NUR 325 Exam 1 | Verified with 100% Correct Answers

NUR 325 Exam 1 | Verified with 100% Correct Answers Which of the following is NOT an accurate statement regarding stress? a. Stress can be an internal or external event b. Stress is experienced by the individual that i ...

NUR 325 Exam 1 | Verified with 100% Correct Answers Which of the following is NOT an accurate statement regarding stress? a. Stress can be an internal or external event b. Stress is experienced by the individual that is perceived and appraised for c. Stress is objective d. Stress can be a demand of life (Stress is subjective. Not everyone feels stress the same way. One thing that may be stressful to you may not be stressful to someone else.) Which of the following definitions accurately describes the key term of cognitive appraisal? a. Describes the body's short-term and long-term reactions to stress b. Condition in which all competing elements are in balance c. Individual's perception regarding how stressful an event is or will be d. Cognitive and behavioral efforts to manage stress Which of the following definitions accurately describes the key term of general adaptation syndrome? a. Describes the body's short-term and long-term reactions to stress b. Condition in which all competing elements are in balance c. Individual's perception regarding how stressful an event is or will be d. Cognitive and behavioral efforts to manage stress Chronic stress may lead to: a. Hypoglycemia b. Loss of homeostasis c. Positive psychological manifestations d. Positive social manifestations Which of the following definitions accurately describes the key term of coping? a. Describes the body's short-term and long-term reactions to stress b. Condition in which all competing elements are in balance c. Individual's perception regarding how stressful an event is or will be d. Cognitive and behavioral efforts to manage stress Which of the following physiologic responses would one expect in an individual that is stressed? (Select all that apply.) a. Decreased water retention b. Increased heart rate and blood pressure, and cardiac output c. Increased bronchial dilation d. Decreased pupil dilation e. Increased blood glucose f. Decreased protein synthesis Which of the following definitions accurately describes the key term of equilibrium? a. Describes the body's short-term and long-term reactions to stress b. Condition in which all competing elements are in balance c. Individual's perception regarding how stressful an event is or will be d. Cognitive and behavioral efforts to manage stress A broken bone would be an example of which source of stress? a. Psychological b. Physiological c. Emotional d. Episodic A patient being diagnosed with dementia would be an example of which source of stress? a. Psychological b. Physiological c. Emotional d. Episodic The loss of a loved one would be an example of which source of stress? a. Psychological b. Physiological c. Emotional d. Episodic A stressful event that doesn't happen often and is unique would be which type of stress? a. Acute b. Episodic c. Chronic d. Psychological A nursing students' stress levels are elevated because of a test that is coming up in a few days. Which type of stress would this example be? a. Acute b. Episodic c. Chronic d. Psychological Which of the following populations would have the lowest risk for having stress? a. Young adults b. Elderly c. Children d. Homeless persons Which of the following qualify as individual factors that would put a someone at risk for developing stress? (Select all that apply.) a. Dementia b. Moving to a different state or country c. Depression d. Chronic pain e. Being a caregiver f. Winning the lottery Which of the following is an example of a primary preventative measure taken to reduce stress? a. Taking a screening test to identify stress b. Taking antidepressants c. Maintaining positive relationships and overall health d. Taking muscle relaxants After the loss of a loved one, you decide to go to counseling sessions to reduce the amount of stress in your life. Which level of prevention does this situation represent? a. Primary b. Secondary c. Tertiary d. Quaternary You decide to schedule an appointment for a screening for stress after your divorce. Which level of prevention does this situation represent? a. Primary b. Secondary c. Tertiary d. Quaternary After going to counseling because of the loss of a loved one, the therapist decides to prescribe SSRIs (Selective serotonin repute inhibitors) because of your stress levels. Which level of prevention does this situation represent? a. Primary b. Secondary c. Tertiary d. Quaternary A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1C, a measure of blood sugar control over the past 90 days, has increased by saying, "The hemoglobin A1C is wrong. My blood sugar levels have been excellent for the last 6 months." Which defense mechanism is the patient using? a. Denial. b. Conversion. c. Dissociation. d. Displacement. (Denial is avoiding emotional stress by refusing to consciously acknowledge anything that causes intolerable anxiety. This patient's statements reflect denial about poorly controlled blood sugars.) A grandfather living in Japan worries about his two young grandsons who disappeared after a tsunami. This is an example of: a. A situational crisis. b. A maturational crisis. c. An adventitious crisis. d. A developmental crisis. (An adventitious crisis is a type of crisis resulting from a natural disaster such as a tsunami.) The nurse plans care for a 16-year-old male, taking into consideration that stressors experienced most commonly by adolescents include which of the following? a. Loss of autonomy caused by health problems b. Physical appearance, family, friends, and school c. Self-esteem issues, changing family structure d. Search for identity with peer groups and separation from family (Stressors that apply to preadolescents are self-esteem issues and a changing family structure. A loss of autonomy caused by health problems applies to the older adult. Stressors that apply to children are physical appearance, family, friends, and school.) When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, one of the first assessments includes which of the following? a. The amount of family support b. A 3-day diet recall c. A thorough physical assessment d. Threats to safety in her home (Stress often causes symptoms similar to physical illnesses. Physical causes for problems need to be investigated and treated before treatment for stress-related symptoms can be initiated.) A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and doesn't see how he can go on much longer. Which of the following would be the nurse's best response? a. "Are you thinking of suicide?" b. "You've been doing a good job raising your children. You can do it!" c. "Is there someone who can help you during the evenings and weekends?" d. "What do you mean when you say you can't go on any longer?" (You need to get information about what the gentleman means when he says he can't go on any longer. He might be thinking of turning his children over to a grandparent or seeking other child-care arrangements. Asking about suicide initially might be premature. Asking, "Are you thinking of suicide?" prematurely might shut the patient down entirely. If the patient talks about suicide, for safety reasons it is very important to further discuss his suicidal thoughts and refer to the appropriate health care professional. Asking the open-ended question provides an opportunity to understand what the person is thinking and open lines of communication.) The nurse is interviewing a patient in the community clinic and gathers the following information about her: she is intermittently homeless, a single parent with two children who have developmental delays, and is suffering from chronic asthma. She does not laugh or smile, does not volunteer any information, and at times appears close to tears. She has no support system and does not work. She is experiencing an allostatic load. As a result, which of the following would be present during complete patient assessment? (Select all that apply.) a. Posttraumatic stress disorder b. Rising hormone levels c. Chronic illness d. Return of vital signs to normal e. Depression (An increased allopathic load can result in long-term physiological and psychological problems such as chronic illness and depression. Posttraumatic stress disorder results from a single traumatic event. Hormone levels rise in the alarm stage. Vital signs return to normal in the resistance stage.) During the assessment interview of an older woman who is recently widowed, the nurse suspects that this woman is experiencing a developmental crisis. Which of the following questions provide information about the impact of this crisis? (Select all that apply.) a. With whom do you talk on a routine basis? b. What do you do when you feel lonely? c. How is having diabetes affecting your life? d. I know this must be hard for you. Let me tell you what might help. e. Do you have any changes in lifestyle habits: sleeping, eating, smoking, and drinking? (A developmental crisis occurs as a person moves through the stages of life, including widowhood. It is important to gather information about how this crisis affects her interactions, coping with loneliness, and any changes in lifestyle habits. Although stress can affect diabetes, there is nothing in this situation that states that the woman has diabetes. Saying, "I know this must be hard for you. Let me tell you what might help" is unacceptable, because the whole purpose of assessment is to gather data and let the patient tell his or her story.) After a health care provider has informed a patient that he has colon cancer, the nurse enters the room to find the patient gazing out the window in thought. Which of the following are appropriate responses or actions of the nurse? (Select all that apply.) a. "I know another patient whose colon cancer was cured by surgery." b. Straighten the patient's bed and room c. "Have you thought about how you are going to tell your family?" d. "Would you like for me to sit down with you for a few minutes so you can talk about this?" e. Sit quietly with the patient (Sitting quietly or asking the patient if he would like you to sit down for a few minutes so he can talk are both effective. This provides the patient some quiet time, knowing that someone is there. Allowing the patient to talk allows the nurse to assess the patient's fears, knowledge, and perception of the situation, which is of utmost importance. The other responses are telling the patient what to do or giving reassurance, and the situation does not call for either of these.) The nurse is evaluating the coping success of a patient experiencing stress from being newly diagnosed with multiple sclerosis and psychomotor impairment. Which of the following statements indicate that the patient is beginning to cope with the diagnosis? (Select all that apply.) a. "I'm going to learn to drive a car so I can be more independent." b. "My sister says she feels better when she goes shopping, so I'll go shopping." c. "I'm going to let the occupational therapist assess my home to improve efficiency." d. "I've always felt better when I go for a long walk. I'll do that when I get home." e. "I'm going to attend a support group to learn more about multiple sclerosis." (Inviting the occupational therapist into the patient's home and attending support groups are early indicators that the patient is recognizing some of the challenges of the disease and participating in positive realistic activities to cope with the stressors related to changes in physical functioning. The other options relate to independence and other coping strategies but do not address coping with the specific challenges of the disease.) A patient with type 2 diabetes is experiencing a lot of work-related stress and is fearful of losing his job. In addition, his wife is threatening divorce. His blood sugar is elevating, and his doctors want him to attend some stress-management classes. He says, "My blood sugar can't be high because of my work stress." What causes blood glucose to rise during stress? (Select all that apply.) a. Increases in antidiuretic hormone (ADH) b. Increases in cortisol c. Increases in aldosterone d. Increases in adrenocorticotropic hormone (ACTH) e. Increases in epinephrine (An increased allopathic load can result in long-term physiological and psychological problems such as chronic illness and depression. Posttraumatic stress disorder results from a single traumatic event. Hormone levels rise in the alarm stage. Vital signs return to normal in the resistance stage.) A crisis intervention nurse is working with a mother whose Down syndrome child has been hospitalized with pneumonia and who has lost her child's disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in special-school classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? (Select all that apply.) a. Referral to social service process reestablishing the child's disability payment b. Sending the child home in 72 hours and having the child return to school c. Coordinating hospital-based and home-based schooling with the child's teacher d. Teaching the mother signs and symptoms of a respiratory tract infection e. Telling the mother that the stress will decrease in 6 weeks when everything is back to normal (The stressors for this parent are her child's illness, missing school, and loss of disability payments. Obtaining resources to resolve these stressors will reduce the mother's stress load and allow her to focus on helping her child improve and preventing another respiratory tract infection. Discharging the child in 72 hours with a return to school may not be best for the child's physical condition and may make the situation worse. Giving the mom a 6-week time frame is unrealistic because everyone's time frame is different. The mom may also need to adjust to a "new normal.") A staff nurse is talking with the nursing supervisor about the stress that she feels on the job. Which of the following are true about work-related stress? (Select all that apply.) a. Job-related stress can affect the quality of patient care. b. Stress can affect nurses' efficiency and decision making. c. Nurses who talk about feeling stress are unprofessional and should calm down. d. Nurses frequently experience stress with the rapid changes in health care technology. e. Nurses cannot resolve job-related stress. (Nurses frequently experience stress with the rapid changes in health care and when the situation seems out of their personal control. When job stress remains unresolved, patient care and clinical decision making can be affected because the stress is perceived as uncontrolled and all consuming.) A nurse is assessing a patient's stressor to determine if it is a threat. What type of appraisal is this? a. Primary b. Secondary c. Tertiary d. Engagement A nurse is evaluating their resources to over, eliminate, or reduce the stressor. What type of appraisal is this? a. Primary b. Secondary c. Tertiary d. Engagement The nurse should document which physiologic stressor after performing a screening assessment on a patient? a. Dementia b. Caregiving of parent c. Divorce d. Death of friend (Physiologic stressors have physical causes. Dementia is an example of a physiological stressor. Caregiving, divorce, and death of a friend are examples of psychological or emotional stressors.) A patient has begun smoking again and drinks six alcoholic beverages per day since experiencing the loss of his job. The nurse recognizes that the patient is exhibiting symptoms of which type of stress? a. Psychological b. Emotional c. Physiological d. Behavioral (Signs and symptoms of behavioral stress include smoking, overeating, and substance abuse.) The nurse is creating the plan of care for a patient who was recently hospitalized for the treatment of anxiety and depression related to a diagnosis of cervical cancer 1 month ago. In planning tertiary prevention strategies for this patient, the nurse knows to add which tertiary interventions to the patient's plan of care: a. Counseling b. Screening for stress-related diseases c. A rehabilitation program focused on stress management d. A daily exercise program (In planning tertiary prevention care for a patient undergoing treatment related to stress, the nurse knows that including recommendations for a rehabilitation program focused on stress management is part of creating tertiary care. The purpose of tertiary care is focused on prevention and rehabilitation of the patient. Option A is incorrect. Counseling is a primary prevention strategy focused on health promotion and protection. Option B is incorrect; screening for stress-related diseases is part of secondary prevention, which focuses on early diagnosis and screening of diseases. Option D is incorrect. Planning a daily exercise program is part of secondary prevention strategies, which focuses on early diagnosis and treatment.) Which nursing interventions are likely to help the patient to cope by addressing the mediators of stress? (Select all that apply.) a. "A divorce, while stressful, can be the beginning of a new, better phase of life." b. "You said you used to jog; getting back to aerobic exercise could be helpful." c. "Journaling gives one more awareness of how experiences have affected them." d. "Perhaps a short-term loan from your father will make your layoff less stressful." e. "Slowing your breathing by counting to three between breaths will calm you." f. "I have found a support group for newly divorced persons in your neighborhood." (Stress mediators are factors that can help persons cope by influencing how they perceive and respond to stressors; they include personality, social support, perceptions, and culture. Suggesting that a divorce may have positive as well as negative aspects helps the patient to alter his perceptions of the stressor. Journaling increases self-awareness regarding how life experiences may have shaped how one perceives and responds to stress (or how one's personality affects how one responds to stressors). A loan could help the patient perceive a layoff differently by reducing the financial pressures that accompany it. Participation in support groups is an excellent way to expand one's support network relative to specific issues. However, neither aerobic exercise nor breathing-control exercises, while helpful in other ways, affect stress mediators.) A diabetic patient who is hospitalized asks the nurse what factors are associated with increased blood glucose while in the hospital? Which response(s) by the nurse are appropriate? (Select all that apply.) a. Blood sugar may be higher in the hospital due to the increased bed rest. b. Stressors such as illness cause the release of hormones that increase blood sugar. c. Increased blood sugar occurs because the kidneys are not able to metabolize glucose as well during stressful times. d. A patient's diet is different here in the hospital than at home, and that is the most likely because of the increased glucose level. e. Medications such as steroids may increase glucose levels. (The release of cortisol, epinephrine, and norepinephrine increases blood glucose levels. Activity decreases blood glucose; therefore, increase in blood glucose while in the hospital could be related to inactivity. Steroids cause increases in blood glucose levels. The kidneys do not control blood glucose. A diabetic patient who is hospitalized will be on an appropriate diet to help control blood glucose.) A patient has come to the health clinic for an annual checkup. He reports an increase of stress at work and having to work a lot of mandatory overtime hours. He has not been able to do his usual daily exercise for several weeks. What is the best response by the nurse? a. "There are other ways you can reduce your stress, such as cutting back on your work hours." b. "Have you considered a medication to help you sleep at night?" c. "Including exercise in your schedule will just increase the stress from work." d. "Regular exercise would be good because it helps the body deal with stress." (Exercise is a form of emotion-based coping that increases a feeling of well-being. Cutting back on hours may not be an option in his current work climate, although it might help reduce stress. There are other nonpharmacologic methods that may help with stress, such as music or meditation, which would not involve possible side effects