Stress and adaptation PrepU

The client is a senior in high school who reports to the school nurse that she has difficulty understanding her coursework and that her grades have plummeted. She states her parents are forcing her to choose which college she is to attend. The nurse does the following activities in order of the nursing process. 1)Determines the nursing diagnosis is Decisional Conflict related to college placement. 2)Collaborates with the client to identify an acceptable outcome. 3)Evaluates outcome is met when the client reports satisfaction with her choice of colleges. 4)Asks, "What do you perceive is the problem?" 5)Encourages the client to verbalize her feelings, perceptions, and fears.

4)Asks, "What do you perceive is the problem?" 1)Determines the nursing diagnosis is Decisional Conflict related to college placement. 2)Collaborates with the client to identify an acceptable outcome. 5)Encourages the client to verbalize her feelings, perceptions, and fears. 3)Evaluates outcome is met when the client reports satisfaction with her choice of colleges.

In contrast to anxiety, fear is characterized by which of the following?

A cognitive response to a known threat

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

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

Upon assessment of a patient being evaluated at the headache clinic, the patient informs the nurse that her headaches started when she started experiencing marital problems. The patient reports that each time she and her husband have a fight, she develops a headache and loses her appetite for several days. Which of the following best defines the physiologic symptoms? a) A coping mechanism b) Fear c) A psychosomatic disorder d) Anxiety

A psychosomatic disorder

An adolescent entering high school voices anxiety over changing schools. Stating anxiety is an act of a) Valuation b) Evaluation c) Reaction d) Adaptation

Adaptation

A nurse is caring for a client who is an investment banker. The client is stressed because of the sudden fall of share prices in the stock exchange. Which of the following stress-reduction techniques should the nurse use with this client? a) Advocate on behalf of the client to others. b) Avoid referring the client to other organizations. c) Discourage family from interacting with the client. d) Avoid discussing the client's condition with client's family.

Advocate on behalf of the client to others.

A nurse hears a patient yelling for help from his room. The nurse runs to the patient'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 is best described by the nurse's physiologic changes? a) Exhaustion b) Resistance c) Rest and recovery d) Alarm reaction

Alarm reaction

Prior to the patient's scheduled bone marrow biopsy, the nurse has devoted time to teaching him about the rationale and the specific details of the procedure. The nurse's actions constitute what stress management technique?

Anticipatory guidance

Family conflict around the care of a recently hospitalized woman has escalated to the point that crisis intervention may be required. What should this process begin with? a) Careful and objective analysis of different proposed options b) Presentation of clear, achievable, and evidence-based solutions c) Clear identification of the relevant problem d) Comparison of the family's situation to other similar situations

Clear identification of the relevant problem

The nurse involved in coordinating a support group for spinal cord injury patients learns that one of the participants in the support group was a college athlete prior to his diving accident. The patient informs the group that he earned a scholarship based upon his athletic abilities and not his academic performance, and after the accident, he focused his energies on his studies and has been on the dean's list for two semesters. What defense mechanism is illustrated in this scenario?

Compensation

Which of the following is a physiological response experienced during the exhaustion stage of general adaptation syndrome?

Decreased blood pressure

The children of a 60-year-old woman are distraught at her apparent lack of recovery following a stroke several weeks earlier. The patient's daughter has frequently directed harsh criticism toward the nurses, accusing them of a substandard effort in rehabilitating her mother despite their best efforts. What defense mechanism may the patient's daughter be exhibiting? a) Sublimation b) Regression c) Displacement d) Denial

Displacement

The nurse would recognize that short-term pharmacological treatment may be appropriate if an anxious patient's nursing diagnoses includes which of the following?

Disturbed Sleep Pattern

The nurse is caring for a client who is a doctor in a general hospital. He complains about the stressful condition of his job. Lately, he has become increasingly susceptible to colds, headaches, muscular tension, excessive tiredness, and many other symptoms. At what stage of stress is the client? a) Secondary stage b) Exhaustion stage c) Alarm stage d) Resistance stage

Exhaustion stage

A nurse is trying to calm a stressed-out client who has been involved in an accident. The client escaped with minor bruises from the accident. What should the nurse do in order to calm the agitated client?

Explain that things could have been worse.

A nurse is assisting a neurologist, who is assessing the norepinephrine level of a client with complaints of stress. Which of the following functions does norepinephrine perform? a) Stabilize mood and regulate temperature b) Transmit sensation of pain c) Promote coordinated movement d) Heighten arousal and increase energy

Heighten arousal and increase energy

A nurse is assessing an obese teenager who is unhappy and stressed out because she has not lost weight despite working out at the gym. The physician asks the nurse to try the modeling intervention for stress management for the client. Which of the following actions should the nurse perform when adhering to the modeling intervention?

Introduce the client to someone with a positive attitude.

A client who is a drug addict visits a health care facility for treatment. During counseling, he discloses that he took to drugs because it helped him deal with stressful situations. The nurse explains that he is not using the correct coping strategy to overcome his stress-related problems. What kind of strategy has the client used in this case?

Non-therapeutic coping strategy

As an occupational health nurse at an oil refinery on the Gulf coast of Texas you are doing patient education with a man in his mid-forties. The patient is being seen after having been exposed to a chemical spill at the refinery. What type of stressor has this patient been exposed to? a) Psychiatric b) Physical c) Psychosocial d) Physiologic

Physical

You are caring for a 65 year old widow whose wife died four months ago. He tells you that he is not doing well and that no one will talk with him about his wife. What could the nurse do to help the patient? a) Refer him to an encounter group b) Refer him to a support group c) Refer him to a religious support group d) Refer him to a consciousness-raising group

Refer him to a support group

The client is a 5-year-old child 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

Regression

A nurse is assessing a client with stress-related problems. Which of the following factors influences responses to stressors? a) Eating habits b) Social support c) Economic status d) Personal hygiene

Social support

The client is a single parent being seen at an employee wellness clinic. The client tells the nurse he has 3 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 the following nursing diagnosis

Stress Overload related to single parenting

A middle-aged woman's father has passed away, and her mother requires physical and emotional help due to disabilities. The woman is married and raising two children, along with working full time. All of the factors described are a) Stressors b) Stimuli c) Illnesses d) Demands

Stressors

A group of nursing students are learning about the body's response to stress. Which system is responsible for initiating the fight-or-flight response to stress? a) Respiratory system b) Parasympathetic nervous system c) Sympathetic nervous system d) Endocrine system

Sympathetic nervous system

The nurse determines that a client understands instruction regarding progressive relaxation when the client states that the technique requires a) Using a biofeedback machine b) Tensing and relaxing various muscle groups c) Using a mantra in a relaxed position d) Focusing on pleasant images

Tensing and relaxing various muscle groups

The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve?

The mindful use of a word, phrase, or visual image which allows one's self to be distracted and temporarily escape from stressful situations.

A 35-year-old client 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) Therapeutic coping strategy b) Sensory manipulation strategy c) Negative coping strategy d) Non-therapeutic coping strategy

Therapeutic coping strategy

The nurse is providing care to the following clients. The nurse assesses the client exhibiting maladaptive behavior as the client who is a) experiencing a terminal illness and states, "If I pray to God and go to church each week, I will live." b) 84 years old with multiple health problems and requesting to see an end-of-life care specialist. c) participating in a smoking cessation program after her father was diagnosed with lung cancer. d) overweight, eats a diet of 1600 calories/day, and exercises 30 minutes a day 5 times each week.

experiencing a terminal illness and states, "If I pray to God and go to church each week, I will live."