Individual and Family Homeostasis, Stress, and Adaptation

A client comes to the clinic and reports frequent headaches and daily fatigue that is interfering with normal functioning. During collection of psychosocial history, the nurse notes a stressor sequence that may be causing the physical deviations. Which series of events represents a stressor sequence?

job loss, bankruptcy, and loss of house

Which of the following would a nurse least likely assess in a client experiencing anxiety?

Positive self-talk

The client asks the nurse about scarring from a surgical incision. The nurse's best response to this inquiry would be?

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

While interviewing the wife of a patient with multiple health problems, the spouse states, "I'm not the one who is ill, but I feel like I'm getting sick all the time." Which response by the nurse would be most appropriate?

"When one family member becomes ill, other members are affected."

Which of the following factors are implicated in the development of heart disease?

Frequent activation of the sympathetic nervous system

For a person to be clinically depressed, signs of a depressed mood or depressed interest in pleasurable activities must occur for at least

2 weeks.

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.

Which of the following responses is most helpful to the client when in an emergency situation?

A response by the sympathetic nervous system

Studying for the NCLEX-RN examination is an example of which type of stressor?

Acute, time-limited

A client has an abnormal result on a Papanicolaou test. The client asks the nurse what dysplasia means. Which definition should the nurse provide?

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

A client exhibits hostility toward the persons from whom she wants love and approval. Which of the following states the client's condition?

Ambivalence

The nurse is discussing health care goals with a client. What intervention will a nurse perform when assisting a client to achieve health care goals?

Appreciate the client's beliefs about the cause of illness.

A client is experiencing difficulty speaking and numbness on his right side. His wife calls a neighbor who is a nurse for help. Upon arrival at the scene, the nurse calls 911 immediately. Which of the following displays the nurse's critical clinical judgment?

Brain cells without oxygen die in approximately 3 to 6 minutes.

Years ago a client was informed that he had pre-hypertension. He admits that he has not had his blood pressure monitored for more than 3 years. Currently, the nurse assesses his blood pressure to be 178/104. Which body system may display a cellular adaptation to this condition?

Cardiovascular

A nurse assesses that a patient is at increased risk for depression based on which of the following?

Co-existing medical problems

Which term, according to Lazarus, refers to the process through which an event is evaluated with respect to what is at stake and what might and can be done?

Cognitive appraisal

Which of the following interventions should a nurse recommend for fostering effective coping skills and a sense of hardiness?

Daily exercise

A client is diagnosed with posttraumatic stress disorder (PTSD). Which finding would the nurse most likely assess?

Diaphoresis

Which of the following conditions triggers the general adaptation syndrome?

Distress

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

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?

Increased sympathetic activity

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

Dopamine

Which of the following would be the priority when providing care to a client with posttraumatic stress disorder (PTSD)?

Establishing a trusting nurse-client relationship

A nurse is developing a plan of care for a patient diagnosed with post-traumatic stress disorder (PTSD). Which of the following would be the priority?

Establishing a trusting nurse-patient relationship

When providing care to a patient with anxiety, which intervention would be the highest priority?

Exploring appropriate coping strategies

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

Hyperplasia

The nurse is obtaining a health history from a client with stress-related illnesses. When the nurse asks the client how the client copes with stress, which coping mechanism causes the nurse the most concern?

I run eight hours per day.

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?

Identification of the event as stressful

A client has gastroenteritis. He not only has diarrhea and dehydration but also complains of feeling very warm. What systemic response may the client experience with this inflammatory infection?

Increased body temperature

Which of the following would least suggest emotional health?

Realistic sense of hopelessness

Which type of healing occurs when the edges are not approximated and the wound fills with granulation tissue?

Second intention

When a person thinks about whether it is possible to do something about a situation, they are exhibiting what type of appraisal?

Secondary

A patient is admitted to the emergency department for observation after a minor automobile accident. On the basis of an understanding of the sympathetic nervous system's response to stress, what would the nurse expect to find during assessment? (Select all that apply.)

Skeletal muscle tension Cold, clammy skin Rapid respirations

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?

Socialization

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?

Viruses

A nurse correctly instructs a client with peripheral vascular disease that stress-reduction techniques:

are helpful because stress stimulates the release of vasoconstricting catecholamines

A client who is going to have surgery is slightly nervous. What nursing intervention is most important for the nurse to perform?

provide education

When implementing nursing interventions for a client with anxiety disorder, it is important for the nurse to stay with the client during periods of severe anxiety in order to

restore control to a more comfortable level.

Which area of the brain controls the alert or waking state of the body?

reticular activating system

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

stress awareness stage

The nurse is completing a client assessment. What is an effect of the sympathetic division of the autonomic nervous system?

vasoconstriction