressful? f. There is a support group for newly divorced persons in your neighborhood.

Which changes reflect short-term physiological responses to stress? Select all that apply. a. Muscular tension, blood pressure, and triglycerides increase. b. Epinephrine is released, increasing heart and respiratory rates. c. Corticosteroid release increases stamina and impedes digestion. d. Cortisol is released, increasing glucogenesis and reducing fluid loss. e. Immune system functioning decreases, and risk of cancer increases. f. Risk of depression, autoimmune disorders, and heart disease increases.

a. Muscular tension, blood pressure, and triglycerides increase. b. Epinephrine is released, increasing heart and respiratory rates. c. Corticosteroid release increases stamina and impedes digestion. d. Cortisol is released, increasing glucogenesis and reducing fluid loss. Increased risk of immune system dysfunction, cancer, cardiovascular disease, depression, and autoimmune disease are all long-term (chronic) effects of stress.

A patient who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the patient returns to the clinic 2 weeks later, which finding most clearly shows the patient is coping more effectively with stress? a. The patients systolic blood pressure has changed from the 140s to the 120s mm Hg. b. The patient reports, I feel better, and that things are not bothering me as much. c. The patient reports, I spend more time napping or sitting quietly at home. d. The patients weight decreased by 3 pounds.

a. The patients systolic blood pressure has changed from the 140s to the 120s mm Hg. Objective measures tend to be the most reliable means of gauging progress. In this case, the patients elevated blood pressure, an indication of the bodys physiological response to stress, has diminished. The patients report regarding activity level is subjective; sitting quietly could reflect depression rather than improvement. Appetite, mood, and energy levels are also subjective reports that do not necessarily reflect physiological changes from stress and may not reflect improved coping with stress. The patients weight change could be a positive or negative indicator; the blood pressure change is the best answer.

A recent immigrant from Honduras comes to the clinic with a family member who has been a U.S. resident for 10 years. The family member says, The immigration to America has been very difficult. Considering cultural background, which expression of stress by this patient would the nurse expect? a. Motor restlessness b. Somatic complaints c. Memory deficiencies d. Sensory perceptual alterations

b. Somatic complaints

Which scenario best demonstrates an example of eustress? An individual: a. loses a beloved family pet. b. prepares to take a one-week vacation to a tropical island with a group of close friends. c. receives a bank notice there were insufficient funds in their account for a recent rent payment. d. receives notification their current employer is experiencing financial problems and some workers will be terminated.

b. prepares to take a one-week vacation to a tropical island with a group of close friends.

According to the Recent Life Changes Questionnaire, which situation would most necessitate a complete assessment of a persons stress status and coping abilities? a. A person who has been assigned more responsibility at work b. A parent whose job required relocation to a different city c. A person returning to college after an employer ceased operations d. A man who recently separated from his wife because of marital problems

c. A person returning to college after an employer ceased operations A person returning to college after losing a job is dealing with two significant stressors simultaneously. Together, these stressors total more life change units than any of the single stressors cited in the other options.

A patient diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently the patient has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the patient be encouraged to visualize? a. Engaging in activity without using any supplemental oxygen b. Sleeping comfortably and soundly, without respiratory distress c. Feeling relaxed and taking regular deep breaths when leaving home d. Having a younger, healthier body that knows no exercise limitations

c. Feeling relaxed and taking regular deep breaths when leaving home

A patient reports, I am overwhelmed by stress. Which question by the nurse would be most important to use in the initial assessment of this the patient? a. Tell me about your family history. Do you have any relatives who have problems with stress? b. Tell me about your exercise. How much activity do you typically get in a day? c. Tell me about the kinds of things you do to reduce or cope with your stress. d. Stress can interfere with sleep. How much did you sleep last night?

c. Tell me about the kinds of things you do to reduce or cope with your stress.

A patient tells the nurse, I know that I should reduce the stress in my life, but I have no idea where to start. What would be the best initial nursing response? a. Physical exercise works to elevate mood and reduce anxiety. b. Reading about stress and how to manage it might be a good place to start. c. Why not start by learning to meditate? That technique will cover everything. d. Lets talk about what is going on in your life and then look at possible options.

d. Lets talk about what is going on in your life and then look at possible options.