Chapter 13: Stress Management Nursing School Test Banks

Chapter 13: Stress Management
Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE

1. A nurse is defining stress to a person. Which of the following statements should the nurse should make?
a. Happy events, such as the birth of a child, are rarely as stressful as unhappy events.
b. An event that requires any change in behavior in stressful.
c. All stressors create a challenge to health.
d. Once stressors are identified, they can be controlled.
ANS: B
Any event that requires a change in behavior is stressful. Some stressful events are beneficial to health and not inherently harmful. Many stressors cannot be controlled.

DIF: Cognitive Level: Apply (Application) REF: pp. 298-299

2. The nurse is conducting community education about stress. Which of the following statements should be made by the nurse?
a. Stress always has a negative effect on the body.
b. A moderate amount of short-term stress can make a person more efficient and goal-focused.
c. Long-term stress is useful in helping one to meet goals.
d. Stress always has a positive effect on the body.
ANS: B
Stress may be either harmful or helpful. Long-term stress is harmful. A moderate amount of stress is a motivator.

DIF: Cognitive Level: Apply (Application) REF: pp. 298-299

3. A nurse is discussing the various types of stress to a group of adults. Which of the following would be used as an example of eustress?
a. Increasing alcohol intake to deal with loss of a job
b. Avoidance of social activities because of anxiety
c. Severely limiting food intake as a way to control stress
d. Joining a cardiac rehabilitation exercise program after a myocardial infarction
ANS: D
Eustress is useful, not harmful. Although a myocardial infarction (MI) is stressful physically and psychologically, joining a cardiac rehab program in response to the MI will improve cardiac and overall health and well-being. The other examples indicate unhealthy coping strategies.

DIF: Cognitive Level: Apply (Application) REF: p. 299

4. A nurse is caring for a person who has experienced a minor injury following a fall. Which of the following physiological responses to stress would the nurse anticipate?
a. Lowered blood pressure
b. Elevated heart rate
c. Lowered respiratory rate
d. Elevated blood supply to the gut
ANS: B
Activation of the neuroendocrine system in response to stress results in elevated blood pressure, heart rate, respiratory rate, and an increased blood supply to large muscles.

DIF: Cognitive Level: Apply (Application) REF: p. 300

5. Which of the following statements concerning spirituality is correct?
a. Spirituality is a search for the meaning of existence.
b. To fully experience spirituality, one needs a religious affiliation.
c. Stress always strengthens the quest for spirituality.
d. Spirituality always prevents depression, which is common following a stressful event.
ANS: A
Religion and spirituality are complementary but not the same. Spirituality is possible without a religious affiliation. Although spirituality can help one cope with stress, depression may still result.

DIF: Cognitive Level: Understand (Comprehension) REF: pp. 301-302

6. A nurse has stated that the person she is working with demonstrates stress hardiness. Which of the following individuals is most likely being described?
a. Refuses to see family members after the nurse practitioner tells him or her about test results
b. Conducts Internet research to learn about the latest treatment options for a health deviation
c. Calls in sick when faced with a personal relationship problem
d. Views stressors as negative life events
ANS: B
Stress hardiness is characterized by feeling in control of situations, viewing stressors as challenging rather than negative events, and using effective coping techniques.

DIF: Cognitive Level: Apply (Application) REF: p. 302

7. A nurse is describing adults who are in the sandwich generation. Which of the following provides the best description of this term?
a. Middle-aged adults who are starting a family at an older age
b. Young adults who are beginning to find jobs, marry, and start a family
c. Middle-aged adults who are caring for children and aging parents
d. Young adults who have several small children
ANS: C
Because of current trends of delayed parenting and increased life span, more middle-aged adults are in the sandwich generation, in which they carry the responsibility to care for their children and aging parents.

DIF: Cognitive Level: Apply (Application) REF: p. 302

8. A nurse is collecting health assessment data about a persons coping mechanisms in relation to stressors. Who would provide the best source of this information?
a. Persons primary care physician
b. Persons spouse/significant other
c. The person
d. Expert objective analysis skills of the nurse
ANS: C
People are the best source of information related to their coping skills.

DIF: Cognitive Level: Apply (Application) REF: p. 303

9. A nurse is assisting a person to cope with stress. Which statement by the nurse would be the most helpful?
a. Most people in this situation feel the way you feel.
b. Tell me what this event means to you.
c. There are many support groups available for you to use.
d. Your family wants to help you through this stressful event. May I call them?
ANS: B
Self-awareness is necessary to evaluate the meaning of an event and can only be assessed by asking the person to think about the meaning of the event.

DIF: Cognitive Level: Apply (Application) REF: p. 304

10. A nurse is counseling a person on how to effectively deal with stress. Which of the following actions would the nurse recommend the person take first?
a. Recognize signs of stress.
b. Take action to reduce stress.
c. Connect warning signs with stressors.
d. Develop effective coping skills.
ANS: A
To prevent negative consequences of stress, the person must first recognize signs of stress. He or she must then pay attention to these stressors, develop coping skills, and finally use the coping skills.

DIF: Cognitive Level: Apply (Application) REF: p. 304

11. A nurse is providing education to a community support group about ways to decrease stress. Which of the following would be the initial nursing intervention discussed by the nurse?
a. Explain how support groups function
b. Demonstrate deep breathing techniques
c. Practice guided imagery techniques
d. Help people to identify their response to stress
ANS: D
The priority nursing intervention is to help the person become aware of the effects of stress on physical, emotional, and spiritual well-being. The other interventions are used after the person becomes aware of the individual reaction to stress.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 304

12. A nurse is explaining the relaxation response to a person. Which of the following statements would be most appropriate for the nurse to make?
a. When the relaxation response is used, your sympathetic nervous system is activated and your pulse rate slows down.
b. The relaxation response helps you to become more aware of your surroundings.
c. Deep breathing is very effective in relaxing muscle groups and relieving stress.
d. Holding your breath for 10 to 15 seconds will reduce your blood pressure and pulse rate.
ANS: C
The relaxation response causes blood pressure and pulse rate to lower and muscles to relax. Activation of the sympathetic nervous system has the opposite result.

DIF: Cognitive Level: Apply (Application) REF: pp. 305-306

13. The nurse conducted a community health education program about the benefits and limitations of alternative therapies. The nurse recognizes that learning has occurred when a participant makes which of the following statements?
a. Acupuncture is a technique that can be easily learned and practiced.
b. Hypnosis can be safely used by a licensed hypnotist to treat all cases of anxiety.
c. Reiki is a type of massage that can be used to relieve stress.
d. Herbal products must be used with caution because some can interact with prescription medications.
ANS: D
Acupuncture is a technique that requires administration by a trained acupuncturist. Hypnosis should not be used for people with severe mental illness. Reiki is not a massage technique.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 306-307

14. A nurse responded to a natural disaster and used expressive writing as a means of coping with the stress related to this experience. Which of the following benefits of expressive writing should the nurse expect?
a. Immediate relief of stress through storytelling
b. Insight into the personal meaning of the experience
c. Absence of the symptoms of stress
d. Feeling a great sense of relief immediately after making a journal entry
ANS: B
Expressive writing helps one reflect on the personal meaning of an experience. Feelings of sadness or anxiety may accompany journal writing as events are analyzed.

DIF: Cognitive Level: Apply (Application) REF: p. 307

15. A nurse is helping a person reduce stress-disinhibition related to poor dietary choices. Which of the following nursing interventions would be most appropriate?
a. Work with the person to develop a plan to slowly replace high-fat, high-calorie foods with more healthy choices.
b. Encourage the person to eliminate all high-calorie, high-fat foods from the diet as quickly as possible.
c. Give the person a standard list of low-fat, low-calorie foods.
d. Provide the person a copy of the Food Guide Pyramid.
ANS: A
Working with people to develop a realistic, culturally sensitive, healthy eating plan is more likely to produce lasting results than simply dictating what he or she should eat.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 307-308

16. The nurse is assisting a person to develop a positive attitude toward exercise. Which of the following nursing interventions would be most successful when working with this person?
a. Educate the person that 60 minutes of moderate to strenuous exercise a day is required to lower the risk of heart disease.
b. Suggest that the person participate in a formal exercise program that has been demonstrated to produce the best results.
c. Educate the person that exercise patterns established in young adulthood are more effective than those established later in life.
d. Suggest that the person walk at a moderate pace for 30 minutes a day, 5 days a week for improvement in physical and psychological health.
ANS: D
Formal exercise programs are no more effective than walking 30 to 60 minutes a day for 3 to 5 days a week. Exercise is beneficial at any stage of life.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 308

17. A nurse is helping a man restructure his eating, sleeping, exercise, and thinking patterns to reduce stress. Which of the following nursing interventions would be most effective for this person?
a. Encourage writing in a journal on a daily basis.
b. Suggest joining a support group.
c. Offer referral to individual or group therapy sessions.
d. Promote purchasing a gym membership.
ANS: A
Before any meaningful change in behavior can take place, one must have an awareness of, and reflection about, personal behavior.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 304-307

18. A nurse is demonstrating how to use effective communication when dealing with conflict. Which of the following statements would be most appropriate for the nurse to make?
a. I am so angry that you are late again that you are grounded for a week.
b. When you miss an appointment, I am hurt.
c. Because you cannot be on time, you cannot have the car for a week.
d. I feel anxious when you do not come home on time because I worry about your safety.
ANS: D
Effective communication relies on assertive communication, which requires an assertive statement (emotion), expressed feelings (behavior), and perceived rights (explanation).

DIF: Cognitive Level: Apply (Application) REF: p. 311

19. A nurse is educating a client about the four-step approach to active listening. Which of the following actions should the nurse suggest the client take first?
a. Formulate a nonaggressive response.
b. Mirror the persons feelings.
c. Hear what is being said.
d. Listen to the response.
ANS: C
Active listening requires the listener to hear what the person is saying, mirror his or her feelings, listening to the persons response, and communicate in a nonaggressive manner.

DIF: Cognitive Level: Apply (Application) REF: pp. 311-312

20. Which of the following statements concerning enjoying healthy activities is true?
a. People enjoy pleasant activities even when they are stressed.
b. People cherish happy activities and feel that such activities are important even during times of stress.
c. People generally feel that they deserve to be happy.
d. People who have hobbies are better able to handle stress than those without hobbies.
ANS: B
Hobbies, and other pleasurable activities, help people balance a stressful life.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 312

21. A nurse is assisting a client in values clarification. Which of the following actions should the nurse assist the client to complete first?
a. Develop a religious affiliation to assist with the process.
b. Identify what is meaningful in ones life.
c. Act in a way that is consistent with ones beliefs.
d. Use beliefs held by others as a guideline for life.
ANS: B
Values clarification begins with examining ones beliefs and then acting in a way that supports those beliefs. Formal religious affiliation is not required for values clarification.

DIF: Cognitive Level: Apply (Application) REF: pp. 313-314

22. The nurse is caring for a person who is obese, sedentary, and has recently been diagnosed with Type 2 diabetes mellitus. Which of the following goals for the person is correctly stated?
a. The person will exercise more often.
b. The person will consume 900 calories a day.
c. The person will walk one-quarter mile a day, 5 days a week.
d. The person will eliminate all refined sugar and processed foods from her diet.
ANS: C
Goals must be realistic, specific, and measurable. Exercising more often is too broad a statement. Consuming 900 calories a day or eliminating all refined sugar, processed foods, and bread products from his or her diet is not realistic.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 314

23. A nurse is caring for a person who has a diagnosis of Sleep disturbance related to stress as evidenced by excessive daytime fatigue. Which of the following nursing interventions would most likely to assist this person?
a. Encourage daytime naps.
b. Encourage exercise one hour before bedtime.
c. Encourage a cool shower before bedtime.
d. Encourage a consistent sleep-wake schedule.
ANS: D
Daytime napping, exercising within 1 hour of bedtime, and taking a cool shower prior to bedtime will not promote nighttime sleep. Following a consistent sleep-wake cycle seven days a week will help establish a sleep pattern.

DIF: Cognitive Level: Apply (Application) REF: p. 309 (Box 13-6)

24. A nurse is educating a person about the process of cognitive restructuring. Which of the following actions should be taken at the end of this process?
a. Take a deep breath.
b. Select a realistic alternative thought.
c. Reflect on the situation.
d. Stop generating negative thoughts.
ANS: B
The most effective approach to restructuring thought patterns is to first stop generating negative thoughts, then take a deep breath to relax, then think about how the thought process is affecting well-being, and last, select a new realistic thought pattern to replace the negative thought pattern.

DIF: Cognitive Level: Apply (Application) REF: p. 310 (Box 13-7)

25. A nurse is explaining the concept of presence.
The nurse should include that presence means that the person:
a. is in the same room as another.
b. multitasks in order to examines all aspects of a situation.
c. sets goals in response to what another is saying.
d. practices active listening and focuses on what is being said.
ANS: D
The concept of presence means that a persons full attention is focused on the situation at hand. Multitasking produces the opposite effect because focus is lost.

DIF: Cognitive Level: Apply (Application) REF: p. 306 (Box 13-4)

MULTIPLE RESPONSE

1. A nurse is educating a group of adults about stress management strategies. Which of the following examples would the nurse include in the presentation? (select all that apply)
a. Participation in a swimming class
b. Keeping a food diary as part of a weight reduction program
c. Joining a smoking cessation support group
d. Setting a goal of walking one mile a day
ANS: A, B, C, D
Goal setting, self-monitoring, exercise, and problem solving are all effective stress reduction strategies.

DIF: Cognitive Level: Apply (Application) REF: pp. 304-308

2. The nurse in the pediatric oncology unit is working with a family whose toddler has been diagnosed with leukemia. The nurse can best assist the family to deal with this extrinsic stressor by doing which of the following? (select all that apply)
a. Setting treatment goals for them until they are able to do so themselves
b. Encouraging them to talk about their concerns
c. Discussing relaxation techniques such as guided imagery with them
d. Asking them if they would like to meet with a member of a pediatric oncology support group
ANS: B, C, D
The nurse can assist this family by active listening, encouraging the family to discuss concerns, teaching them relaxation techniques, and providing access to a support group. It is not appropriate for the nurse to set goals for the family.

DIF: Cognitive Level: Apply (Application) REF: pp. 314-315

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