Nursing 101 Chapter 42: Stress and Adaptation

The perception and effects of stressors are highly individualized

Cold temperatures and loud noises are stressors to one person but not another. Why does this occur? A) Although the perception is the same, the response is individualized. B) Both individuals will respond the same, depending on the situation. C) The perception and effects of stressors are highly individualized. D) The internal environment of one person is more selective.

Hypertension

If a nurse assessed the vital signs of a person who was in the initial alarm reaction stage (shock phase) of the GAS, what would be the expected findings? A) Slow, deep breathing B) Fatigue and lethargy C) Hypotension D) Hypertension

Heat

Of the following physiologic stressors, which one is a physical agent? A) Heat B) Drugs C) Bacteria D) Hypoxia

regression

The client is a child age 5 years hospitalized for a surgical procedure. The client is bedwetting. The parents report this is a new behavior and their child is toilet trained. The nurse assesses the client is exhibiting the defense mechanism of ... A) compensation. B) displacement. C) reaction formation. D) regression.

Stress overload related to single parenting

The client is a single parent being seen at an employee wellness clinic. The client tells the nurse he has three school-age children who participate in various activities. He states, "Every night, I am taking them to soccer practice, football practice, Girl Scouts. I have to fix dinner and then go over homework. I have no time for myself. I am so tired." The client exhibits tremors of his hands. Blood pressure is 140/88 mm Hg, heart rate is 98 beats/minute, and respirations are 30 breaths/minute. Data best supports which of the following nursing diagnoses? A) Stress Overload related to single parenting B) Defensive Coping related to inability to appraise stressors C) Hopelessness related to multiple responsibilities D) Disturbed Sleep Pattern related to anxiety

Heart rate of 102 beats/minute

The client is under immediate stress. The nurse assesses which sign as an effect of the sympathetic system? A) Blood sugar of 65 mg/dL B) Heart rate of 102 beats/minute C) Increased bowel sounds D) Cool, clammy skin

Client will adapt relaxation techniques to reduce stress

The nurse walks into the client's room and finds her sobbing uncontrollably. When the nurse asks what the problem is, the client responds I am so scared. I have never known anyone who goes into a hospital and comes out alive. On this client's care plan the nurse notes a nursing diagnosis of Ineffective coping related to stress. What is the best outcome you can expect for this client? A) Client will adapt relaxation techniques to reduce stress. B) Client will be stress free. C) Client will avoid stressful situations. D) Client will start anti-anxiety agent

Prolonged stress from caring for a family member at home

The wife of a client on hospice at home is diagnosed with "caregiver burden." Which of the following best describes this syndrome? A) Prolonged stress from caring for a family member at home B) Inability to provide competent care for a family member C) Insufficient funds to pay for medical care of a family member D) Effect of the illness causing stress in siblings

Homeostasis

Various physiologic mechanisms within the body respond to internal changes to maintain relative constancy in the internal environment. The state that results is called what? A) Nirvana B) Homeostasis C) Fight-or-flight response D) Anxiety

Adaptation

What is the term for the change that takes place in response to a stressor? A) Rehabilitation B) Adaptation C) Positive movement D) Negative movement

Stage of exhaustion

What phase of the general adaptation syndrome is a client in when he uses all of his adaptive mechanisms for dealing with stress, leaving no defense against the distress? A) Alarm reaction stage B) Fight-or-flight stage C) Stage of resistance D) Stage of exhaustion

Take control of the situation

When discussing his problem, a client tells the nurse that he is always doing small, petty jobs for everyone and he is not happy about it. Because of this, he is feeling stressed and has been getting into fights with his wife. What should the nurse suggest to help the client overcome this problem? A) Change jobs. B) Avoid people who dump tasks on him. C) Take control of the situation. D) Avoid doing petty jobs.

New graduates

Which area of nursing experiences the highest levels of stress in the work setting? A) Obstetric nurses B) Pediatric nurses C) New graduates D) Aging nurses

Anxiety related to conflicts about values and goals in life.

Which diagnoses would be written for stress as the cause of the problem? A) Anxiety related to conflicts about values and goals in life B) Caregiver Role Strain related to long-term stress of care for a parent with Alzheimer's disease C) Spiritual Distress related to inability to accept diagnosis of terminal illness D) Hopelessness related to presence of disabling physical injuries

A response to changes in the normal balanced state

Which of the following best describes stress? A) A response to changes in the normal balanced state B) A perception that something is threatening C) A response to internal environment for homeostasis D) A localized response of a tissue or organ to a stressor

A) Autonomic nervous system B) Endocrine system

Which of the following body systems are the primary controllers of homeostatic mechanisms? Select all that apply. A) Autonomic nervous system B) Endocrine system C) Respiratory system D) Cardiovascular system E) Gastrointestinal system

Unknown cause, emotional, apprehensive

Which of the following group of terms best describes anxiety? A) Cognitive, known threat, depression B) Cognitive, visible threat, anger C) Known source, prolonged, solely physical D) Unknown cause, emotional, apprehensive

Cardiovascular disease

Which of the following illnesses has been associated with long-term stress? A) Bacterial infections B) Cardiovascular disease C) Renal disease D) Fractures

A middle adult accepting signs of aging

Which of the following is an example of developmental stress? A) A newborn who needs to be fed by bottle B) A school-age child learning to read C) A teenager learning to drive a car D) A middle adult accepting signs of aging

"How does your body feel when you are upset?"

Which of the following questions would be helpful in eliciting data about the effects of stress during a health history? A) "Why are you having so much difficulty breathing at night?" B) "Why do you think smoking and drinking will calm you?" C) "Do you often drink too much and have hangovers?" D) "How does your body feel when you are upset?"

A girl quickly withdraws her hand from a stream of hot tap water.

Which of the following responses to stressors results from the activation of the local adaptation syndrome? A) A girl quickly withdraws her hand from a stream of hot tap water. B) A woman's impending job interview has prompted the activation of her fight-or-flight response. C) A man is experiencing moderate anxiety before meeting with an important client. D) A man has a sudden urge for a bowel movement before undergoing thoracentesis.

As one grows older, their stress decreases

Which of the following statements, made by a senior citizen who has taken a class on stress reduction, would indicate to the nurse the need for further instruction? A) Adults draw on coping skills learned throughout life. B) Family members can be supportive during stress. C) Stress may be positive or negative. D) As one grows older, their stress decreases.

Therapeutic coping strategy

A client age 35 years is stressed because he is having problems with his superiors at work. The client says that he had an argument with his superiors about his salary. He has become very anxious and has started consuming large amounts of caffeine very frequently. He also suffers from insomnia and gets angry quickly. Which of the following techniques should the nurse suggest to help the client? A) Non-therapeutic coping strategy B) Negative coping strategy C) Therapeutic coping strategy D) Sensory manipulation strategy

The client's mind is preparing for a fight-or-flight response as he relates the incident

A client has been brought to the health care facility with accident-related injuries. During the initial interview, the client becomes agitated, upset and is unable to answer any more of the nurse's questions. What does the nurse conclude about the condition of the client? A) The client's mind is preparing for a fight-or-flight response as he relates the incident. B) The client's mind is numb, and he is notable to react to further questions from the nurse C) The brain is receiving less oxygen with each passing minute, which does not allow him to speak. D) The brain is sending chemicals to the bloodstream that make the client afraid of the questions.

Coping mechanism

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? A) Adaptation B) Homeostasis C) Coping mechanism D) Defense mechanism

Psychosomatic disorder

A client who is being seen at a physician's office states that he has "bad headaches all the time." Diagnostic tests are normal. What is this type of response to stress called? A) Psychosomatic disorder B) Acute illness C) Chronic illness D) Pretend disorder

A local adaptation syndrome

A client with an inflamed appendix is feeling pain in the stomach area. What is the term for this body response to stress? A) Local adaptation syndrome B) General adaptation syndrome C) Physiological homeostasis D) Fight-or-flight response

Situational

A friend has lost her job and is becoming increasingly anxious to the point of crisis. What type of crisis is she experiencing? A) Adventitious B) Maturational C) Situational D) Emotional

Denial

A man has noticed bright red blood in his bowel movements for over a month. He says to himself, "Oh, it's just my hemorrhoids." What defense mechanism is the man using? A) Rationalization B) Repression C) Denial D) Compensation

30 to 45 minutes, most days of way week

A nurse is educating a client about the benefits of exercise in reducing stress. How often would the nurse recommend the client exercise? A) Two hours every day B) One hour once a week C) 30 to 45 minutes, most days of the week D) 60 to 75 minutes, four to five times a week

Postpone implementation of the education plan

A nurse is preparing to educate a client about care at home. On entering the room, she finds the client pacing around the room, hyperventilating, and complaining of nausea. Based on these manifestations of severe anxiety, what would the nurse do? A) Provide both verbal and written information to the client. B) Ignore the client and teach the family the information. C) Modify the education plan to the client's anxiety level. D) Postpone implementation of the education plan.

Relaxation

A nurse teaches a client deep-breathing exercises to help control his anxiety. This is considered what type of stress management technique? A) Meditation B) Relaxation C) Anticipatory guidance D) Guided imagery

Mind-body interaction

A student is preparing for her first client assignment. She wakes up at 4 AM with a pounding pulse and diarrhea. What type of adaptive response to stress is she experiencing? A) General adaptation syndrome B) Mind-body interaction C) Local adaptation syndrome D) Coping or defense mechanism

Panic

A woman who was assaulted in the street is brought to the emergency room for observation. A nurse documents that the woman has difficulty communicating verbally, is agitated, and complains of chest pain and a sense of impending doom. What type of anxiety is this client experiencing? A) Mild anxiety B) Moderate anxiety C) Severe anxiety D) Panic

Reflex pain response

An individual steps into a tub of very hot water and immediately jumps out again. What mechanism caused this response? A) Inflammatory response B) Reflex pain response C) General adaptation syndrome D) Fight-or-flight response