Ch. 41: Stress and Adaptation PrepU

A teenager is unable to eat breakfast and is pacing in the house 2 hours before his appointment for his driving road test. He takes the test and passes. The driving test administrator says to the teen, "You did very well. You weren't nervous at all, were you?" What level of anxiety was the teen experiencing prior to and during his road test? a) Severe anxiety b) Moderate anxiety c) Mild anxiety d) Panic

Mild anxiety Explanation: The teenager was exhibiting symptoms of mild anxiety, which includes increased focus and alertness, leading to positive effects. Moderate, severe, and panic levels of anxiety produce negative symptoms ranging from poor concentration to inability to function.

A client who is recently divorced reports sleeping during the day and an inability to adapt to the life change. Which teaching by the nurse would promote healthy adaptation? a) "It's best to just procrastinate, then you can do everything all at once." b) "Try making a list to prioritize what needs to be done." c) "Thinking about the past will help you to move forward." d) "You should get a dog so you will feel needed."

"Try making a list to prioritize what needs to be done." Explanation: Procrastination only prolongs and intensifies the original stressor and does not help the client cope or move forward. Making a list prioritizing what needs to be accomplished and attending to that which is most important or difficult is often helpful in moving forward.

A 56-year-old construction worker is in for his annual physical. As the nurse takes his vital signs, he tells her that his blood pressure may be a little off this morning. He tells the nurse that he is recently unemployed, is quite stressed, and is having a hard time coping. He feels like he needs to numb the pain. What is the nurse most concerned about regarding this client? a) Projection b) Cocaine use c) Exercise d) Alcohol abuse

Alcohol abuse Explanation: Alcohol abuse is a common altered coping pattern for individuals with poor coping skills. It is legal and easily accessible. Phrases such as "I just cannot cope" and "I need to numb the pain" are common among those who abuse alcohol.

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) Guided imagery b) Normalization c) Anticipatory guidance d) Relaxation

Anticipatory guidance Explanation: Anticipatory guidance involves preparing a client psychologically for an event in the knowledge that familiarity reduces anxiety. Guided imagery involves the creation of mental image, not education. Relaxation focuses on the control of the body's responses to stress. Normalization is not a specific stress management technique.

When nurses become overwhelmed in their jobs and develop symptoms of anxiety and stress, they are experiencing what condition? a) Ineffective coping b) Culture shock c) Adaptation syndrome d) Burnout

Burnout Explanation: The feeling of being overwhelmed in one's job and development of symptoms of anxiety and stress is referred to as burnout. Burnout can be compared with the exhaustion stage of anxiety and is characterized by a wide range of behaviors.

A Spanish-speaking client is admitted to the Emergency Department with a urinary tract infection and is experiencing a stress response from hospitalization. What is the priority nursing intervention? a) Contact a translator. b) Administer broad-spectrum antibiotic. c) Begin taking a client history. d) Collect a urine specimen

Contact a translator. Explanation: In order to decrease the stress response, it is important to provide explanations in understandable language. Contacting a translator to facilitate communication is the priority nursing intervention. While taking a history, collecting urine, and starting antibiotics is important, they are not emergent and effective communication takes precedence especially when a stress response is present.

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) Alarm reaction d) Reflex pain response

Resistance Explanation: This client's situation is an example of the resistance stage of the GAS. Stress is continuing, but the client is maintaining homeostasis. Alarm is the initial stage when major stress is encountered. Exhaustion is when homeostasis can no longer be achieved. The reflex pain response is part of the local adaptation syndrome.

A client has been diagnosed with breast cancer. An example of adaptation to this physiologic stressor would be: a) going to happy hour every day after work. b) giving away personal possessions. c) participating in a cancer survivors 5K walk/run. d) missing a chemo appointment to attend a wedding.

participating in a cancer survivors 5K walk/run. Explanation: Adaptation is the process by which individuals use coping mechanisms to balance out the level of stress they are under, so they can maintain homeostasis. Joining a support system such as a cancer group's charity event can turn negative stress to positive. Giving away possessions is anticipatory grieving. Drinking and missing appointments are avoidance behaviors.

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) Respiratory system b) Parasympathetic nervous system c) Endocrine system d) Sympathetic nervous system

Sympathetic nervous system Explanation: Functions of the sympathetic nervous system under stressful conditions bring about the fight-or-flight response.

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) Perform meditation to relax. b) Tense and relax muscle groups systematically. c) Seek assistance from family and friends. d) Keep the home environment noise free.

Seek assistance from family and friends. Explanation: The nurse should suggest that the client seek assistance from family and friends as a crisis intervention. Adequate support during a crisis and its resolution can help clients realistically perceive the problem and reinstitute coping strategies.

The nurse is describing the effect of stress on the body to a group of health practitioners. Which statements accurately describe the role of stress on the health and illness of clients? Select all that apply. a) The health-illness continuum is affected by stress. b) Stress has a negative impact on a person as he strives to meet basic human needs at each level. c) The effects of stress on a sick or injured person are usually positive. d) As the duration, intensity, or number of stressors increases, a person's ability to adapt is lessened. e) People react to stress in a consistent and predictable manner. f) Recovery from illness and return to normal function are compromised by prolonged stress.

• The health-illness continuum is affected by stress. • As the duration, intensity, or number of stressors increases, a person's ability to adapt is lessened. • Recovery from illness and return to normal function are compromised by prolonged stress. Explanation: The health-illness continuum is affected by stress. Health and homeostatic balance are at one extreme of the continuum; exhaustion and death are at the other extreme. Adaptation is compromised as the duration, intensity, and number of stressors increase. Prolonged stress makes it difficult for a person to recover from illness. For a healthy person, stress can be a positive motivator. Everyone reacts to stress in his own way. If a person is ill, stress has a negative impact on the person and their illness.

The nurse is reviewing the care of a client who is experiencing the exhaustion stage. Which sign or symptom is the nurse expected to find? a) higher than normal blood glucose levels b) lower than normal blood glucose levels c) lower than normal iron levels d) higher than normal iron levels

higher than normal blood glucose levels Explanation: The higher than normal blood glucose level occurs in a response to the prolong level of cortical, which is produced to inhibit insulin in order to meet the increased need for energy when a person is stressed.

A client is on a stress management program. She states that she is open to trying a guided meditation class. When helping her get started, a nurse tells her that which of the following is not important? a) a quiet environment b) a focus of attention c) soft music d) an open attitude

soft music Explanation: Music may be helpful for some, but is not essential for meditation.

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) 3 years b) 7 years c) 21 years d) 15 years

7 years Explanation: This is an example of magical thinking. Magical thinking is a common reaction to stress in a school-aged child.

A Red Cross volunteer has recently returned from assisting families in the Northwest who survived a devastating forest fire. She is having trouble sleeping and has taken up smoking again. Which statement by her leads the nurse to suspect a nursing diagnosis of Caregiver Role Strain related to stress from disaster volunteer activities? a) "I guess the smoke in the air brought out my mental addiction to cigarettes." b) "I can't seem to calm down. I keep seeing those faces and hearing their words every time I close my eyes." c) "I need to get back to work here at home. That will get me back into a routine." d) "I get so tired from working long hours at the site."

"I can't seem to calm down. I keep seeing those faces and hearing their words every time I close my eyes." Explanation: This person is exhibiting a physiologic response to stress, while also taking up a negative coping solution to diminish the symptoms. Reliving the events that were stressful is a common complaint when under anxiety. The other statements do not demonstrate the burden of role strain.

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) "It's so hard to get them into a routine after summer break. I go through this every year with all my kids." 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) "I am bringing him to the orientation so he can meet his teacher and some classmates." d) "We've all been talking to him about what school will be like; his brother had the same teacher and really liked her."

"I don't know why he is acting like this. He hasn't had anyone to play with but his little brother all summer." Explanation: Each developmental stage includes tasks that must be achieved so that normal growth and development can occur, but change can be stressful. In a school-age child, starting school and being around strangers can be challenging. One way to counteract the anxiety is to introduce them to others in social situations, and teach acceptable social behaviors, before they start school.

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) "I have a fever with this flare." c) "I just had a baby 3 weeks ago." d) "My lupus typically flares twice a year."

"I just had a baby 3 weeks ago." Explanation: The brain-immune connection suggests that changes in body chemistry during periods of stress may trigger an autoimmune (self-attacking) response like those associated with lupus. While having a baby can be positive it is stress both physically and emotionally and could be a stress trigger for the lupus flare. The other options present differences in lupus flare presentation, which is not specific to a stress response.

The emergency department nurse suspects that an older adult client who fell and broke her hip is using a defense mechanism when the client states: a) "Can you call my next-door neighbor for me? I'm so worried that my cat Clancy won't have any food or water." b) "Does this mean I have to stay here in the hospital?" c) "They must have given me the wrong medication at the drug store. I don't have trouble with my eyesight." d) "I'm so clumsy. I'm surprised it hasn't happened before this."

"They must have given me the wrong medication at the drug store. I don't have trouble with my eyesight." Explanation: Defense mechanisms are psychological tools individuals use to deal with high levels of anxiety from stressors. Clients under extreme stress may self-protect by using denial and rationalization; they may convince themselves that the problem didn't happen or was not caused by them, or that it must have resulted from someone else's mistake. Additionally, the denial may be nonacceptance of the developmental stressors of aging.

An emergency department nurse is caring for four clients. Which client would the nurse suspect as using displacement as a defense mechanism? a) A client on dialysis who missed two appointments in one week. b) A client with a fractured hand after punching a wall c) An adult client crying and stating, "I want my mommy." d) A client with a traumatic amputation refusing to look at the extremity

A client with a fractured hand after punching a wall Explanation: The defense mechanism of displacement transfers the emotional response from one person to another person or object. The client who punched a wall may have used displacement by punching a wall and not a person. Refusing to look at a traumatic injury can be denial. The adult client is demonstrating regression. The client who missed two dialysis appointments is not demonstrating displacement.

Upon arrival to the emergency room, the mother of a client involved in a motor vehicle accident becomes upset when she learns her son is unconscious and unstable. The mother begins to yell at the emergency room staff in unintelligible words, and she is trembling. She becomes short of breath and yells she can't breathe. What is the mother likely experiencing? a) Moderate anxiety b) Mild anxiety c) A panic attack d) Severe anxiety

A panic attack Explanation: Panic causes the person to lose control and experience dread and terror. Panic is characterized by a disorganized state, increased physical activity, difficulty communicating, agitation, trembling, dyspnea, palpitations, a choking sensation, and sensations of chest pressure or pain.

Which patient is experiencing the panic level of anxiety? a) A patient focuses narrowly on specific detail. b) A patient experiences increased alertness and motivated learning. c) A patient loses control and expresses irrational thinking. d) A patient displays a narrow perception field.

A patient loses control and expresses irrational thinking. Explanation: Panic causes the person to lose control and experience dread and terror. The resulting disorganized state is characterized by increased physical activity, distorted perception of events, and loss of rational thought. Increased alertness and motivated learning describes mild anxiety. Narrowing the focus on a specific detail describes moderate anxiety. A patient displaying a narrow perception field is a characteristic of severe anxiety

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) Guided imagery c) Meditation d) Anticipatory guidance

Anticipatory guidance Explanation: Anticipatory guidance is the technique wherein the nurse uses teaching about a procedure to prepare the client for what is to come. This can help foster trust, diminish fear of the unknown, and lessen the chance of a negative response to necessary treatments. Guided imagery, biofeedback, and meditation would take time to learn and would not be effective in this current situation

The client is a single mother of two children who attends college and works full time. She is seeing the college nurse due to a crying outburst in class. The first step of crisis intervention that the nurse employs is: a) Assisting the client to identify the reason for her outburst b) Outlining several solutions to the crisis with the client c) Having the client select an acceptable solution to her problem d) Advising the client to try any solution that comes to mind

Assisting the client to identify the reason for her outburst Explanation: Crisis intervention is a five-step problem-solving technique. The first step is to identify the problem. The other options follow problem identification.

A client expresses to the nurse that she constantly feels irritated and loses her temper. During the course of the interview, the nurse finds that the client takes care of her mother who was confined to bed following a stroke. The client struggles to balance caring for her family and her mother. Which nursing diagnosis would the nurse most likely identify for this client? a) Compromised Family Adjustment b) Caregiver Role Strain c) Ineffective Coping d) Anxiety

Caregiver Role Strain Explanation: The most appropriate nursing diagnosis is Caregiver Role Strain, because the client feels tired and fatigued by struggling to care for her mother and fulfilling family needs. Ineffective Coping, Compromised Family Adjustment, and Anxiety would be inappropriate nursing diagnoses based on the information provided.

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

Compensation Explanation: Compensation is overcoming a perceived weakness by emphasizing a more desirable trait or achieving in a more comfortable area.

The children of a woman 60 years of age are distraught at her apparent lack of recovery following a stroke several weeks earlier. The client's daughter has frequently directed harsh criticism toward the nurses, accusing them of a substandard effort in rehabilitating her mother despite their best efforts. What defense mechanism may the client's daughter be exhibiting? a) Regression b) Displacement c) Sublimation d) Denial

Displacement Explanation: The daughter may be transferring her feelings about her mother's health status to the care providers, an act that involves the displacement of the emotional reaction to another person. Denial about her mother's potential for recovery may underlie her response, but this is not demonstrated as clearly as displacement.

A client tells the nurse that he is feeling depressed and low. Further assessment reveals that the client has difficulty verbalizing his feelings and needs, often feeling manipulated by others. Which action would the nurse suggest to the client to help relieve stress? a) Be realistic about how much you can accomplish. b) Practice rephrasing thoughts that are negative or irrational. c) Enroll in a class or workshop in assertiveness training. d) Gain control over self-defeating thoughts.

Enroll in a class or workshop in assertiveness training. Explanation: The nurse should suggest that the client enroll in a class or workshop in assertiveness training. Assertive behavior enables people to act in their best interests, to stand up for themselves, to express their feelings openly and honestly, and to exercise their rights without infringing on the rights of others.

A 78-year-old widower was recently relocated to an assisted living facility. His aunt used to live in this facility and always talked fondly about her fellow residents and the staff. However, the nurse has noticed that the client has spent most of his time in his room alone. What type of stress is the nurse most concerned about with this client? a) Sociocultural stress b) Physiologic stress c) Environmental stress d) Psychological stress

Environmental stress Explanation: Environmental stress is common when individuals move to a new location, even if that move is voluntary. It is associated with a lack of familiarity with the sights, smells, and sounds of the location. Relocation also requires alteration in daily routine which is in itself stressful.

The nurse is caring for a client who is a doctor in a general hospital. He complains about the stressful condition of his job. Lately, he has become increasingly susceptible to colds, headaches, muscular tension, excessive tiredness, and many other symptoms. At what stage of stress is the client? a) Secondary stage b) Resistance stage c) Alarm stage d) Exhaustion stage

Exhaustion stage Explanation: The client is in the exhaustion stage when one or more adaptive/resistive mechanisms can no longer protect the person experiencing a stressor; this results in exhaustion. The effects of stress-related neurohormones suppress the immune system and the body is open to various ailments.

A nurse is working with a 67-year-old Asian American woman on diet changes to help with weight loss. She is explaining her role in the family as the one who prepares the meats for the family, while her daughter is responsible for preparing vegetables. Based on the nurse's knowledge of traditional Asian cultures, the nurse knows what to be true? a) Families operate in an individualistic manner. b) Older adults never change their eating patterns. c) Families operate in a collectivistic manner. d) Family is the only thing that is important.

Families operate in a collectivistic manner. Explanation: Collectivistic culture views the self as an interdependent part of others.

A nurse working on an oncology floor often sits with her clients in a calm, quiet, dimly lit environment and describes a walk along the ocean's shore. The nurse provides details of the walk and verbally paints a picture for the client. What best defines this form of stress management? a) Meditation b) Biofeedback c) Guided imagery d) Anticipatory guidance

Guided imagery Explanation: Guided imagery involves creating a mental image based upon a verbal description offered by another individual.

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate? a) Limit the family visits to once daily. b) Tell the family they are causing too much stress. c) Explain that family visits and support are important. d) Do not intervene and allow the client to work out the family issue.

Limit the family visits to once daily. Explanation: When a person is experiencing a stressor, it is important for the nurse to reduce or eliminate the stress. In this case, it is appropriate to limit the family visiting time to allow the client to recover without experiencing a stress response. Telling the family they are causing the stress is not therapeutic. Telling the client that they family should be there invalidates the client's feelings. Doing nothing is not an appropriate response to decrease or remove the stressor.

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) Moderate anxiety b) Type 2 diabetes c) Obstructive sleep apnea d) Herniated lumbar disc

Moderate anxiety Explanation: This client may have increased anxiety from adjusting to retirement, a significant life stressor. There are not enough data to identify any of the other disorders as being present.

A school nurse is listening to a teen describe symptoms related to his schoolwork. The boy states he can't focus when studying, is unable to eat and sleep, and felt like he was going to "pass out" the other day during a geometry test. The nurse believes the teen is experiencing which disorder? a) Obsessive-compulsive disorder (OCD) b) Psychological alarm reaction c) Moderate anxiety response d) Panic attacks

Moderate anxiety response Explanation: Inability to concentrate, nausea, insomnia, dizziness, and hyperventilation are all symptoms of moderate-level anxiety. Alarm reaction is the initial physiologic response to a stressor described in Selye's general adaptation syndrome theory. OCD is a psychiatric pathology. Panic attacks go a step further in the anxiety cascade; the client is unable to function at this level.

A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects tertiary level of prevention? a) Conduct mental status assessment every 2 hours. b) Discuss family history of hypertension. c) Provide care transition at discharge for speech therapy. d) Assess blood pressure every 4 hours.

Provide care transition at discharge for speech therapy. Explanation: Tertiary prevention minimizes the consequences of a disorder through aggressive rehabilitation or appropriate management of the disease. An example is speech therapy to help restore ability. Blood pressure and mental status exams are examples of secondary prevention associated with the acute stroke. Discussing family history is also secondary prevention in terms of assessing for further risk factors.

A new graduate is having difficulty coping with the role transition from student to registered nurse (RN). Which defense mechanism is she exhibiting when she states, "I hate going in to work on weekends. The aides are lazy, the clients are all complaining, and the families are all crazy!" a) Denial b) Reaction formation c) Projection d) Displacement

Reaction formation Explanation: New RNs are often faced with a tremendous challenge—adapting to the "real world." While wanting to maintain the compassion, empathy, and altruism that caused them to choose health care as a profession, the realities of day-to-day conflict and stress at work are difficult to accept and may be even more difficult to resolve. Sometimes the new nursing graduate will cope by using reaction formation—developing attitudes that are opposite to what the nurse really would prefer to do (or needs to do) in the situation

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) Immediately administer an antiemetic. c) Contact the primary care provider. d) Sit with the client and ask them about their feelings.

Sit with the client and ask them about their feelings. Explanation: Somatization is manifesting an emotional stress through a physical disorder. Treating the nausea with an antiemetic will not get at the root cause of the emotional issue.

The nurse is preparing to administer an injection to an adult client and states, "Try to stay as still as possible." Which stage of the General Adaptation Syndrome (GAS) is the nurse addressing by making this statement? a) alarm b) resistance c) exhaustion d) pathological

alarm Explanation: The alarm stage is correct because this stage prepares the client for a "fight or flight" response to overcome the perceived danger, such as the injection of a needle. Stage of Resistance is designed to restore homeostasis and is therefore incorrect. Stage of exhaustion occurs when more adaptive or resistive mechanisms are no longer to protect the patient experiencing a stressor. Pathological response is not a phase of GAS

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) repression. b) allostatic load. c) burnout. d) sleep deprivation

burnout . Explanation: Burnout is the term used to describe behaviors that occur when a person is overwhelmed with the demands of a situation and is similar to the exhaustion stage of anxiety. This is commonly seen in nurses who work in high-stress environments. The individual in this scenario may have a great allostatic load and/or sleep deprivation, but there is no evidence of this in the given scenario. Repression is when a person copes by unconsciously denying the occurrence of a stressful event.

A client who responds to bad news concerning his lab reports by crying uncontrollably is handling stress by using: a) defense mechanism. b) withdrawal behavior. c) adaptation technique. d) coping mechanism.

coping mechanism. Explanation: Anxiety often is managed without conscious thought by coping mechanisms, which are behaviors used to decrease stress and anxiety. Coping mechanisms are immediate responses and are often involuntary. Crying is considered a coping mechanism. The change that takes place as a result of the response to a stressor is adaptation. Withdrawal is a type of coping mechanism. Defense mechanisms protect one's self-esteem and are useful in mild to moderate anxiety; if they used to an extreme, however, they distort reality and create problems with relationships.

A client's body uses physiologic mechanisms from within to respond to internal changes and maintain an essential balance.This process is known as: a) homeostasis. b) stress. c) self-regulation. d) fight-or-flight response.

homeostasis. Explanation: To maintain health, the body's internal environment must remain in a balanced state. Various physiologic mechanisms within the body respond to internal changes to maintain relative constancy in the internal environment, which is referred to as homeostasis.

A 65-year-old client has experienced the death of a parent and a family pet in the span of 1 month. Which action is a coping mechanism that demonstrates adaptation? a) visiting a psychic b) buying a new car c) deciding to no longer attend his family reunion picnic d) joining the local garden club

joining the local garden club Explanation: While each individual's response to stress is different, we know that coping mechanisms can be healthy or unhealthy. Buying things, isolating oneself socially, or looking for support in questionable places can be ways of coping, but are not necessarily healthy. Joining a social group of people with similar interests can provide distraction and serve as an outlet for feelings of sadness and loss.

During a counseling session a client states, "I just try to forget about my spouse hitting me." Which coping mechanism should the nurse document based on this client's statement? a) repression b) reaction formation c) rationalization d) regression

repression Explanation: Repression is the coping mechanism that this client is using, in which the client has removed the experience of being abused from conscious memory.

In order to make ends meet, a single mother of two small children is working two part-time jobs. She comes into the community health center looking disheveled and fatigued. She asks the nurse to make this appointment quick because she must go home and make dinner. Which health promotion activities would this client benefit from? Select all that apply. a) reducing stressors b) using aggressiveness c) cognitive behavioral therapy d) perfection reduction

• reducing stressors • perfection reduction Explanation: Assertiveness, not aggressiveness, is a preferred health promotion strategy. CBT is a treatment, not health promotion.

Which behaviors represent effective coping mechanisms? Select all that apply. a) setting limits with family members who upset you b) sleeping 14 hours a night c) learning relaxation techniques d) sleeping 3 hours a night e) denying responsibility for a DUI conviction f) taking a vacation

• setting limits with family members who upset you • learning relaxation techniques • taking a vacation Explanation: Coping mechanisms can have positive or negative effects on a client's well-being. All of these examples represent coping, either effective or ineffective.