a
5. During the stress response in human beings, the primary hormone secreted by the adrenal cortex is:
A) cortisol.
B) insulin.
C) epinephrine.
D) thyroxin.
Ans: A
Feedback:
Cortisol is the main glucocorticoid hormone from the adrenal cortex. Cortisol affects glucose metabolism, which is necessary for increased energy expenditure.
25. A 7-year-old boy has been the victim of abuse. He appears stoic and disconnected while being interviewed by the nurse. Although he currently has a painful injury, he does not cry or flinch when the area is touched. The nurse understands that:
A) the child has learned to cope by shutting off his feelings.
B) the child is mentally ill.
C) the child is refusing to cooperate with the interview.
D) the abuse is likely short lived.
Ans: A
Feedback:
Children in an abusive home may find ways to protect themselves through forms of escape, such as talking to imaginary friends or learning to shut off feelings.
13. The client asks the nurse to explain stress and its effect on the body. Which will the nurse include? Select all that apply.
A) Stress begins in children at about age 2.
B) All stress has a negative effect on the human body in some form. C) Stress begins in utero.
D) Stress is ever-present.
E) Some forms of stress are positive events.
Ans: C, D, E
Feedback:
Stress is part of our lives from the time we are developing in utero through death. Stress is an ever-present component of our physical and social environments. Although stress predominately has a negative overtone, it can be a positive experience as well. Good stress, or eustress, is when a sense of accomplishment or even exhilaration is felt with overcoming a challenge or obstacle.
22. The client asks the nurse what to do about a skin lesion causing the client to be very worried. The nurse suggests the client should notify the physician for a
diagnosis. The client is relieved and states, “I will make an appointment.” This type
of activity is considered:
A) coping.
B) social buffering.
C) appraisal.
D) secondary appraisal.
Ans: B
Feedback:
Social buffering is the act of soliciting other individuals to help resolve or provide comfort during a stressful event and can be quite effective.
3. A high school student comes to the nurse’s office to discuss the student’s anxiety
regarding an upcoming test. This test-taking anxiety is a(an):
A) concern.
B) stressor.
C) threat.
D) adjustment.
Ans: B
Feedback:
Stress, coping, and adaptation are interrelated. Survival depends upon successful coping responses to ordinary and sometimes extraordinary circumstances and challenges.
20. A young woman, who has recently suffered acute stress, asks the nurse why she seems to be more sensitive to stress than her husband. The nurse explains that a contributor to this phenomenon is:
A) thyroid production.
B) adrenal function.
C) estrogen levels.
D) cortisol.
Ans: C
Feedback:
Women have higher levels of estrogen, which are associated with greater sensitivity to stress and a tendency towards being emotionally supportive and building meaningful relationships.
10. An example of a long-term coping strategy is:
A) crying to release tension after a stressful event.
B) indulging in a rich desert after a stressful day.
C) walking briskly three times a week for 20 minutes.
D) taking a stick and banging it on a tree.
Ans: C
Feedback:
Long-term coping mechanisms are positive, constructive ways of dealing with stress and can be effective over long periods.
15. A young mother has accidentally locked her keys in her car with her baby strapped in the car seat. In a panic, the mother summons help from a lock-out service. This action would be considered:
A) stressor.
B) adaptation.
C) coping.
D) appraisal.
Ans: C
Feedback:
Coping can be problem focused (taking actions to directly work with the event or situation causing the stress) or emotion focused (finding ways to lessen the feelings of anxiety and angst triggered by the stressful event).
8. A young woman who has just started college is 6 weeks into the semester and has several tests and assignments due in approximately 3 days. She has developed a sore throat and fever. The development of illness is related to:
A) immunosuppression with stress.
B) exposure to streptococcus.
C) decreased energy.
D) sleep deprivation.
Ans: A
Feedback:
Chronic stress is associated with immunosuppression.
21. A client is discussing stressors with the nurse and is describing feeling better
after taking a brisk walk. The client’s action is an example of:
A) appraisal.
B) secondary appraisal.
C) buffering.
D) adaptation.
Ans: D
Feedback:
Adaptation is the process of adjusting to, or accommodating, a stressor. Appraisals involve the subjective evaluation of a potential stressor. Buffering is something that reduces the intensity of stress.
6. A middle-age woman’s father has passed away, and her mother requires physical and emotional help due to disabilities. The woman is married and raising two children, along with working full time. All of the factors described are:
A) stressors.
B) stimuli.
C) illnesses.
D) demands.
Ans: A
Feedback:
Stress is defined as any event or set of events (a stressor) that causes a response. Everyday triggers associated with work or social relationships, and uncommon events such as natural disasters, physical trauma, injuries, illnesses, divorce, death of a loved one, or loss of a job are commonly recognized stressors.
17. The nurse is explaining the body’s response to a stressful situation. The nurse
includes which manifestation? Select all that apply.
A) Hypoglycemia
B) Dilated pupils
C) Increased pulse
D) Inhibition of urination
E) Increased digestive function
Ans: B, C, D
Feedback:
During a stressful situation, the excitatory actions will cause pupil dilation, increased heart rate and force of contraction, bronchial dilation, and stimulation of converting glycogen to glucose. These inhibitory effects include decreasing digestive function, inhibiting insulin secretion from the pancreas, and preventing urination.
1. A client is using prayer to assist in relieving stress. The use of prayer allows the client to:
A) cope.
B) understand.
C) plan.
D) recover.
Ans: A
Feedback:
The ability to cope is a crucial element that influences well-being.
24. The nurse is caring for a postoperative client of Asian descent who speaks minimal English. The nurse notes the client has not requested medication for pain.
Considering the client’s culture, the nurse would:
A) understand that, culturally, Asians often do not take medicine.
B) understand that, culturally, Asians may see pain as weakness.
C) understand that the client is not in pain.
D) understand that the client is being difficult.
Ans: B
Feedback:
Some cultural beliefs, for example, discourage admitting feeling pain, as it may be thought of as a sign of weakness. A patient experiencing pain may hesitate to ask for pain medication so as not to break the cultural norm.
7. To assess the coping abilities of a first-time mother who expresses to the nurse that she is feeling overwhelmed by the needs of her newborn, the nurse should ask the client about her:
A) cognition and orientation.
B) interpretation of events.
C) nutritional patterns.
D) exercise patterns.
Ans: B
Feedback:
An individual’s subjective interpretation of an event must be known before
interventions can be chosen. Knowing the nature of potential stressors provides the
means of anticipating problems and their related psychological reactions. The
extent of activation of physiologic responses and subsequent recovery to daily
hassles is important to a person’s health, because accumulated allostatic responses may adversely affect the body.
16. During acute stress, the body secretes cortisol. Cortisol has which effect on mood?
A) Depression
B) Mood protection
C) Anxiety
D) Chronic worry
Ans: B
Feedback:
Under acute stress, cortisol is protective of mood, whereas under chronic stress, it is associated with depression and anxiety.
9. Which action demonstrates a coping mechanism to deal with anxiety produced by a very demanding, yet well-paying job?
A) Accepting understanding and sympathy from others
B) Expressing an opinion to the manager about the job
C) Taking a benzodiazepine regularly
D) Applying for a less demanding job
Ans: D
Feedback:
The person may respond by limiting his or her emotional response, taking direct action to solve a problem, or using defense mechanisms. Medications are not considered to be coping mechanisms.
19. A dancer has suffered a fall injury, which will prevent participation in a much- anticipated event. The fall is classified as what?
A) Stressor
B) Adaptation
C) Chronic stress
D) Resolution
Ans: A
Feedback:
A stressor can be a number of things, including environmental changes, alterations in routine activities of daily living, unexpected traumas, or tragedies.
11. Which statement, made by a senior citizen who has taken a class on stress reduction, would indicate to the nurse the need for further instruction?
A) Adults draw on coping skills learned throughout life.
B) Family members can be supportive during stress.
C) Stress may be positive or negative.
D) As one grows older, the stress decreases.
Ans: D
Feedback:
As a person ages, stress does not decrease; in fact, some people experience increased stressors associated with commonly encountered circumstances, such as experiencing empty nest syndrome or dealing with the death of a spouse, relatives, or friends.
14. An adult receives a call from his or her bank stating his or her account is overdrawn and a significant fee has been assessed. The adult would have an initial reaction of:
A) appraisal.
B) coping.
C) confusion.
D) adaptation.
Ans: A
Feedback:
The initial reaction to a potentially stressful situation is appraisal. Appraisal is the process of interpreting a situation and determining if it is a stressor.
2. An adolescent entering high school voices anxiety over changing schools. Stating anxiety is an act of:
A) adaptation.
B) evaluation.
C) reaction.
D) valuation.
Ans: A
Feedback:
Adaptation is generally considered a person’s capacity to flourish and survive, even with diversity.
23. A teenage girl is discussing her recent breakup with her boyfriend. She tells the nurse she just stays in bed all day and cannot seem to feel any better. She says she is only relieved of the pain while sleeping. The nurse identifies this coping strategy as:
A) avoidance coping.
B) buffering.
C) chronic stress.
D) adaptation.
Ans: A
Feedback:
Temporary mechanisms called avoidance coping may alleviate the feelings of anxiety brought on by the stress for a short period of time, but the stressor still needs to be dealt with.
12. During an interview, the client states, “When my stress is really high, I have diarrhea.” The physiologic response affects:
A) adequacy of sleep.
B) nutritional status.
C) gastrointestinal status.
D) heart rate.
Ans: C
Feedback:
Because the physiologic response to stress is an activation or arousal response, the nurse should ask about fatigue, adequacy of sleep, level of physical activity, and bowel elimination patterns.
18. The grief and angst following a stressful event is sometimes described as: A) chaos.
B) coping.
C) distress.
D) adaptation.
Ans: C
Feedback:
Stress is unavoidable. The resulting feelings of angst and grief are sometimes labeled distress.
4. In human beings, the physiologic response to a stressor includes the: A) sympathetic nervous system slowing the heart rate.
B) hypothalamus secreting adrenocorticotropic hormone.
C) hypothalamus secreting thyroid-stimulating hormone.
D) epinephrine increasing the blood glucose level.
Ans: D
Feedback:
Homeostasis in physiologic systems is maintained within a narrow range around a set point through continual changes in internal processes. Adjustments in heart rate, blood pressure, body temperature, fluid and electrolyte balance, blood glucose concentration, and blood oxygen level occur automatically to maintain proper system functioning and survival.