Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth
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Chapter 9- Stress and Adaptation
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | According to Walter B. Cannon, homeostasis is a stable internal environment achieved through a system of: | |
| A) | Interdependent system-wide adaptive responses | |
| B) | Variable internal and external conditioning factors | |
| C) | Coordinated physiologic processes that oppose change | |
| D) | Compatibility between cells and the internal environment | |
| Ans: | C | |
| Feedback: | ||
| Walter B. Cannon identified homeostasis, achieved by a coordinated physiologic process that opposes change. Claude Bernard recognized the importance of compatibility between cells and the internal environment. Hans Selye identified the general (systemic) adaptive and interdependent responses to stress. According to Selye, stressors produce different responses due to the influence of adaptive internal or external factors (conditioning factors). | ||
| 2. | A child has been experiencing hypoglycemic episodes. “How does the body know when to secrete insulin and when to stop secreting it?” The best response by the nurse, explaining the physiologic background, would be: | |
| A) | “The body knows that if the blood glucose level falls, it will inhibit insulin secretion and release glycogen to release glucose from the liver.” | |
| B) | “It’s just a big guessing game; first we give sugar like orange juice, and then we withhold the carbohydrates if the blood glucose level is too high.” | |
| C) | “Your pituitary gland in the brain is the ‘master gland,’ and it controls and regulates all the hormones.” | |
| D) | “Once the child starts getting confused, the brain will send a message to the pancreas to stop producing insulin.” | |
| Ans: | A | |
| Feedback: | ||
| In the negative feedback mechanism that controls blood glucose levels, an increase in blood glucose stimulates an increase in insulin, which enhances removal of glucose from the blood. When glucose has been taken up by cells and blood glucose levels fall, insulin secretion is inhibited and glucagon and other counterregulatory mechanisms stimulate release of glucose from the liver, which causes blood glucose levels to return to normal. | ||
| 3. | A client presents to the emergency department following a major traffic accident. Though outwardly there are no apparent physical injuries found, the client is experiencing chest pain and heightened alertness, which the health care worker attributes to the first stage of general adaptation syndrome (GAS). The health care worker concludes the client is experiencing manifestations related to the release of: | |
| A) | Aldosterone, which interferes with sodium absorption | |
| B) | Epinephrine | |
| C) | Too little cortisol | |
| D) | Thyroid-stimulating hormone | |
| Ans: | B | |
| Feedback: | ||
| The general adaptation syndromes has three stages—the first is alarm (fight or flight); second is resistance (fight); and the third is exhaustion. The alarm stage is characterized by a generalized stimulation of the sympathetic nervous system (SNS) and the HPA, resulting in release of catecholamines and cortisol. Increased insulin release or TSH release is not part of the GAS. | ||
| 4. | Although stress exposure initiates integrated responses by multiple systems, the functional results are first manifested as: Select all that apply. | |
| A) | Enhanced respiratory rate/depth | |
| B) | Cravings for high-carbohydrate foods | |
| C) | Increased alertness and focus | |
| D) | Increased glucose utilization | |
| E) | Increased GI peristalsis | |
| Ans: | A, C, D | |
| Feedback: | ||
| Exposure to stress activates an immediate response by the neuroendocrine system that plays a role in most of the responses to stress and attempts to adapt. Results of the coordinated release of these neurohormones include mobilization of energy, a sharpened focus and awareness, increased cerebral blood flow and glucose utilization, enhanced cardiovascular and respiratory functioning, redistribution of blood flow to the brain and muscles, modulation of the immune response, inhibition of reproductive function, and a decrease in appetite. | ||
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