Stress Prep-U
A client is refusing to get out of bed the day after hip surgery. The nurse knows that for the intervention to be safe, therapeutic, and nonthreatening, she will need to not only enlist the client's cooperation, but also her willing participation. Which stress reduction technique does the nurse acknowledge as the best choice in this situation?
Anticipatory guidance
Prior to the client's scheduled bone marrow biopsy, the nurse has devoted time to educating him about the rationale and the specific details of the procedure. The nurse's actions constitute what stress management technique?
Anticipatory guidance
When nurses become overwhelmed in their jobs and develop symptoms of anxiety and stress, they are experiencing what condition?
Burnout
An intensive care unit (ICU) nurse with 11 years of experience has been frequently absent or late for shifts, has been verbally abusive with coworkers she feels are unskilled at the technological tasks of the job, and cursed under her breath at a distraught family member today. The nurse manager is threatening to suspend her if it happens again. The ICU nurse may be experiencing:
burnout
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?
denial
A recently retired client reports that he has been able to sleep only 3 hours a night and that he has nausea, frequent urination, and headaches. He is asking the nurse what she thinks is going on with his health. What is the most probable cause of his symptoms?
moderate anxiety
A new graduate is having difficulty coping with the role transition from student to registered nurse (RN). Which defense mechanism is being exhibited when the nurse states, "I hate going in to work on weekends. The aides are lazy, the clients are all complaining, and the families are all crazy!"
reaction formation
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?"
A client presents with a flare of lupus. Which statement made by the client would cause the nurse to suspect a stress reaction?
"I just had a baby 3 weeks ago."
A client is admitted to the oncology unit with a diagnosis of leukemia. Her sister comes to visit. The healthy sibling tells the nurse that her sister is sick because "I got mad at her and wished she would go away." Based on this information, the nurse would estimate the sister's age to be:
7
Which response to stressors results from the activation of the local adaptation syndrome (LAS)?
A girl quickly withdraws her hand from a stream of hot tap water.
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.
A nurse working on an oncology floor often sits with her clients in a calm, quiet, dimly lit environment and describes a walk along the ocean's shore. The nurse provides details of the walk and verbally paints a picture for the client. What best defines this form of stress management?
Guided imagery
The client is under immediate stress. The nurse assesses which sign as an effect of the sympathetic system?
Heart rate of 102 beats/minute
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
A 35-year-old woman comes to the local health center with a large mass is her right breast. She has felt the lump for about a year but was afraid come to the clinic because she was sure it was cancer. What is the most appropriate nursing diagnosis for this client?
Ineffective Individual Coping
An older adult client assumed care of a parent with dementia and had to decrease work hours to stay and home and care for the parent. Due to the decrease in hours, it is difficult to meet financial obligations. What actions by the nurse would be appropriate for this client? Select all that apply.
Make a referral to the case manager to determine available resources. Have the client make an appointment with social services to assist with financial resources. Suggest the client join a support group for caregivers of parents with dementia.
A client with cancer has recovered from tumor removal surgery and is now stable while undergoing a chemotherapy treatment schedule. She is not having any symptoms at this time and is continuing to work and enjoy social events. What stage of the general adaptation syndrome (GAS) would the nurse place her in?
Resistance
While obtaining an initial assessment of a client, the nurse gathers information about the client's stress history. What would the nurse collect as subjective data?
Structured interview
A nurse is meeting with a young woman who has recently lost her mother, lost her job, and moved with her husband to a new city. She is reporting acute anxiety and depression. What does the nurse know about stress that would be helpful with this client's situation?
Sometimes too many stressors disrupt homeostasis, and if adaptation fails, the result is disease.
In contrast to anxiety, fear is characterized by:
a cognitive response to a known threat.
Which of the following best describes stress?
a response to changes in the normal balanced state
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
A 56-year-old construction worker is in for his annual physical. As the nurse takes his vital signs, he tells her that his blood pressure may be a little off this morning. He tells the nurse that he is recently unemployed, is quite stressed, and is having a hard time coping. He feels like he needs to numb the pain. What is the nurse most concerned about regarding this client?
alcohol use
When discussing his concerns with the nurse, the client discloses that when he comes home from work, he plays with his pet dog and this makes him feel relaxed. His friends make fun of him because of this, however. The nurse explains that this is perfectly normal and is not a cause of worry. In this case, how is the client relieving stress?
by adopting an alternative lifestyle
A client who responds to bad news concerning his lab reports by crying uncontrollably is handling stress by using:
coping
The nurse is providing care to the following clients. The nurse assesses the client exhibiting maladaptive behavior as the client who is:
experiencing a terminal illness and states, "If I pray to God and go to church each week, I will live."
Which are considered internal stressors? Select all that apply.
illness hormonal change fear
While obtaining an initial assessment of a client, the nurse gathers information about the client's stress history. What would the nurse collect as subjective data?
joining the local garden club
A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate?
limit the family visits to once daily
Which situations are threats to psychological homeostasis in a client? Select all that apply.
loss of job a parent being diagnosed with dementia
A nurse is reviewing coping methods with a client who is a new teacher and who is struggling to meet the demands of her job. What would the nurse include as an example of a problem-focused coping method?
making a schedule and sticking to it
A nurse is teaching a client regarding effective coping strategies. Which teaching will the nurse include? Select all that apply.
making an appointment with a counselor writing a list of pros and cons practicing yoga and relaxation praying
The nurse is making preparations for a group of clients who have been experiencing some stressful events in their lives. Which nursing strategies should the nurse use to assist these clients? Select all that apply.
preventing additional stressors assessing the client's response to stress implementing stress management techniques assisting in maintain a network of social support
A nurse teaches a client deep-breathing exercises to help control his anxiety. This is considered what type of stress management technique?
relaxation
During a counseling session a client states, "I just try to forget about my spouse hitting me." Which coping mechanism should the nurse document on the basis of this client's statement?
repression
A nurse has been caring for a client who experienced a physical assault a year ago. The client now describes being "totally recovered from it." Which stage of stress is the client currently experiencing?
resistance stage
Which behaviors represent effective coping mechanisms? Select all that apply.
setting limits with family members who upset you taking a vacation learning relaxation techniques
What is the term for the change that takes place in response to a stressor?
adaption
What are examples of psychosocial stressors? Select all that apply.
news reports on television about a war fearing a terrorist attack Being involved in an accident
What philosophy for handling stress can nurses encourage clients to adopt?
"Accept what can't be changed, change what can't be accepted."
The nurse teaches a client about the use of yoga as a stress management intervention. Which client statement indicates to the nurse that learning has taken place?
"It reduces physical and emotional tension through postural changes and focused concentration."
The nurse is caring for a client diagnosed with terminal cancer who wishes to use meditation and prayer to be cured. What is the appropriate nursing action?
Advocate for the client's choice.
A young mother tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior?
Coping mechanism
A nurse is working with a 67-year-old Asian American woman on diet changes to help with weight loss. She is explaining her role in the family as the one who prepares the meats for the family, while her daughter is responsible for preparing vegetables. Based on the nurse's knowledge of traditional Asian cultures, the nurse knows what to be true?
Families operate in a collectivistic manner.
A nurse assigned to a newly admitted client realizes that the client finds the facility environment extremely stressful. What would be most appropriate for the nurse to do to decrease sensory stimulation of the client?
Keep down the conversational noise in the hallway.
A client has been brought to the health care facility with accident-related injuries. During the initial interview, the client becomes agitated and 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.
A nurse is trying to assess a client's stress type; however, the client is very depressed and quiet and does not reply to the nurse's questions. The nurse is unable to maintain her calm while repeating the questions. Where is the nurse going wrong in assessing the client?
The nurse should demonstrate confidence and expertise.
The nurse is caring for two clients on the same unit. One client states that cold temperatures and loud noises are stressors. The other client says the temperature is fine and the noises do not bother him. What is the difference between the two clients related to these stressors?
The perception and effects of stressors are highly individualized.
A group of nursing students is reviewing information about stress and coping. The students demonstrate an understanding of the information when they identify what as the outcome of coping?
adaptation
Family conflict around the care of a recently hospitalized woman has escalated to the point that crisis intervention may be required. This process should begin with:
clear identification of the relevant problem.
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?
nontherapeutic coping strategy
A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention?
provide care transition at discharge for speech therapy
In what phase of the general adaptation syndrome (GAS) is a client who is using all of the physiologic adaptive mechanisms for dealing with stress leaving no defense against the distress?
stage of exhaustion
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?
take control of the situation
The nurse is with a young client who has just been informed of terminal illness. The client's heart rate increases, pupils dilate, and blood pressure increases. The nurse recognizes this response as:
the sympathetic nervous response.
