Potter and Perry Chapter 37 Stress and Coping

Stress can trigger the arousal of the sympathetic nervous system, preparing a person for action. This response is known as the _____.

A. Crisis response

B. Traumatic response

C. Fight-or-flight response

D. Ego-defense mechanisms

C

What is a 3 stage reaction to stress that describes how the body reponds to stressors through the alarm reaction, the resistance stage, and the exhaution stage?

A. Fight-or-flight response

B. General adaptation syndrome

C. Ego-defense mechanisms

D. Posttraumatic stress disorder

B

During the _____ rising hormone levels result in increased blood volume, blood glucose levels, epinephrine and norepinephrine amounts, heart rate, blood flow to muscles, oxygen intake, and mental alertness. In addition, pupils of the eyes dilate to produce a greater visual field.

A. Alarm reaction

B. Resistance stage

C. Exhaustion stage

D. Allostatic load

A

During the _____ _____ the body stabilizes. Hormone levels, heart rate, B/P, and cardiac output return to normal; and the body repairs any damage that has occurred.

A. Alarm reaction

B. Resistance stage

C. Exhaustion stage

D. Allostatic load

B

A chronic arousal with the presence of powerful hormones causes excessive wear and tear on the person is called _____.

A. Alarm reaction

B. Resistance stage

C. Exhaustion stage

D. Allostatic load

D

The _____ _____ occurs when the body is no longer able to resist the effects of the stressor and has depleted the energy necessary to maintain adaptation.

A. Alarm reaction

B. Resistance stage

C. Exhaustion stage

D. Allostatic load

C

A person's effort to manage psychological stress is called _____.

Coping

Which type of stress begins when a person experiences, witnesses, or is confronted with a traumatic event and responds with intense fear or helplessness?

A. Developmental crisis

B. Flashbacks

C. Situational crisis

D. PTSD

D

What are 3 types of crises?

1. Developmental

2. Situational

3. Adventitious

This type of crisis occurs as a person moves through stages of life.

A. Developmental

B. Situational

C. Adventitious

A

Marriage, birth of a child, or retirement are examples of which type of crisis?

A. Developmental

B. Situational

C. Adventitious

A

External sources such as a job change, a motor vehicle crash, a death, or severe illness provoke which type of crisis?

A. Developmental

B. Situational

C. Adventitious

B

A major disaster, man-made disaster, or crime of violence often creates which type of crisis?

A. Developmental

B. Situational

C. Adventitious

C

This model views the person, family, or community as constantly changing in response to the environment and stressors and helps explain individual, family, and community responses to stressors.

Neuman Systems Model

A stressful job and adjusting to chronic illness are examples of which factor that influences stress and coping?

A. Situational

B. Maturational

C. Sociocultural

A

Preadolescents experience stress related to self-esteem issues, changing family structure as a result of divorce or death of a parent, or hospitalization so. These are examples of which type of factor that influences stress and coping?

A. Situational

B. Maturational

C. Sociocultural

B

Adolescents searching for their identity with peer groups and separate themselves from their families, experience which type of factor that influences stress and coping?

A. Situational

B. Maturational

C. Sociocultural

B

Stress for adults center around major changes in life circumstances including milestones of beginning a family and career, losing parents, seeing children leave home, and accepting physical aging. These are examples of which type of factor that influences stress and coping?

A. Situational

B. Maturational

C. Sociocultural

B

In old age, stressors include the loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition. These are examples of which factor that influences stress and coping?

A. Situational

B. Maturational

C. Sociocultural

B

Prolonged poverty, physical handicap, and living under conditions of continuing violence, disintegrated neighborhoods, or homelessness can affect people of any age especially the young. These are examples of which factor that can influence stress and coping?

A. Situational

B. Maturational

C. Sociocultural

C

When teaching a patient about the negative feedback response to stress, the nurse includes which of the following to describe the benefits of this stress response?

A. Results in neurophysiological response.

B. Reduces body temperature

C. Causes a person to be hypervigilant

D. Reduces level of consciousness to conserve energy.

A

A nurse observes that a patient whose home life is chaotic with intermittent homelessness, a child with spina bifida, and an abusive spouse appears to be experiencing an allostatic load. As a result, the nurse expects to detect which of the following while assessing the patient?

A. Posttraumatic stress disorder

B. Rising hormone levels

C. Chronic illness

D. Return of vital signs to normal

C

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." The patient is using the defense mechanism:

A. Denial.

B. Conversion.

C. Dissociation.

D. Displacement.

A

When doing an assessment of a young woman who was in an automobile accident 6 months before, the nurse learns that the woman has vivid images of the crash whenever she hears a loud, sudden noise. The nurse recognizes this as ____________.

Post-traumatic Stress Disorder (PTSD)

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.

C

During the assessment interview of an older woman experiencing a developmental crisis, the nurse asks which of the following questions?

A. How is this flood affecting your life?

B. Since your husband has died, what have you been doing in the evening 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.

B

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 separating from family

D

A child who has been in a house fire comes to the emergency department with her parents. The child and parents are upset and tearful. During the nurse's first assessment for stress the nurse says:

A. "Tell me who I can call to help you."

B. "Tell me what bothers you the most about this experience."

C. "I'll contact someone who can help get you temporary housing."

D. "I'll sit with you until other family members can come help you get settled."

B

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

C

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. The nurse's first response is which of the following?

A. "Don't be sad. People live with cancer every day."

B. "Have you thought about how you are going to tell your family?"

C. "Would you like for me to sit down with you for a few minutes so you can talk about this?"

D. "I know another patient whose colon cancer was cured by surgery."

C

A 34-year-old man who is anxious, tearful, and tired from caring for his three young children tells you that he feels depressed and doesn't see how he can go on much longer. Your best response would be which of the following?

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?"

D. "You have so much to live for."

A

The nurse is evaluating the coping success of a patient experiencing stress from being newly diagnosed with multiple sclerosis and psychomotor impairment. The nurse realizes that the patient is coping successfully when the patient says:

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've always felt better when I go for a long walk. I'll do that when I get home."

D. "I'm going to attend a support group to learn more about multiple sclerosis."

D

A patient newly diagnosed with type 2 diabetes says, "My blood sugar was just a little high. I don't have diabetes." The nurse responds:

A. "Let's talk about something cheerful."

B. "Do other members of your family have diabetes?"

C. "I can tell that you feel stressed to learn that you have diabetes."

D. With silence.

D

A staff nurse is talking with the nursing supervisor about the stress that she feels on the job. The supervising nurse recognizes that:

A. Nurses who feel stress usually pass the stress along to their patients.

B. A nurse who feels stress is ineffective as a nurse and should not be working.

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 and organizational restructuring.

D

A crisis intervention nurse working with a mother whose Down syndrome child has been hospitalized with pneumonia and who has lost her entitlement check while the child is hospitalized can expect the mother to regain stability after how long?

A. After 2 weeks when the child's pneumonia begins to improve

B. After 6 weeks when she adjusts to the child's respiratory status and reestablishes the entitlement checks

C. After 1 month when the child goes home and the mother gets help from a food pantry

D. After 6 months when the child is back in school

B