HN: Stress Management
Which factor determines how a person responds to a stressor? A person's tolerance level The severity of the stressor The ability to change the situation A person's perception of the stressor
A person's perception of the stressor Rationale A person's perception of the potential stressor influences the way an individual responds to that stressor. A person's tolerance level, ability to change the situation, and severity of the stressor do not address how a person may respond to the stressor.
Which hormone is derived from proopiomelanocortin? Human growth hormone Thyroid-stimulating hormone Adrenocorticotropic hormone Corticotropin-stimulating hormone
Adrenocorticotropic hormone Rationale Stress activates the hypothalamus to release proopiomelanocortin. Adrenocorticotropic hormone is derived from proopiomelanocortin. Stimulation of adrenocorticotropic hormone results in the secretion of corticosteroids and aldosterone. Human growth hormone, also known as somatropin, regulates growth and cell reproduction in the patient. Human growth hormone is derived from the pituitary, not from proopiomelanocortin. The hypothalamus produces thyrotropin-releasing hormone, which stimulates the pituitary to release thyroid-stimulating hormone. Corticotropin-stimulating hormone is secreted by the paraventricular nucleus of the hypothalamus in response to stress. It is not derived from proopiomelanocortin.
Which substance is released when the corticotropin-releasing hormone (CRH) acts on the anterior pituitary? Corticosteroids Catecholamines Thyroid hormone Adrenocorticotropic hormone
Adrenocorticotropic hormone Rationale The CRH acts on the anterior pituitary to promote the release of adrenocorticotropic hormone, which in turn stimulates the adrenal cortex to release corticosteroids. The adrenal medulla is also stimulated to secrete catecholamines. Thyroid hormones are secreted from the thyroid gland.
Which hormone has the most significant effects on a person's physiologic state during a stressful time? Insulin Cortisol Glucagon Antidiuretic hormone (ADH)
Cortisol Rationale The mediating and controlling effects of cortisol on stress are pronounced. These effects are more numerous and more pronounced during times of stress than those of insulin, glucagon, or ADH.
Which hormones inhibit the immune system during stress? Select all that apply. Cortisol Glucagon Aldosterone Catecholamines Growth hormone
Cortisol Catecholamines Rationale The corticosteroids (e.g., cortisol) and catecholamines (e.g., epinephrine, norepinephrine) inhibit the immune system after their release is stimulated by the stress response. Glucagon leads to the increase of glucose in the blood during stress. Aldosterone helps to "save salt" and doesn't really affect the immune system. Growth hormone stimulates the growth of bones, muscles, and other organs by promoting protein synthesis, but it is not specifically stimulated by stress.
Which type of coping strategy is effective during a stressful circumstance that is uncontrollable? Avoidance Delayed acceptance Problem-focused coping Emotion-focused coping
Emotion-focused coping Rationale When a situation is unchangeable or uncontrollable, emotion-focused coping may predominate. Emotion-focused coping helps to decrease negative emotions because these strategies help to create a feeling of well-being. If a problem can be changed or controlled, problem-focused coping is the most helpful coping strategy. Avoidance and delayed acceptance are not appropriate.
Which personal characteristic helps a patient turn stressful circumstances into an opportunity for personal growth? Attitude Hardiness Optimism Resilience
Hardiness Rationale Hardiness is a personal characteristic that provides courage and motivation to turn a stressful situation into an opportunity for personal growth. Hardiness is a combination of commitment, control, and openness to change. Attitude also influences the effect of stress on a person. A positive attitude can prevent patients from developing diseases and can prolong life. Optimistic patients have lower levels of cortisol and respond better to stress and illness. Resilience is the ability of an individual to adapt to stress and adversity. Resilience provides good problem-solving skills and flexibility, making the patient less likely to sense an event as stressful.
The nurse is teaching a patient about conditions that may result from chronic stress. Which conditions would the nurse discuss? Select all that apply. Hypertension Alzheimer's disease Hiccups or facial tics Increased frequency of colds Uncontrolled diabetes mellitus
Hypertension Increased frequency of colds Uncontrolled diabetes mellitus Rationale Chronic stress can lead to cardiovascular disease such a hypertension, can decrease the body's ability to fight infections such as colds, and can affect the control of metabolic conditions like diabetes mellitus. There is no evidence that chronic stress causes hiccups, facial tics, or Alzheimer's disease, and these conditions may be signs of other problems.
In which way does a patient's use of emotion-focused coping help to reduce stress? It decreases negative feelings. It works toward finding a solution. It takes action to resolve the problem. It supports viewing the problem objectively.
It decreases negative feelings Rationale Emotion-focused coping helps to manage the feelings associated with the stressful event. It decreases the negative emotions by promoting a feeling of well-being. The objective of problem-focused coping is to reduce the stress by resolving the issue and finding a solution. Problem-focused coping attempts to resolve the problem and helps to view it objectively.
In which way would a back massage be helpful for a patient who has been on bed rest for several days? It stimulates blood circulation. It makes the patient more active. It helps to realign the flow of energy. It increases the risk of a pressure ulcer.
It stimulates blood circulation Rationale Back massage stimulates blood circulation and helps prevents skin breakdown that leads to pressure ulcers. Massage therapy helps to relax the patient and promotes sleep; it does not make the patient more active. Acupuncture or energy therapy, rather than massage therapy, helps to realign the energy flow in the patient. A back massage reduces the risk of skin breakdown by increasing the blood supply to the massaged area and decreases risk of a pressure ulcer.
Which manifestation is likely in a patient who reports high stress levels? Weight gain Hypoventilation Increased energy Musculoskeletal pain
Musculoskeletal pain Rationale Musculoskeletal pain exists with increased muscle tension from sympathetic nervous system stimulation as part of the stress response. Other manifestations include loss of appetite and weight loss, hyperventilation, hypertension, increased heart rate, sweating, gastrointestinal upset, skin disorders, and fatigue.
Which internal factor affects a patient's response to stressors? Optimistic attitude Supportive spouse Middle-class income Regular church attendance
Optimistic attitude Rationale There are a number of internal and external factors that can help to predict how well a person will handle stress. Optimism is an internal factor that increases a patient's ability to cope with stress. A patient's social support, socioeconomic status, and religious status are external factors that may affect his or her reaction to stress.
Which personal characteristic of a patient is associated with resourcefulness, flexibility, and good problem-solving skills? Attitude Hardiness Optimism Resilience
Resilience Rationale Resilience is associated with good problem-solving skills and flexibility, allowing the patient to experience an event as less stressful and freeing him or her to solve the problem. This characteristic helps the patient to adapt to adversity. Attitude also influences the effect of stress on person. Stress is associated with health problems, and a positive attitude can prevent patients from developing diseases and illness. Hardiness is a combination of commitment, control, and openness to change. This personal characteristic in a patient provides courage to turn stress conditions into opportunities for personal growth. An optimist has lower cortisol levels compared to pessimists and can find opportunity in difficult situations.
Which physical reaction would the nurse expect to find in a patient under prolonged stress? Low blood pressure Drowsiness and lethargy Low blood glucose levels Weakened immune system
Weakened immune system Rationale Though stress can have positive effects on the body, prolonged stress generally has a negative effect on health and can weaken the immune system. Prolonged stress can also raise blood glucose levels and increase blood pressure. Stress can also increase alertness and wakefulness.
Which statement reflects the relationship between resistance to illness and the mind-body-spirit connection? A healthy state of mind must exist for a patient to achieve a healthy spirit and a healthy body. When the mind and spirit are healthy, the patient has a better chance of resisting illness. Spiritual distress can create anxiety but is generally not severe enough to result in a stress response. While the spirit is important in maintaining a healthy balance, the body plays the primary role in resisting illness.
When the mind and spirit are healthy, the patient has a better chance of resisting illness. Rationale The mind-spirit-body connection is important. A healthy mind and spirit can help the body resist illness. Although a healthy state of mind is important, the lack of a healthy mind does not necessarily imply lack of healthy spirit or body. Spiritual distress can be a cause of stress for patients. The mind, body, and spirit are all interconnected; the strength of the role of each is unknown and may vary from situation to situation.
