Chapter 25: Stress and Coping

Chapter 25: Stress and Coping

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient who was injured in a motor vehicle accident is taken via ambulance to the emergency department. The nurse performing the physical assessment knows that, according to the general adaptation syndrome, the patient should be expected to exhibit:

ANS:   B

In the early part of the twentieth century, the fight-or-flight response was described. This arousal of the sympathetic nervous system prepares a person for action by increasing heart rate; diverting blood from the intestines to the brain and striated muscles; and increasing blood pressure, heart rate, respiratory rate, and blood glucose levels.

PTS:    1                      DIF:    Cognitive Level: Understanding (Comprehension)

REF:    638                  OBJ:    Formulate nursing diagnoses based on assessment data.

TOP:    Nursing Process: Diagnosis               MSC:   NCLEX: Physiological Integrity

2. The nurse is administering flu vaccines. One of the children who is scheduled to receive the vaccine is afraid of needles and is tearful, and his younger brother is trying to calm him down. The nurse knows that the tearful child has evaluated this event as challenging and therefore is experiencing psychological stress caused by which of the following?

ANS:   A

When a person encounters an event, there is an immediate process of primary appraisal or rating of the event. If this appraisal results in the event being identified as a potential harm, loss, threat, or challenge, the person has stress. Coping refers to strategies or practices that help people deal with stress. Following the recognition of stress, secondary appraisal focuses on the resources or coping strategies that can meet the stress. Dissociation is experiencing a subjective sense of numbing and a reduced awareness of one’s surroundings.

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    638 | 640         OBJ:    Formulate nursing diagnoses based on assessment data.

TOP:    Nursing Process: Diagnosis               MSC:   NCLEX: Psychosocial Integrity

3. The nurse is assigned a patient who has experienced the alarm reaction and continues to recover. The nurse knows that the primary hormone impacting the stress response in the resistance stage of the general adaptation syndrome is:

ANS:   D

Corticotropin stimulates the adrenal gland to increase the production of corticosteroids, including cortisol, the primary hormone impacting the stress response. Cortisol increases blood glucose, enhances the brain’s use of glucose, and increases the availability of substances for tissue repair. Vasopressin increases reabsorption of water by the kidneys and induces vasoconstriction, thereby raising blood pressure. The adrenal gland also releases catecholamines, adrenaline, and noradrenaline, which are important parts of the alarm reaction.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    638 | 639         OBJ:    Describe the three stages of the general adaptation syndrome.

TOP:    Nursing Process: Diagnosis               MSC:   NCLEX: Physiological Integrity

4. The nurse is talking to a patient who was involved in a motor vehicle accident. The patient asks the nurse why there was no sensation of pain at the time of the accident. The best explanation would be:

ANS:   B

Endorphins are hormones that interact with the opiate receptors in the brain to reduce our perception of pain and produce a sense of well-being. Vasopressin increases reabsorption of water by the kidneys and induces vasoconstriction, thereby raising blood pressure. It has no effect on pain sensation. Unhealthy coping choices, such as the use of alcohol or tobacco, negatively affect a person’s health as well as increasing the perception of stress. Persistent elevated cortisol levels are associated with chronic health conditions, such as obesity, heart disease, depression and anxiety, diabetes, and osteoporosis.

PTS:    1                      DIF:    Cognitive Level: Understanding (Comprehension)

REF:    638-640           OBJ:    Identify how stress and coping relate to health.

TOP:    Nursing Process: Diagnosis               MSC:   NCLEX: Physiological Integrity