Chapter 40- Stress, Coping, and Adaptation Nursing School Test Banks

 

1.

The patient tells the nurse she has never gotten over the loss of her husband two years ago. The patient states she is drinking alcohol to excess every day and has started smoking, saying both help her cope. The best response by the nurse would be

A)

You need to decrease your alcohol consumption and stop smoking for your overall health.

B)

It may be time for you to consider a comprehensive treatment program.

C)

Many people develop these habits in response to severe stress. As you learn to better cope, you will see a decrease in your need for these substances.

D)

This is the way you are coping with the stress. Everyone copes in their own way.

Ans:

B

Feedback:

People exhibiting stress and altered coping through substance abuse or overeating require a comprehensive treatment program to address their coping and adaptation problems.

2.

A woman has just suffered the loss of her husband. The woman tells the nurse she cannot eat. The nurse understands this form of coping is:

A)

part of the normal sympathetic stress response.

B)

maladaptive coping.

C)

the womans coping style.

D)

resolution of loss.

Ans:

A

Feedback:

Some individuals lose their appetite during stressful situations. This is actually part of the normal sympathetic stress response that diminishes appetite and digestive function. Sympathetic Nervous System activity, however, should be short-term and a persons appetite should return.

3.

A teenaged boy describes a dysfunctional home life to the nurse. The boy states he is running 10 miles or more a day to keep his mind off of his home life. The nurse identifies this form of coping as:

A)

beneficial

B)

maladaptive

C)

generational

D)

cultural

Ans:

B

Feedback:

Substance abuse, beginning or increasing smoking, oversleeping, over- or undereating, oversleeping, overexercising, excessive daydreaming, and fantasizing are various ways individuals with the inability to cope with stress successfully deal with stress.

4.

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.

5.

The nurse is caring for a post-operative Asian patient who speaks minimal English. The nurse notes the patient has not requested medication for pain. Considering the patients 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 patient is not in pain.

D)

Understand that the patient 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.

6.

A teenaged 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.

7.

The patient asks the nurse what she should do about a skin lesion she is very worried about. The nurse suggests the patient should notify her physician for a diagnosis. The patient is relieved and states she will make an appointment. This type of activity is considered:

A)

coping

B)

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.

8.

The nurse is discussing an event with a patient. The patient has perceived the event as stress and states she feels better when she takes a brisk walk. The development of coping mechanisms is an example of:

A)

appraisal

B)

secondary appraisal

C)

buffering

D)

adaptation

Ans:

B

Feedback:

This is called secondary appraisal and is associated with engaging in coping mechanisms to deal with the stress.

9.

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 which of the following contribute to this phenomenon?

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.

A dancer has suffered a fall injury, which will prevent participation in a much anticipated event. The fall is classified as which of the following?

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.

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 also unavoidable. The resulting feelings of angst and grief are sometimes labeled distress.

12.

The nurse is explaining the bodys response to a stressful situation. The nurse includes which of the following manifestations? 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.

13.

During acute stress, the body secretes cortisol, which has which of the following effects 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.

14.

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 through taking actions to directly work with the event or situation causing the stress, or emotion-focused through finding ways to lessen the feelings of anxiety and angst triggered by the stressful event.

15.

An adult receives a call from her bank stating her account is overdrawn and a significant fee has been assessed. The adult would have an initial reaction of which of the following?

A)

appraisal

B)

coping

C)

adaptation

D)

intervention

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 stress.

16.

The patient asks the patient to explain stress and its effect on the body. Which of the following will the nurse include? Select all that apply.

A)

Stress begins in children at about age two.

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.

17.

During an interview, the patient 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.

Which of the following statements, 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, their 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 family and friends.

19.

An example of 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.

20.

Which of the following actions 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 daily walk in the neighborhood park

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.

21.

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.

22.

To assess the coping abilities of a first-time mother who expresses concern to the nurse about feeling overwhelmed by the needs of her newborn, the nurse should ask the patient about her

A)

Past experiences with childcare

B)

Interpretation of events

C)

Nutritional patterns

D)

Exercise patterns

Ans:

B

Feedback:

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 persons health because accumulated allostatic responses may adversely affect the body.

23.

A middle-aged womans 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.

24.

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.

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.

26.

A high school student comes to the nurses office to discuss her anxiety regarding an upcoming test. Her 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.

27.

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 persons capacity to flourish and survive, even with diversity.

28.

A patient is using prayer to assist in relieving stress. The use of prayer allows the patient to

A)

Cope

B)

Understand

C)

Plan

D)

Recover

Ans:

A

Feedback:

The ability to cope is a crucial element that influences well-being.

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