Stress & Coping (Nursing Fundamentals)

3 exam questions

A nurse explains stress to a patient. Which statement best defines stress?

Stress is the body's response to a change in the environment that is perceived as challenging, threatening, or damaging to a person's dynamic balance.

A patient asks why prolonged stress is harmful. What is the nurse's best response?

Prolonged stress:

• Impairs immune function

• Increases susceptibility to hypertension

• Increases infection risk

• Increases risk of diabetes

• Increases risk of cancer

A patient reports sleeping only 3 hours each night due to stress. Why is this concerning?

Both too much and too little sleep place a significant burden on the cardiovascular system and increase the risk of myocardial infarction (heart attack)

Which stressor category includes workload, deadlines, and staffing shortages?

Occupational stressors

A nurse notices a patient's pupils are dilated and heart rate has increased after receiving bad news. What stage of the stress response is occurring?

The body's immediate physiologic stress response (fight-or-flight):

• Dilated pupils

• Increased heart rate

• Increased respiratory rate

• Slowed digestion

• Increased blood flow to muscles

Prolonged stress can produce what gastrointestinal complication?

Deep ulcers in the stomach lining.

A stressed nursing student says, "I can't focus and I keep forgetting everything." What type of stress manifestation is this?

Cognitive manifestations, including:

• Difficulty concentrating

• Forgetfulness

• Rumination

• Negative self-talk

• Racing thoughts or mental blocking

Which behavior is considered a behavioral indicator of stress?

• Sleep disturbances

• Appetite changes

• Social withdrawal

• Increased alcohol/tobacco use

• Pacing or fidgeting

How does prolonged stress affect the body?

Prolonged stress has harmful effects on multiple body systems:

• Impairs immune function, increasing susceptibility to hypertension, infection, diabetes, and cancer.

• Too much or too little sleep increases cardiovascular strain and the risk of myocardial infarction (heart attack).

• Can cause deep stomach ulcers.

• Causes enlargement of the adrenal glands.

• Causes atrophy of the thymus, spleen, and lymph nodes.

• May lead to local inflammation.

What is the difference between problem-focused and emotion-focused coping?

• Problem-focused: directly addresses the stressor through planning, seeking information, or problem solving.

• Emotion-focused: manages the emotional response through relaxation, distraction, or emotional support

What is the difference between adaptive and maladaptive coping?

• Adaptive: healthy strategies that reduce stress without causing new problems, such as exercise, talking, or planning.

• Maladaptive: may provide short-term relief but cause harm over time, such as avoidance, substance use, or angry outburst

What are healthy stress-management and coping techniques?

• Regular exercise

• Talk with a trusted person/counselor

• Deep breathing or meditation

• Consistent sleep schedule

• Humor/social connection

• Spiritual/religious practices if meaningful

• Time management/realistic prioritizing

• Journaling/creative expression

What nursing interventions can reduce a patient's stress and anxiety?

• Listen attentively

• Establish warmth and trust

• Convey caring and empathy

• Include the patient in the plan of care

• Promote safety and security

• Minimize additional stressors when possible

What are flashbacks associated with PTSD?

Recurrent, intrusive recollections that cause the person to re-experience the traumatic event. They may also include disturbing dreams.

What are the three stages of General Adaptation Syndrome (GAS)?

• Alarm reaction

• Resistance

• Exhaustion

What occurs during the alarm reaction stage of general adaptive syndrome?

The body gains more energy and sharper concentration. Blood sugar, blood pressure, heart rate, and respiratory rate increase while blood flow to the skin and digestive organs decreases.

It is not harmful if short-term.

What occurs during the resistance stage of general adaptive syndrome?

The body attempts to adapt to and cope with the stressor.

This stage should not be prolonged because remaining in resistance too long leads to exhaustion

What occurs during the exhaustion stage of general adaptive syndrome?

Prolonged/chronic stress drains physical, emotional, and mental resources, making it difficult for the body to cope.

Risk increases for hypertension, stroke, heart disease, depression, infections, and cancer.

What major health conditions are associated with prolonged stress?

Prolonged stress increases susceptibility/risk for:

• Hypertension

• Infection

• Diabetes

• Cancer

• Stroke

• Heart disease

• Depression

What are the major categories of stressors?

• Physiological: illness, injury, pain, fatigue, poor nutrition, disrupted sleep

• Psychological: fear, worry, low self-esteem, unresolved grief, major life changes

• Sociocultural: conflict, discrimination, financial pressure, role strain

• Environmental: noise, crowding, unsafe surroundings, extreme temperatures

• Developmental: life-stage transitions

• Occupational: workload, deadlines, staffing shortages, coworker conflict

What is the difference between acute and chronic stress?

• Acute stress: time-limited threatening events occurring for a relatively brief period.

• Chronic stress: occurs in stable conditions and results from stressful roles