Chapter 5 Stress and Inflammation Response

The plan of care for a client with anxiety includes a nursing diagnosis of ineffective coping. The nurse determines that the plan of care was successful when the client states which of the following? "I know that the breathing techniques I've learned help me relax." "I need to avoid any kind of stress in my life." "I guess I'll just have to learn to live with my fears." "I won't have to take my medication for very long."

"I know that the breathing techniques I've learned help me relax."

A client with a foodborne illness is concerned his gastrointestinal tract will never be the same again. Which of the following would be an appropriate response from the nurse? "Gastrointestinal cells can adapt to the new environment created by the infection." "New gastrointestinal cells replace damaged ones constantly." "It's true. You may have to readjust your eating habits." "Give it time. Don't worry."

"New gastrointestinal cells replace damaged ones constantly."

The nurse is instructing a community education class on stress. The nurse asks the participants, "Is all stress bad for you?" Which answer by the participants indicates that teaching has been effective? "No, not all stress is bad, but all stress can make a person sick." "Yes, all stress is bad but in varying degrees depending on the nature." "Yes, all stress has negative effects on the body systems." "No, the right amount of stress can be motivating to accomplish goals."

"No, the right amount of stress can be motivating to accomplish goals."

The client asks the nurse about scarring from a surgical incision. The nurse's best response to this inquiry would be? "There will be significant scarring." "The wound will fill in with granulation tissue that you may see." "Since the edges are approximated, there will be little scar formation." "Scar-reducing creams are available if you are concerned."

"Since the edges are approximated, there will be little scar formation."

A client with type 2 diabetes is concerned because the client requires insulin injections while being treated for an acute illness. Which response will the nurse give to this client? "Having the extra insulin will make your body heal faster." "The stress of your illness is raising your blood glucose level temporarily." "The illness revealed that you really have type 1 diabetes." "You will learn how to give yourself these injections after discharge."

"The stress of your illness is raising your blood glucose level temporarily."

Brain cell death may occur in as little as: 1 minute 7 minutes 5 minutes 3 minutes

3 minutes

The physician tells a client, "You are lucky. This episode of chest pain is a warning sign." How can the nurse explain to the client what the physician means? A decrease in blood supply to the heart causes stress to cells through the perception of pain. As the cardiac cells display pain, the cells are not able to make proteins for energy. Chest pain alerts a client that the ability of the cell to transform energy is compromised. The pressure on the heart is warning of a muscular disease.

A decrease in blood supply to the heart causes stress to cells through the perception of pain.

A client has an abnormal result on a Papanicolaou test. The client asks the nurse what dysplasia means. Which definition should the nurse provide? Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found Increase in the number of normal cells in a normal arrangement in a tissue or an organ Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin Alteration in the size, shape, and organization of differentiated cells

Alteration in the size, shape, and organization of differentiated cells

A nurse identifies a nursing diagnosis of spiritual distress for a patient based on assessment of which of the following? Select all that apply. Ambivalence Anger Acceptance Despair Peacefulness

Anger Ambivalence Despair

Which of the following would be the priority when providing care to a client with posttraumatic stress disorder (PTSD)? Helping the client address the trauma experienced Teaching the client appropriate methods for coping Establishing a trusting nurse-client relationship Assisting the client in working through the trauma

Establishing a trusting nurse-client relationship

A nurse correctly instructs a client with peripheral vascular disease that stress-reduction techniques: are helpful because they distract the client from focusing on claudication pain. are helpful because stress stimulates the release of vasoconstricting catecholamines. haven't proven useful in clients with peripheral vascular disease. are helpful only because they assist in smoking cessation.

Are helpful because stress stimulates the release of vasoconstricting catecholamines.

The nurse is caring for a client with diabetes who has an infection. The nurse creates a plan of care for the client based on a knowledge of the hypothalamic-pituitary response to stress by including which nursing intervention in the plan of care? Assessment for hyperglycemia Restriction of dietary protein Increase in insulin dosage Measurement of intake/output

Assessment for hyperglycemia

The nurse is performing an assessment to determine the patient's social support systems. What question is important for the nurse to ask? Does the client regularly attend a support group? Does the client have an exercise plan to stay motivated? Does the patient belong to a group that is mutually dependent and communicative? What is the client's current employment status?

Does the patient belong to a group that is mutually dependent and communicative?

The nurse is caring for a client with an anxiety disorder. The client reports feelings of anxiousness when in social situations. Which classification of medications does the nurse anticipate? Corticosteroids Adrenergic blockers Antipsychotics Benzodiazepines

Benzodiazepines

Cells in which organ are unable to regenerate? Brain Kidney Liver Pancreas

Brain

A nurse is working with a family that is under stress. Which trait would the nurse emphasize in the plan of care as being most useful to the family's coping? Cognitive abilities Communication skills Emotional strengths Individual talents

Communication skills

The nurse is working with a client who is in a stressful situation. The nurse evaluates the client's resiliency by assessing the client's ability to do what? Admit past mistakes Respond with strong emotions Verbalize feelings of anger Continue to function well

Continue to function well

The nurse is reviewing a client's 0800 laboratory data. Which laboratory value concerns the nurse? potassium 3.7 mEq/l (3.7 mmol/l) calcium 9.1 mg/dl (2.27 mmol/l) sodium 137 mEq/l (137 mmol/l) cortisol 35 mcg/dl (965.58 mmol/l)

Cortisol 35 mcg/dl (965.58 mmol/l)

Impaired balance and uncontrolled tremors of Parkinson's disease is correlated with which neurotransmitter? Glutamate Acetylcholine Serotonin Dopamine

Dopamine

A client comes to the emergency department with swelling in the left knee. The nurse is aware of the cardinal signs of inflammation occurring in the knee. Identify the correct cardinal signs of inflammation. Select all that apply. Rash Subluxation Erythema Warmth Paralysis

Erythema Warmth

A nurse is preparing a teaching plan for a client with anxiety. Which technique would be least appropriate to include? Talking about feelings Progressive relaxation techniques Use of distraction Focusing on positive aspects of the future

Focusing on positive aspects of the future

When providing care to a patient with anxiety, which intervention would be the highest priority? Ensuring adequate nutritional intake Improving the patient's sleeping patterns Administering prescribed anti-anxiety medications Exploring appropriate coping strategies

Exploring appropriate coping strategies

A nurse suspects that a client has adrenal insufficiency. Which electrolyte imbalances support adrenal insufficiency? Select all that apply. hypokalemia hypermagnesemia hypernatremia hyperkalemia hyponatremia

Hyperkalemia Hyponatremia Hypermagnesemia

What is the term for an adaptation to environmental stress that occurs when tissue mass enlarges due to cell multiplication and increased stimulation? Atrophy Metaplasia Hyperplasia Dysplasia

Hyperplasia

The nurse conducting a community educational program on stress is including Lazarus's cognitive appraisal theory. The nurse evaluates that the participants understand the teaching when they state that during primary appraisal, which action occurs? Evaluation of what might be done Identification of the event as stressful Change in a previous opinion Conflict between desire and need

Identification of the event as stressful

After educating a class about depression, the instructor determines that additional class time is needed for teaching when the class identifies which of the following as an indicator of depression? Sleep disturbances Increased concentration Feelings of worthlessness Increased thoughts about death

Increased concentration

A nurse is assessing a patient with posttraumatic stress disorder (PTSD) who is exhibiting physiologic manifestations. The nurse interprets these manifestations as being the result of which of the following? Decreased plasma catecholamine levels Decreased urinary epinephrine levels Increased sympathetic activity Increased parasympathetic activity

Increased sympathetic activity

A patient with diabetes is admitted to the hospital with a blood sugar level of 320 mg/dL. Why should the nurse monitor fluid intake and output for this patient? Polydipsia occurs when glucose catabolism is accelerated, thereby increasing the body's need for fluids. Polyuria results from osmotic diuresis, which is compensatory to hyperglycemia. Decreased blood osmolarity causes fluid to shift into the interstitial spaces, resulting in polydipsia. The blood's hypotonicity will result in tissue fluid retention and weight gain.

Polyuria results from osmotic diuresis, which is compensatory to hyperglycemia.

Which of the following would least suggest emotional health? Pursuit of personal goals Realistic sense of hopelessness Management of every day challenges Acceptance of reality

Realistic sense of hopelessness

Which type of healing occurs when the edges are not approximated and the wound fills with granulation tissue? Cellular necrosis Second intention Third intention First intention

Second intention

The patient wants to be prescribed an anti-infective drug for the flu. The nurse understands that anti-infective medications would not be useful against which biologic agents? Mycoplasmas Bacteria Fungi Viruses

Viruses

The nurse provides care for a client who is critically ill due to a diagnosis of pneumonia and is at risk for developing shock. Assessment data reveals a white blood cell (WBC) count of 15 × 103 cells/mm3 (15 × 109/l) (normal: 4.5 to 10.5 × 103 cells/mm3 (4.5 to 10.5 × 109/l), a temperature of 102.2°F (39°C), and warm, flushed skin. Complete the following sentence by choosing from the lists of options. The client is at the highest risk for developing Select...cardiogenic shock hypovolemic shock septic shock Select... as evidenced by Select...decreased urine output altered mentation chest pain Select....

Septic shock, Altered mentation

During a family assessment, the mother states, "When I was a child, we always had a special dinner on Christmas Eve, that my mother had when she was a child. Now our family follows the same tradition." The nurse interprets this statement as indicating which family function? Education Boundary setting Socialization Management

Socialization

Which type of cell has a latent ability to regenerate? Labile Permanent Stable Epithelial

Stable

The general adaptation syndrome (GAS) is a nonspecific physiologic response to a stressor. Which stage is not a part of the process? exhaustion stage resistance stage stress awareness stage alarm stage

Stress awareness stage

When caring for a family who is coping with a crisis illness situation, which family function would the nurse identify as being most crucial? Communication Boundary setting Support Management

Support

The nurse is using progressive muscle relaxation with a client to reduce stress. What will the nurse teach the client to do? use a weight and lift in sessions of 10 movements tense and relax specific muscles repeat a word or phrase while bending at the waist imagine a pleasant scene

Tense and relax specific muscles

The nurse is caring for a client with hypoxia. What is the nurse's consideration with regard to the client experiencing brain cell death? The client may have brain cell death in 1 to 3 minutes. The client may have brain cell death in 3 to 6 minutes. The client may have brain cell death in 6 to 9 minutes. The client may have brain cell death in 9 to 12 minutes.

The client may have brain cell death in 3 to 6 minutes.

The nurse is assessing a postoperative client's surgical incision site. The nurse anticipates which finding? Granulation tissue formation Moderate amount of scar formation Abnormal cell functionality Wound edge approximated

Wound edge approximated