Chapter 32: Stress and Coping

Fundamentals Nursing Active Learning 1st Edition Yoost Crawford

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Chapter 32: Stress and Coping

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. The nurse knows that one theory explaining the variation in response to stress among individuals is called:
a. stress appraisal.
b. sense of coherence.
c. allostasis.
d. homeostasis.

 

 

ANS:  B

Sense of coherence (SOC) is a characteristic of personality that references one’s perception of the world as comprehensible, meaningful, and manageable. Stress appraisal is the automatic, often unconscious assessment of a demand or stressor. Allostasis is an alternative term for the stress response. Homeostasis is the tendency of the body to seek and maintain a condition of balance or equilibrium.

 

DIF:    Understanding                                 REF:   pp. 730-732    OBJ:   32.1

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Stress

 

  1. The nurse is caring for a patient with a new diagnosis of diabetes type 2. Which of the following statements indicates a negative coping response?
a. “I will look up information on the Internet about diabetes.”
b. “I will join a support group.”
c. “I will only focus on learning to manage my medication first.”
d. “I will make changes slowly so I can adapt to each change.”

 

 

ANS:  C

When the patient puts limits on learning by stating he/she will only learn about medication, he/she is using avoidance strategies to alleviate stress. Using strategies such as information gathering (seeking information about diabetes) is positive. Joining support groups and making changes slowly to adapt is also taking direct action by moving forward.

 

DIF:    Understanding                                 REF:   p. 733             OBJ:   32.1

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Coping

 

  1. The nurse is caring for a patient who is undergoing a major cardiac procedure. The patient tells you her heart is racing and she feels nauseated. You know this is part of hormone response known as:
a. sense of coherence.
b. stress appraisal.
c. fight or flight.
d. sympathoadrenal response.

 

 

ANS:  C

In the “fight or flight” response, the corticotropin-releasing hormone (CRH) released by the hypothalamus stimulates the pituitary to release adrenocorticotropic hormone (ACTH). These hormones increase the heart rate, resulting in increased cardiac output, and the motility of the digestive tract is decreased, slowing digestive processes that could result in abdominal distress. Sense of coherence (SOC) is a characteristic of personality that references one’s perception of the world as comprehensible, meaningful, and manageable. Stress appraisal is the automatic, often unconscious, assessment of a demand or stressor. The sympathoadrenal response is a consequence of hypothalamic activation in sympathetic stimulation, which triggers epinephrine and norepinephrine release from the adrenal medulla.

 

DIF:    Applying        REF:   p. 730 | pp. 732-733                         OBJ:   32.2

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Coping

 

  1. The nurse is measuring her patient’s blood glucose levels after an acute myocardial infarction (MI). She knows the rationale for doing this is:
a. damaged muscle tissue releases glucose.
b. corticosteroids increase glucose.
c. myocardial infarctions are often seen in diabetics.
d. all patients should have their blood glucose checked.

 

 

ANS:  B

The endocrine system responds to stress on the body such as what happens during an acute MI. Corticosteroids are important in the stress response because they increase serum glucose levels and inhibit the inflammatory response. Although MIs can be seen in diabetics, there is nothing to indicate this patient is diabetic. All patients do not routinely have their blood glucose checked regularly.

 

DIF:    Applying        REF:   p. 734            OBJ:   32.2               TOP:   Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity      NOT:  Concepts: Coping

 

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