NUR 304 Final Exam | Questions and Answers (Complete Solutions)

NUR 304 Final Exam | Questions and Answers (Complete Solutions) Which statements about stressors are accurate? Select all that apply. A. Stressors can be different, depending on the situation. B. Stressors impact each ...

NUR 304 Final Exam | Questions and Answers (Complete Solutions) Which statements about stressors are accurate? Select all that apply. A. Stressors can be different, depending on the situation. B. Stressors impact each person the same way. C. Stressors change throughout the life span. D. Stressors are measurable for each person. E. Stressors always impact physiological health. Martha is stressed from the overwhelming amount of work she is responsible for since her charge nurse quit her position. She has spoken with her director but nothing seems to change. She decides to apply for another position within the hospital. Which coping approach is Martha using? A. Assigning the stressor B. Avoiding the stressor C. Altering the stressor D. Adapting to the stressor Which behaviors are consistent with adaptive coping behaviors? Select all that apply. A. Working additional hours to complete a task B. Exercising each day to relieve tension C. Going to a movie with friends D. Seeking a support group E. Sleeping additional hours each night A client is scheduled for a major surgery the next morning and appears anxious that family has not visited. Which question by the nurse would help to determine the level of anxiety that the client is experiencing? A. "Do you have questions about the surgery tomorrow?" B. "Would you like for me to call a family member to come support you?" C. "Would you like to talk with another client who had the same surgery?" D. "You seem worried about something. Would it help to talk about it?" The nurse is caring for a client after abdominal surgery. The client is afraid of having pain and experiences physiological changes when the stressor of pain is introduced. Which changes are a result of this stressor? Select all that apply. A. Increased blood pressure B. Vasoconstriction of the skin C. Increased peristalsis D. Constriction of the bronchioles E. Increased glucose in the blood Which of the following are physiological stressors? Select all that apply. A. Cold exposure B. Bacteria C. Obesity D. High-fat diet E. Tobacco F. Active lifestyle G. Sexual difficulties H. Vacation Which of the following are adaptive coping behaviors? Select all that apply. A. Seeking advice B. Overeating C. Oversleeping D. Exercising E. Spending time alone F. Drinking alcohol G. Posting on social media H. Taking a class Which of the following are factors that influence successful adaptation? Select all that apply. A. Exaggerated perception of the stressor B. Healthy lifestyle C. Church support group D. Living alone E. Age F. Developmental level G. Good coping skills H. Hardiness Which of the following are stages of General Adaptation Syndrome? Select all that apply. A. Recovery B. Homeostasis C. Alarm D. Inflammatory E. Reflexive F. Resistance G. Exhaustion H. Multifaceted Which of the following are physiological responses to stress? Select all that apply. A. Excess saliva B. Hyperventilation C. Decreased heart rate D. Dilated pupils E. Headaches F. Eczema G. Dysrhythmias H. Decreased glucose Which of the following are psychological responses to stress? Select all that apply. A. Difficulty learning B. Preoccupation C. Rebellion D. Irritability E. Forgetfulness F. Fear G. Overly confident H. Depression Which of the following are problems that occur when stress adaptation fails? Select all that apply. A. Inability to cope effectively in the workplace B. Purposefully making a drastic change in routine C. Anxiety and flashbacks to a traumatic event D. Physical symptoms with no known organic cause E. Exposing self to other stable environments F. Preoccupation with physical illness G. Pain as the main focus of life without physical cause H. Perceived threat to self or others Which of the following are stress management techniques? Select all that apply. A. Exercise B. Biofeedback C. Imagery D. Humor E. Journal writing F. Social drinking G. Massage H. Meditation At the end of a meditation session, which physical assessment finding would suggest that the relaxation technique was successful? A. Decreased blood pressure B. Decreased peripheral skin temperature C. Increased respiratory rate D. Increased bowel motility An older adult is tearful, shaky, withdrawn, tachycardic, and sleepless. She tells you that she is “worrying herself to death” about losing her aging husband and being “all alone.” Which statement can be made about this anxiety reaction? Select all that apply. A. It concerns future or anticipated events. B. It concerns anticipation of danger rather than a present danger. C. Her symptoms are emotional and not physical. D. There is a psychological rather than a physical threat. E. She lacks adaptive coping mechanisms. A 44-year-old female client who was just admitted states, “I must be under too much stress at work and home. I just do not feel well.” Which physical findings are consistent with the client’s statement? Select all that apply. A. Blood pressure is 178/96 mm Hg. B. Palms of her hands are sweaty. C. Pupils are constricted and reactive to light. D. Legs are continually moving in the bed. E. Mucous membranes are dry. An older client with a history of congestive heart failure was just admitted to the hospital for chest pain. The patient asks a nurse, "Why did the chest pain begin after I thought someone was trying to break into my house?" What is the nurse's best response? A. "Fear causes an increase of the body's heart rate and blood pressure, which can place additional stress on your damaged heart and cause chest pain." B. "Fear causes the parasympathetic system to use all available adrenaline, leaving you so tired that you developed chest pain." C. "The decrease in the need for oxygen during the fight-or-flight response experienced with fear is most likely the reason that you developed chest pain." D. "Fear causes an increase in glucose levels, which limits blood flow and causes chest pain." The nurse is presenting a workshop on stress and adaptation to a group of teenagers. A teenager approaches the nurse and says, "Sometimes I feel stressed when I have to take a test. I feel my heart is going faster and I have a hard time focusing. I'm scared I'm going to fail. Do you think that is normal?" What is the most appropriate response by the nurse? A. "As long as you are getting through the test, I think you will be just fine." B. "A little stress is not necessarily a bad thing. It can help you to focus." C. "You may need to develop some additional stress-reducing activities." D. "I think you should talk to your teacher about getting accommodations for testing." The hospitalized client states, "I need to know when I'm going to be discharged. I'm so upset and worried that I'm missing work." The nurse knows: A. This is an example of "eustress" and no intervention is necessary. B. This is an example of psychological stress and the client should be placed on antidepressants. C. This is an example of developmental stress and the client should talk to someone his own age. D. This is an example of distress and could affect the client's health status. An older patient becomes bedridden after a fall that resulted in a hairline fracture of her pelvis. She begins to develop a cough of yellow sputum and requires higher amounts of oxygen at night to maintain adequate oxygen levels. Which physiological changes of aging contribute to her current condition? Select all that apply. A. Weakened immune system B. Decreased muscle strength C. Decreased cardiac output D. Decreased skin elasticity E. Decreased intercostal muscle strength The nurse is planning a teaching workshop about maintaining an active lifestyle at the local community center for a group of older adults. What information is most important to discuss at the workshop? A. Prevention of injury and falls B. Planning and participating in leisure activities and exercise C. Use of social media to stay connected with family members D. Resources for assisted living centers and nursing homes What is the leading cause of injury and preventable source of mortality and morbidity in older adults? A. Heart disease B. Car accidents C. Pneumonia D. Falls A frail elderly man lives at a senior independent living apartment complex. He is weak, stays in bed most of the time, and becomes fatigued after taking only two or three steps with a walker. His personal hygiene is poor. He moves very slowly when doing even small tasks such as eating a meal. Which interventions are most appropriate for this person? Select all that apply. A. Arrange for an aide to assist with activities of daily living. B. Refer the client to a senior center for an adapted physical activity program. C. Assess the patient for symptoms of depression and memory loss. D. Arrange for nutritious meals to be delivered to the patient’s home. E. Contact his children to move in with him. The nurse practitioner is performing an annual physical examination on an 88-year-old female. Which assessments are most important to include? Select all that apply. A. Height and weight B. Pap test C. Breast cancer screening D. Gait and balance E. Visual acuity exam The nurse suspects that an older adult patient may have difficulty hearing. Which strategies will the nurse use to improve communication? Select all that apply. A. Use sign language. B. Look directly at the patient when speaking. C. Speak more slowly than usual. D. Speak loudly toward the patient’s ears. E. Allow some extra time for the patient to respond. Practicing positive health habits may prevent the development of chronic illness later in life. Which positive health habits will the nurse teach to a middle-aged adult patient? Select all that apply. 1. Routine screening and diagnostic tests 2. Unprotected sexual activity 3. Regular exercise 4. Excess alcohol consumption Which theory of aging focuses on the accumulation of metabolic wastes? A. Wear-and-tear B. Genetic C. Cellular malfunction D. Autoimmune reaction Which is a normal developmental change of aging? A. Confusion and dementia B. Dry skin C. Joint pain D. Urinary incontinence The nurse receives hand-off report for a group of clients. Which client is most likely to experience difficulty in adapting to a change in body image? A. 2-year-old with severe facial burns B. 61-year-old experiencing hyperthyroidism with accompanying hair loss C. 23-year-old requiring a colostomy with external bag D. 35-year-old undergoing gastric bypass surgery for obesity A teenage client with facial fractures and a large laceration on the left side of the face tells the nurse that she does not want anyone to see her "looking like this." Which statement by the nurse is most appropriate? A. "Tell me what you mean by 'looking like this.” B. "You are young, so your face will heal nicely." C. "Okay, we can restrict your visitors until your face heals." D. "Your looks shouldn't matter to your family and true friends." A client is admitted to the hospital after a trauma that resulted in an above-the-knee amputation of the right leg. How can the nurse promote self-esteem and a positive body image? Select all that apply. A. Encourage participation in self-care. B. Welcome visitors. C. Focus on care of the surgical site. D. Begin physical therapy as soon as possible. E. Support small accomplishments. The nurse is completing an admission assessment on a client who recently lost her husband of 57 years. Which behavioral symptoms may indicate depression? A. Preoccupation with loss, self-blame, and ambivalence B. Anger, helplessness, guilt, and sadness C. Tearfulness, withdrawal, and presence of substance abuse D. Difficulty concentrating, loss of interest in activities, and worthlessness The nurse is caring for a young adult who is recovering from burns over 75% of his body. While the nurse is changing his dressings, he says “it really doesn’t matter if you do a good job or not. Once I’m out of here, it won’t matter anyway.” What should be the nurse’s next actions? Select all that apply. A. Inquire further about what he means by that statement B. Deliver additional pain medication C. Let his family know what he said D. Notify other healthcare team members E. Perform a depression assessment Drew just celebrated his 12th birthday and has been an insulin-dependent diabetic for one year. He often thinks about how everything in his life revolves around his illness and everyone sees him as a diabetic, not a "normal" kid. Which psychosocial understanding is this an example of? A. Self-Concept B. Body Image C. Self-Esteem D. Personal Identity Ethan is a confident college student. He is the star of his school's football team and expected to play professionally after college. During the championship game, he suffered a significant injury and was told he can never play football again. He now feels worthless and as if his life is not worth living. Which psychosocial understanding is this an example of? A. Self-Concept B. Role Performance C. Personal Identity D. Self-Esteem Shannon is a nursing student in her second semester. She finds herself waking up in the middle of the night with a knot in her stomach thinking about school. During the day, she is often tense with frequent headaches, her heart races, and she feels shaky. Shannon has a hard time focusing on her schoolwork and reading. Which psychosocial understanding is this an example of? A. Self-Esteem B. Anxiety C. Depression D. Role Performance Kris feels alone. He's lost contact with his best friends and family since becoming involved with drugs. He doesn't care what happens in his life and lacks the energy to make a change. He feels worthless. Which psychosocial understanding is this an example of? A. Self-Concept B. Self-Esteem C. Depression D. Personal Identity Nancy is a middle-aged woman who struggles with male relationships. She's been married four times and has never had what she calls a "successful" relationship. During her therapy sessions, she discusses how her father and primary caregiver was abusive, often calling her ugly, stupid, and worthless. Which psychosocial understanding is this an example of? A. Self-Concept B. Self-Esteem C. Role Performance D. Personal Identity Carlie is 5 foot 6 inches tall and weighs 97 pounds. When she looks in the mirror she sees a "fat person" looking back. More than anything, she wants to look like the models in fashion magazines. She continually counts every calorie she eats and exercises three times a day in order to become "beautiful." Which psychosocial understanding is this an example of? A. Self-Concept B. Body Image C. Self-Esteem D. Personal Identity Margie is a new teen mother who lives in a group home for teen mothers and has little support from her family. She knows that finishing high school is important for her future but is torn between attending school and caring for her newborn. She begins skipping classes. Which psychosocial understanding is this an example of? A. Self-Concept B. Self-Esteem C. Role Performance D. Personal Identity Candy often says she feels like "a man in a woman's body." From a young age, she preferred trucks over dolls and pants over skirts. She often refers to herself as "a freak." Which psychosocial understanding is this an example of? A. Self-Concept B. Body Image C. Self-Esteem D. Personal Identity Olivia was involved in a street fight and ended up with a large facial scar. She considers it a mark of power and strength and won't let it define who she is. Which psychosocial understanding is this an example of? A. Self-Concept B. Body Image C. Self-Esteem D. Personal Identity Which of the following best describes an individual’s self-concept? Select all that apply. A. An understanding of how one is perceived by others B. Developed from an evaluation of oneself C. The overall view a person has of oneself D. A perspective of one’s role in society E. A person’s perception of his or her physical appearance The nurse is caring for a mother with three small children who has been admitted with a newly diagnosed chronic illness. The nurse would like to encourage communication between the parents about sharing household responsibilities and child care. What is the intention of this strategy for the client? A. Promote self-esteem B. Facilitate role enhancement C. Prevent depersonalization D. Decreasing anxiety The nurse is caring for a client admitted with a bleeding duodenal ulcer. He states that he has difficulty concentrating, is often "short of breath," and "awakes at night thinking and cannot get back to sleep." He has been unable to work or care for his family for the past 3 months. What should be the nurse's next action? A. Provide emotional support for the patient using reflective listening technique. B. Do nothing; people with duodenal ulcers typically cannot work. C. Notify the primary care provider and ask for a referral to a mental health professional. D. Ask more questions about his shortness of breath. A client has been hospitalized for 4 weeks with aggressive therapy for lung cancer. She has become very withdrawn, refuses visitors, and does not participate in personal grooming. Which activity should be encouraged? A. Getting washed and dressed independently B. Thinking positively about the treatments C. Contacting a support group and psychological consultation D. Becoming more physically independent and returning to prior activities