the point pre infection and stress

Which statement, made by a senior citizen who has taken a class on stress reduction, would indicate to the nurse the need for further instruction?

"As one grows older, their stress decreases."

A recently divorced client presents to the emergency department with chest pain, nausea, headaches, palpitations, and diaphoresis. An electrocardiogram (ECG) and lab work do not demonstrate an ischemic cardiovascular event. What question during the data collection might lead the nurse to a nursing diagnosis of Anxiety?

"Can you tell me what has been going on in your life recently?"

A teen is worried that her boyfriend is under "a lot of stress" with his home life, classes, clubs, community service, and part-time work. She asks the nurse what medication he should take to "calm down." Which response would be best?

"Do you think he would be willing to sit down and talk with me? I'd like to get to know him better so I can suggest some healthy alternatives."

Which question would be helpful in eliciting data about the effects of stress during a health history?

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

Several family members are visiting a client with an antibiotic-resistant infection who has been placed on contact precautions. When the nurse teaches the visitors about wearing gloves and gown, a family member states, "I don't want to wear those. I can't catch anything just by holding my loved one's hand." What is the appropriate nursing response?

"These barriers help to prevent the transmission of infection."

Which client is adapting to physiologic stressors?

A 62-year-old with breast cancer who researches breast reconstruction websites

If a nurse assessed the vital signs of a person who was in the initial alarm reaction stage (shock phase) of the general adaptation syndrome, what would be the expected findings?

hypertension

Which nurse is most likely to experience the greatest amount of stress related to his or her position as a nurse?

A graduate nurse working on a telemetry unit

A middle-age adult discusses with the nurse the loss of his job due to frequent illness. The nurse recognizes the client's loss of his income as which of the following?

A stressor

What is an accurate guideline for removing soiled gloves after client care? Use the nondominant hand to grasp the opposite glove, near the cuffed end on the outside exposed area. Remove the glove on the nondominant hand by pulling it straight off, keeping the contaminated area on the outside. After removing the glove on the nondominant hand, hold the removed glove in the remaining gloved hand. After removing the first glove, slide the fingers of the ungloved hand between the remaining glove and the wrist and pull the glove straight off, with the contaminated area on the outside.

After removing the glove on the nondominant hand, hold the removed glove in the remaining gloved hand.

A freshman college student comes to the health clinic reporting insomnia and difficulty concentrating in class. The student has three red, scaly patches of skin on his arms and chest. The nurse believes the primary nursing diagnosis for this client is:

Anxiety related to stress of achievement in school

Which statement correctly explains a person's interactions with basic human needs?

As a person strives to meet basic human needs at each level, stress can serve as either a stimulus or barrier.

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 the nurse can expect for this client? Client will adapt relaxation techniques to reduce stress. Client will be stress free. Client will avoid stressful situations. Client will start on an antianxiety agent.

Client will adapt relaxation techniques to reduce stress.

Which are considered internal stressors?

Fear Illness Hormonal change

A child has been admitted to the medical center with severe depression and stress, and has been avoiding going to school for these reasons. How should the nurse attempt to treat the child?

Find the factors that have caused stress and depression

A nursing student is performing a urinary catheterization for the first time and inadvertently contaminates the catheter by touching the bed linens. What should the nurse do to maintain surgical asepsis for this procedure?

Gather new sterile supplies and start over.

The client is under immediate stress. The nurse assesses which sign as an effect of the sympathetic system?

Heart rate of 102 beats/min.

Which statement best explains the rationale for bringing an extra pair of sterile gloves into an adult client's room before preparing for a sterile procedure?

If the first pair is contaminated and needs to be replaced, the nurse does not need to leave the room for a new pair.

The nurse caring for a client after hip surgery enters the room to take the client's vital signs. Which precaution should the nurse use? Select all that apply.

Nonsterile gloves Hand hygiene

A nurse has collected the blood, urine, and stool specimens of a client with meningococcal meningitis. Which precaution should the nurse take when transporting the specimens?

Place the specimens into plastic biohazard bags.

The friend of a long-term care client comes to visit despite having an upper respiratory infection. What is the appropriate nursing response?

Please use a mask when visiting with the client to prevent infection."

A nurse is preparing to educate a client about care at home. On entering the room, the client is pacing around the room, hyperventilating, and reporting nausea. Based on these manifestations of severe anxiety, what is the priority action by the nurse?

Postpone implementation of the education plan and reassess the client.

Of all possible nursing interventions to break the chain of infection, which is the most effective?

Practicing hand hygiene

A client asks about general adaptation syndrome (GAS). Which details provided by the nurse are correct?

The alarm stage of GAS can last from minutes to hours. It can be a response to physiologic or psychological stress. There are three stages to GAS.

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? The client's mind is preparing for a fight-or-flight response as he relates the incident. The client's mind is numb, and he is not able to react to further questions from the nurse. The brain is receiving less oxygen with each passing minute, which does not allow him to speak. The brain is sending chemicals to the bloodstream that make the client afraid of the questions.

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

Which action should the nurse perform first after an exposure to a client's body fluids?

Wash the exposed area with soap and water.

When caring for a client with a respiratory infection, the nurse washes her hands frequently and thoroughly. What are the other precautionary steps the nurse should take in order to prevent infection?

Wear a mask when talking to the client.

Which description most accurately defines an infection?

a disease resulting from pathogens in or on the body

Which scenario describes an example of developmental stress? a newborn who needs to be fed by bottle a school-age child learning to read a teenager learning to drive a car a middle adult accepting signs of aging

a middle adult accepting signs of aging

What is the term for the change that takes place in response to a stressor?

adaptation

A nurse hears a client yelling for help from his room. The nurse runs to the client's room, and upon arriving in the room, the nurse's heart rate and oxygen demands have increased. What phase of the general adaptation syndrome (GAS) is best described by the nurse's physiologic changes?

alarm reaction

While conducting the physical assessment of a client, the nurse notes an increase in the blood glucose levels. Upon inquiry, the client discloses that lately he has been under a lot of stress at work. Which stage of stress is the client experiencing?

alarm stage

When nurses become overwhelmed in their jobs and develop symptoms of anxiety and stress, they are experiencing what condition?

burnout

The nurse is caring for an older adult with pneumonia. Which assessment finding requires immediate nursing intervention?

client is more difficult to arouse

A client's body uses physiologic mechanisms from within to respond to internal changes and maintain an essential balance. This process is known as:

homeostasis

During an interview, the client states, "When my stress is really high, I have diarrhea." The physiologic response affects:

gastrointestinal status.

Health care professionals are required to follow certain principles to ensure that healthcare-associated infections (HAI) do not occur in the health care facility. What contributes to infections during health care?

health professionals donning artificial nails

Which is an example of the body's defense against infection?

immune response

A young woman who has just started college is 6 weeks into the semester and has several tests and assignments due in approximately 3 days. She has developed a sore throat and fever. The development of illness is related to:

immunosuppression with stress.

Which area of nursing experiences the highest levels of stress in the work setting?

new graduate nurses

An occupational health nurse at an oil refinery on the gulf coast of Texas performs client education with an adult client. The client is being seen after having suffering a chemical burn in an accident at the refinery. Which type of stressor has this client been exposed to?

physiologic

A nurse is assessing a client with stress-related problems. Which factor influences responses to stressors?

social support

What nursing action will the nurse perform to reflect safe injection practices?

using sterile, single use, disposable, syringes for each injection

When performing hand hygiene, the nurse prefers to use an alcohol-based hand sanitizer. Which situation should the nurse use a different method?

visibly soiled hands

Before and after doing aseptic techniques with a client, the nurse should: sterilize equipment. apply clean gloves. replace equipment. wash hands.

wash hands