Coping

The nurse is reviewing the care plan for a patient experiencing difficulty coping with stress. The nurse recognizes that an example of initiating a cognitive restricting intervention to enhance coping abilities is known as which of the following? a. Identifying the cause of fear b. Accessing a community support group c. Identifying relaxation methods d. Reviewing an educational pamphlet

Answer: A - Identifying the cause of a negative perception is the first step in restricting how a patient perceives a stressor, also called "cognitive restructuring".

A patient is the primary caregiver for a disabled family member at home, and has now been unexpectedly hospitalized for surgery. What action can the nurse take to enhance the coping ability of the patient? a. Ask if there is another family member who can help at home while the patient is in the hospital. b. Plan to transfer the patient to a rehabilitation until after surgery to allow uninterrupted time to recover. c. Coordinate an ambulance transfer of the family member to an alternate family member's home. d. Ask social services to assess what the patient's needs will be after discharge to home.

Answer: A - The best action by the nurse is to help the patient develop an action plan to assess what resources may already be available to meet responsibilities at home.

The school nurse is assessing coping skills of high school students who attend an alternative school for students at high risk to not graduate. What is the PRIORITY concern that the nurse has for this student population? a. Altered vital sign readings. b. Inaccurate perceptions of stressors. c. Increased risk for suicide d. Decreased access to alcoholic beverages.

Answer: C - Adolescent with poor coping have increased risk for drug and alcohol use, risky sexual behaviors, and suicide. Pulse, respiratory rate, and blood pressure may change during stress, but patient safety is the priority concern. Adolescents may have inaccurate perceptions of stressors, and this actually increases the risk for unsafe behaviors. Adolescent under stress are more at risk for increasing their access to alcohol and illegal drugs.

After a management decision to admit terminal care patients to a medical unit, the nursing manager notes that nursing staff on the unit appear tired and anxious. Staff absences from work are increasing. The nurse manager is concerned that staff may be experiencing stress and burnout at work. What action would be best for the manager to take that will help the staff? a. Ask administration to require staff to meditate daily for at least 30 minutes. b. Have a staff psychologist available on the unit once a week for required counseling. c. Have training sessions to help the staff understand their new responsibilities. d. Ask support staff from other disciplines to complete some nursing tasks to provide help.

Answer: C - Feeling unprepared for work responsibilities contributes to stress and poor coping in the workplace.

The nurse is developing a care plan for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy? a. Scheduling a regular exercise program b. Attending a seminar on treatment options c. Identifying a confidant to share feelings. d. Attending a support group for families.

Answer: C - Problem focused strategies are used to find solutions or improvement to the underlying stressor, such as assessing community resources or attending educational seminars. Exercise, emotional support, and support groups are emotion-based strategies that create a feeling of a well-being.

The nurse has been asked to administer a coping measurement instrument to a patient. What education would the nurse present to the patient related to this tool? a. This tool will let us present to the patient related to this tool? b. This tool is short because it only measures the negative stressors you are experiencing. c. You will need to ask your parents about stressors as a child to complete this tool. d. This tool will help assess recent positive and negative events you are experiencing.

Answer: D - Coping measurement tools measure recent positive and negative life events as perceived by the individual. There is no objective scale for comparison with other patients because each person reacts differently to stressors. Both negative and positive events are assessed.

MULTIPLE RESPONSE The nurse is assessing the coping patterns of a newly admitted patient. What will the nurse include in this assessment? Select all that apply. a. Current stressors as perceived by the patient. b. Use of drugs or alcohol. c. Recent weight changes. d. Age and height e. Temperature

Answers: A, B, C, - Stressors are subjective based on patient perception and assessment of stressors as part of a patient history. Stressors trigger coping behaviors that can include negative uses of drugs and alcohol and appetite changes that affect weight.