Prep U- stress and coping

A client had a breast biopsy that was positive for adenocarcinoma and is scheduled for a mastectomy. She has two young children and she is very concerned with the prognosis. She states that she feels at an all-time low in her life and wants to know ways to help her adjust to this news. Which nursing statement would best assess the client's coping abilities? a) "Wait until the surgery is done, and then you will have a better idea of the extent of the cancer." b) "What ways have you used to help reduce stress and help you cope with significant events in your life?" c) "For the sake of your children, I know you will handle this situation well." d) "You could get some spiritual help from your church or pastor."

"What ways have you used to help reduce stress and help you cope with significant events in your life?" Explanation: Helping the client identify stress reduction methods that have been effective and ways to cope with stress help to identify strengths. This provides the nurse with the best information to assist the client in coping with stress. The other choices do not assess coping abilities and are not therapeutic.

Studying for the NCLEX-RN examination is an example of which type of stressor? a) Stressor sequence b) Chronic intermittent c) Chronic enduring d) Acute, time-limited

Acute, time-limited Explanation: An acute, time-limited stressor includes studying for final examinations, such as the NCLEX-RN exam. A stressor sequence is a series of stressful events that result from an initial event such as a job loss or divorce. Chronic intermittent stressors consist of daily stressors. A chronic enduring stressor is a stressor that persists over time, such as chronic illness, disability, or poverty.

An older adult who identifies herself as a devout Catholic has recently relocated to an assisted-living facility. The client is pleased with most aspects of the living situation but laments the fact that the church is not nearby, so attending daily mass is not an option. She is quite upset by this restriction and states, "Going to daily mass was my life." The nurse recognizes that this client is suffering which of the following? a) Spiritual distress b) Hopelessness c) Spiritual pain d) Depression

Spiritual distress Explanation: A diagnosis of depression does not apply to this situation. Spiritual distress involves the inability to integrate meaning and purpose in life, while spiritual pain involves angst over the nature and actions of a higher power. The woman's statements do not directly reflect an outlook of hopelessness.

A middle-aged woman's father has passed away, and her mother requires physical and emotional help due to disabilities. The woman is married and raising two children, all while working full time. All of the factors described are: a) Stimuli b) Illnesses c) Demands d) Stressors

Stressors Explanation: Stress is defined as any event or set of events, a stressor, that causes a response. Everyday triggers associated with work or social relationships, and uncommon events such as natural disasters, physical trauma, injuries, illnesses, divorce, death of a loved one, or loss of a job are commonly recognized stressors.

A client with a history of drug abuse gives birth to a low-birth-weight neonate who is experiencing drug withdrawal. Which intervention is helpful for this neonate? a) Place the isolette in a quiet area of the nursery. b) Dress the neonate in loose-fitting clothing. c) Withhold medications until liver function improves. d) Place the isolette close to the nurse's station.

a

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) Seek assistance from family and friends c) Keep the home environment noise free d) Perform meditation to relax

b

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 which of the following? a) Sleep deprivation b) Burnout c) Repression d) Allostatic load

b

Prior to the patient's scheduled bone marrow biopsy, the nurse has devoted time to teaching him about the rationale and the specific details of the procedure. The nurse's actions constitute what stress management technique? a) Normalization b) Relaxation c) Anticipatory guidance d) Guided imagery

c

Which is a priority goal for the client with chronic obstructive pulmonary disease (COPD)? a) minimizing chest pain b) treating infectious agents c) increasing carbon dioxide levels in the blood d) maintaining functional ability

d

A child, age 6, is anxious and upset before a scheduled bone marrow aspiration. During client preparation, the nurse should keep in mind that: a) describing what the child will hear, see, smell, and feel will help the child cope with the procedure. b) no small detail about the procedure should go unexplained. c) explaining bone marrow function will help the child understand the reason for the procedure. d) the child's anxiety will decrease with each successive procedure

describing what the child will hear, see, smell, and feel will help the child cope with the procedure. Explanation: Children cope with situations better when they can anticipate sensations rather than just trying to comprehend technical explanations. Therefore, describing what the child will hear, see, smell, and feel will help the child cope. Commonly, a child's anxiety increases rather than decreases with each successive procedure. A school-age child can't assimilate every detail. A 6-year-old child can't understand an explanation of bone marrow function; also, such an explanation would be irrelevant.