Bachelor of Science in Nursing 1 (BSN 1)

Alzheimer’s, Delirium, & Dementia Nursing Care Management NCLEX Practice Exam 1. Question Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxie ...

Alzheimer’s, Delirium, & Dementia Nursing Care Management NCLEX Practice Exam 1. Question Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is: Incorrect Correct Answer: D. Diarrhea Diarrhea is a common physiological response to stress and anxiety. The ability of stress to impair physiological processes such as growth, reproduction, and immune competence and its association with diseases such as cardiovascular disease, type 2 diabetes, anxiety, and depression are well known. While acute responses to stress are generally considered effective in dealing with immediate threats, prolonged activation of stress processes could have significant adverse consequences for individuals Option A: Hives are red, swollen, itchy bumps on the skin. Some people get them as part of an allergic reaction to food, medicine, or an insect sting. Others notice hives popping up on their skin on a more regular basis. Stress can also cause hives and can make hives you already have even worse. Stress is also one of the most common triggers of rosacea flare-ups. Rosacea appears as a red flush that spreads across the nose, cheeks, and chin. Option B: About 5 percent of American adults experience vertigo, and many people notice it when they’re feeling stressed or anxious. Even though stress doesn’t directly cause vertigo, it can contribute to dysfunction of the part of your inner ear that controls balance, called your vestibular system. Option C: Stress does not cause sedation. During stress, activation of the sympathoadrenal medullary (SAM) system results in the release of noradrenaline from sympathetic nerve terminals and adrenaline and noradrenaline from the adrenal medulla, which results in a range of rapid physiological and behavioral responses such as increases in heart rate (HR) and blood pressure and heightened vigilance. 2. Question When performing a physical examination on a female anxious client, nurse Nelli would expect to find which of the following effects produced by the parasympathetic system? Incorrect Correct Answer: B. Hyperactive bowel sounds The parasympathetic nervous system would produce incomplete G.I. motility resulting in hyperactive bowel sounds, possibly leading to diarrhea. The parasympathetic nervous system, in contrast, exerts both excitatory and inhibitory control over gastric and intestinal tone and motility. Although GI functions are controlled by the autonomic nervous system and occur, by and large, independently of conscious perception, it is clear that the higher CNS centers influence homeostatic control as well as cognitive and behavioral functions. Option A: When the body is stressed, muscles tense up. Muscle tension is almost a reflex reaction to stress—the body’s way of guarding against injury and pain. With sudden onset stress, the muscles tense up all at once and then release their tension when the stress passes. Chronic stress causes the muscles in the body to be in a more or less constant state of guardedness. When muscles are taut and tense for long periods of time, this may trigger other reactions of the body and even promote stress-related disorders. Option C: During micturition, parasympathetic stimulation causes the detrusor muscle to contract and the internal urethral sphincter to relax. The external urethral sphincter (sphincter urethrae) is under somatic control and is consciously relaxed during micturition. In infants, voiding occurs involuntarily (as a reflex). Option D: The parasympathetic nervous system controls processes in the body such as digestion, repair, and relaxation. When the parasympathetic nervous system is dominant in the body it conserves energy, slows heart rate, increases digestion, and relaxes sphincter muscles in the digestive tract. These changes in the function of the digestive system due to stress may result in spasms through the digestive tract and an increase in the amount of acid present in the stomach – causing indigestion and burning sensations, and irritation of the large intestine which may lead to symptoms such as diarrhea, constipation, cramping and bloating.