Chapter 4: DAVIS Quiz

Which of the following choices shows the correct sequence for Hans Selye's stress response? A. Exhaustion, alarm, resistance B. Resistance, alarm, exhaustion C. Alarm, resistance, exhaustion D. Alarm, exhaustion, resistance

- Alarm, resistance, exhaustion Rationale: This shows the correct order for the stress response. **Test Taking Tips:Pay close attention to answers that differ in only one component. For example, "alarm, resistance, exhaustion" and "alarm, exhaustion, resistance" differ in only one point. One of these may be the correct choice.

A group of nursing students has created a flowchart to learn the hormones of the stress response. Which of the following show a mistake has been made on the flowchart? A. Hypothalamus—post pituitary—adrenal gland B. Posterior pituitary—antidiuretic hormone (ADH)—fluid retention C. Corticotropin-releasing factor (CRF)—Adrenocorticotropic hormone(ACTH)—cortisol D. Anterior pituitary—adrenal cortex-cortisol

A. Hypothalamus—post pituitary—adrenal gland Rationale: The hypothalamus stimulates the anterior pituitary, which then stimulates the adrenal gland.

While taking a patient's history, the nursing student learns that the patient has been under extreme stress at school and has suffered repeated infections of the common cold. The nursing student knows that prolonged stress may produce wear and tear on the body's systems. What term describes the nursing student's understanding? A. Alarm stage of stress B. Eustress C. Allostasis D. Allostatic load

allostatic load rationale: allostatic load is the wear and tear on the body due to repeated stressors

Which of the following are conditions associated with chronic stress? Select all that apply. A. Migraines B. Hypertension C. Acute, traumatic fractures D. Myocardial infarctions E. Peptic ulcer disease

migraines hypertension myocardial infractions peptic ulcer disease

In order to make studying easier, some nursing students have decided to group together items that increase during the stress response. Which of the following should be included on the students' list? Select all that apply. A. Urine output B. Gastrointestinal (GI) motility C. Epinephrine D. Blood glucose E. Acute immune response F. Blood flow to skin

- Epinephrine Rationale: Epinephrine increases during the stress response. - Blood glucose Rationale: Blood glucose levels elevate during the stress response. - Acute immune response Rationale: Immune system is initially stimulated with stress. **Test Taking Tips:For each answer choice, state the answer relative to the question stem to see if it should be selected. For example, state "urine output is increased during the stress response" to see if it sounds correct before selecting that answer choice.

A patient presents with the following characteristics: reduced white blood cell (WBC) levels, immunosuppression, a sense of being rundown and unable to cope, and suppressed hormone levels. Which stage of the stress response may the patient be experiencing? A. Alarm B. Resistance C. Exhaustion D. Indeterminate

- Exhaustion Rationale: In the exhaustion stage of the stress response, hormone levels decline, immunosuppression develops, and sense of being overwhelmed may develop.

A nurse rushes up to a trauma victim. Which of the following signs and symptoms is the nurse expecting to encounter? Select all that apply. A. Decreased heart rate (HR) B. Increased blood pressure (BP) C. Pupil dilation D. Slow, deep breathing E. Cool, clammy extremities

- Increased blood pressure (BP) Rationale: BP increases during the stress response. - Pupil dilation Rationale: Pupils dilate during the stress response. - Cool, clammy extremities Rationale: Peripheral vasoconstriction, which occurs during the stress response, causing coolness of the extremities.

A nurse has received a series of laboratory values and vital signs for a patient who recently experienced a traumatic accident. The laboratory values were taken when the patient was in the alarm stage of the stress response. Which of the following laboratory values and vital signs does the nurse expect to see? Select all that apply. A. Decreased respiratory rate B. Decreased antidiuretic hormone (ADH) C. Increased blood pressure (BP) D. Increased heart rate (HR) E. Elevated white blood cells (WBCs)

- Increased blood pressure (BP) Rationale: BP levels increase during the stress response. - Increased heart rate (HR) Rationale: HR increases during the stress response. - Elevated white blood cells (WBCs) Rationale: WBCs initially increase in acute stress response.

A patient arrives at the emergency department having come from the scene of a motor vehicle accident. Initial blood laboratory values indicate elevated blood glucose levels. Which of the following are likely explanations? Select all that apply. A. Patient must have diabetes mellitus B. Increased epinephrine C. Inaccurate specimen as blood glucose tests require fasting D. Adrenal gland suppression E. Increased cortisol release F. Increased antidiuretic hormone

- Increased epinephrine Rationale: Epinephrine increases blood glucose levels during the stress response. - Increased cortisol release Rationale: Cortisol raises blood glucose levels. Test Taking Tips: Do not simply read the answer choices and "guess." Take a moment to determine whether each term in an answer choice is clearly understood before answering. For example, the "adrenal gland suppression" choice requires knowledge of the adrenal gland's role, and then the understanding of what would happen if this gland was suppressed.

A nurse is educating a patient about the stress response because the patient wants to know why the stress response is so strong. The nurse responds that several systems are the initial primary responders to stress. Which systems was the nurse speaking about? Select all that apply. A. Gastrointestinal tract B. Cardiac C. Nervous D. Endocrine E. Respiratory

- Nervous Rationale: The nervous system, particularly the sympathetic nervous system, is a primary responder to a stress event. - Endocrine Rationale: The endocrine system is a primary responder to a stress event. **Test Taking Tips: Be careful not to overthink the question. The key phrase in the question stem is "initial primary responders." The cardiac system is involved in the stress response, but it is activated by the nervous and endocrine systems.

Some individuals appear to suffer from stress to a greater degree than others. Which of the following may account for a more pronounced stress response? Select all that apply. A. Poorer ability to adapt B. Infrequent stressors C. Shorter duration stressors D. Longer duration stress response E. Strong adaptations and copings

- Poorer ability to adapt Rationale: Some individuals have a reduced capacity to adapt to stressful events. -Longer duration stress response Rationale: Individuals with a prolonged stress response are more likely to have a pronounced response to stress.

A patient has developed a tumor of the hypothalamus disrupting hypothalamic hormone production. As the nurse scans the laboratory report, which finding most directly supports this conclusion? Elevated cortisol Reduced aldosterone Elevated antidiuretic hormone (ADH) Reduced corticotropin releasing factor(CRF)

- Reduced corticotropin releasing factor(CRF) Rationale: CRF is produced by the hypothalamus. If the hypothalamus is damaged, CRF production will be reduced. Test Taking Tips:Be cautious about overthinking the question stem. The key phrase "most directly" indicates to select the answer choice most closely associated with the hypothalamus.

A nursing educator overhears some students speaking about how amazing the adrenal glands are for the stress response. Which of the following comments indicate the students need help? A. The adrenal cortex produces epinephrine and norepinephrine. B. Adrenal cortex hormones help maintain blood volume and blood sugar. C. The hypothalamus and the anterior pituitary regulate adrenal cortex hormone production. D. Several hormones—cortisol, aldosterone, epinephrine—are produced by the adrenal gland.

- The adrenal cortex produces epinephrine and norepinephrine. Rationale: The adrenal medulla produces epinephrine and norepinephrine, not the adrenal cortex. **Test Taking Tips:The phrase "need help" indicates to select answer choices that contain incorrect information.

A patient with rheumatoid arthritis, an autoimmune condition, is upset because she has been prescribed corticosteroids to suppress the immune system. The patient feels this is wrong, as she has learned that cortisol activates the immune response. Which of the following would be an appropriate response by the nurse? A. Support the patient's views, as patients seems resistant to correction. B. Inform the patient of the different effects of cortisol on the immune system, whether the cortisol is present for a short duration or long term. C. Offer to change the prescription. D. Tell the patient she is misinformed. Corticosteroids do not work on immune system. They were prescribed to help her bones grow.

B. Inform the patient of the different effects of cortisol on the immune system, whether the cortisol is present for a short duration or long term. Rationale: This response provides the patient with correct information.

A patient is speaking to a nurse about the patient's stressful life. Which of the following recommendations may the nurse make? A. Up your caffeine intake so you have more energy. B. Stop all activity and exercise, and rest as much as possible. C. If you sleep less, you can get more done. D. Eat a balanced, nutritious diet.

D. Eat a balanced, nutritious diet. Rationale: Stress can disrupt eating patterns. Eating a balanced diet can help restore the body during times of stress.