Question 1

The nurse believes that a patient may be experiencing a lot of stress at home.The patient is angry and states,"It is too much for me to handle.You don't know what I am going through." What is the most appropriate response(s)by the nurse? Select all that apply.

Accepted Answer

A)   "I don't know what you are going through, can you tell me more?"
B)   "Please don't be angry with me. We all do the best we can here."
C)   "How long have you been dealing with this stress?"
D)   "How do you usually manage your stress?" A,C,D

Question 2

When counseling a patient about behaviors to reduce stress,which of the following goals should the nurse put on the care plan?

Accepted Answer

A)   "The patient will limit his intake of fat to 15% of the daily calories consumed."
B)   "The patient will eat three meals per day at approximately the same time each day."
C)   "The patient will limit his intake sweet and salty foods."
D)   "The patient will consume no more than three alcoholic beverages a day." C

Question 3

A 35-year-old female comes to the clinic for her annual physical.Upon examination,the nurse palpates a lump in the left breast.She informs the client of the finding and the client responds,"Yes,I found it a few months ago too but just didn't want to think about it." The nurse recognizes that this client has been using which approach to coping with the lump?

Accepted Answer

A)   Altering
B)   Adapting
C)   Changing
D)   Avoiding D

Question 4

What is the function of antidiuretic hormone when released in the alarm stage of the general adaptation syndrome?

Accepted Answer

A)   Promotes fluid retention by increasing the reabsorption of water by kidney tubules
B)   Increases efficiency of cellular metabolism and fat conversion to energy for cells and muscle
C)   Increases the use of fats and proteins for energy and conserves glucose for use by the brain
D)   Promotes fluid excretion by causing the kidneys to reabsorb more sodium

Question 5

Before entering the room of a patient who is angry and yelling,the nurse removes her stethoscope from around her neck.The best rationale for doing so is that the stethoscope:

Accepted Answer

A)   Could be used by the patient to hurt her
B)   Might cause the patient not to trust her
C)   Would distract her from focusing on the patient
D)   Will function as another stressor for the patient

Question 6

You are caring for a patient who suddenly experiences a cardiac arrest.As you respond to this emergency,which substance will your body secrete in large amounts to help prepare you to react in this situation?

Accepted Answer

A)   Epinephrine
B)   Corticotrophin-releasing hormone
C)   Aldosterone
D)   Antidiuretic hormone

Question 7

A patient who has been hospitalized for weeks becomes angry and tells the nurse who is caring for him,"I hate this place; nobody knows how to take care of me or I'd be home by now." Which response by the nurse is best in this situation?

Accepted Answer

A)   "You seem angry; what's going on that makes you hate this place?"
B)   "I'm sorry that we aren't caring for you according to your expectations."
C)   "You were very sick; don't be angry; you're lucky to be alive."
D)   "You shouldn't be angry with us; we're trying to help you."

Question 8

The nursing student asks his instructor,"Why do some of my patients get a headache when they have stress and others cry?" The most appropriate response by the instructor is which of the following?

Accepted Answer

A)   "All patients react to stress differently."
B)   "Stress responses can be physical, mental, behavioral, and spiritual."
C)   "Some patients are more emotional than others."
D)   "Some patients overreact to the stress they are experiencing."

Question 9

A patient is in crisis.After assessing the situation,what should the nurse do first?

Accepted Answer

A)   Determine the imminent cause of the crisis
B)   Intervene to relieve the patient's anxiety
C)   Decide on the type of help the patient needs
D)   Ensure the safety of both the nurse and patient

Question 10

Why is it important for you as a nurse to understand stress and adaptation? Select all that apply.

Accepted Answer

A)   You need to identify your own stressors and develop healthy adaptation responses.
B)   Understanding stress will help you identify client stressors and adaptive responses.
C)   Understanding stress will help you balance stress for your patients.
D)   There are very specific adaptation strategies used for all patients and nurse must know them.

Question 11

The nurse is working on an orthopedic unit in the local hospital.While assessing her patient the patient states,"Ever since we had the earthquake in California I can't sleep for fear of another one happening during the night,and I just keep having flashbacks of the earthquake." The nurse knows that these patient statements are most consistent with:

Accepted Answer

A)   Anxiety
B)   Lack of coping skills
C)   Post-traumatic stress disorder
D)   Crisis

Question 12

During the alarm stage of the general adaptation syndrome,which metabolic change(s)occur(s)? Select all that apply.

Accepted Answer

A)   Rate of metabolism decreases.
B)   Liver converts more glycogen to glucose.
C)   Use of amino acids decreases.
D)   Amino acids and fats are more available for energy.

Question 13

When released in response to alarm,which of the following substances promotes a sense of well-being?

Accepted Answer

A)   Aldosterone
B)   Thyroid-stimulating hormone
C)   Endorphins
D)   Adrenocorticotropic hormone

Question 14

The nurse caring for a patient with unresolved anger.For which associated complication should the nurse assess?

Accepted Answer

A)   Depression
B)   Hypochondriasis
C)   Somatization
D)   Malingering

Question 15

Two days after a patient undergoes abdominal surgery,his surgical incision is red and slightly edematous; it is oozing a small amount of serosanguineous (pink-tinged serous)fluid.On the basis of these data,what can you conclude? Select all that apply.

Accepted Answer

A)   The wound is most likely infected.
B)   This is a vascular response to inflammation.
C)   Damaged cells are being regenerated.
D)   Exudate formation is occurring.

Question 16

A 75-year-old patient is tearful,shaky,and withdrawn.She tells you that she is "worrying herself to death" about losing her aging husband and being "all alone." Why do you recognize this reaction as Anxiety rather than Fear? Select all that apply.

Accepted Answer

A)   It concerns future or anticipated events.
B)   It concerns anticipation of danger rather than a present danger.
C)   There is no shakiness or tearfulness present.
D)   There is a psychological rather than a physical threat.

Question 17

You are caring for a patient with numerous physiological complaints.A family member tells you that the patient is pretending to have the symptoms of a stomach ulcer to avoid going to work.Which somatoform disorder is this patient most likely experiencing?

Accepted Answer

A)   Hypochondriasis
B)   Somatization
C)   Somatoform pain disorder
D)   Malingering

Question 18

After sustaining injuries in a motor vehicle accident,a patient experiences a decrease in blood pressure and an increase in heart rate and respiratory rate despite surgical intervention and fluid resuscitation.Which stage of the general adaptation syndrome is the patient most likely experiencing?

Accepted Answer

A)   Alarm
B)   Resistance
C)   Exhaustion
D)   Recovery

Question 19

A patient who has been diagnosed with breast cancer decides on a treatment plan and feels positive about her prognosis.Assuming the cancer diagnosis represents a crisis,this patient is most likely experiencing which phase of crisis?

Accepted Answer

A)   Precrisis
B)   Impact
C)   Crisis
D)   Adaptive

Question 20

A 60-year-old male attends a smoking cessation class.He tells the nurse,"Even though I smoke,I don't smoke around children,in my car,or in my house" Which defense mechanism is this male exhibiting?

Accepted Answer

A)   Displacement
B)   Rationalization
C)   Denial
D)   Repression

Exam 12: Stress Adaptation

The nurse believes that a patient may be experiencing a lot of stress at home.The patient is angry and states,"It is too much for me to handle.You don't know what I am going through." What is the most appropriate response(s) by the nurse? Select all that apply.