Module 31 Stress and Coping

Module 31   Stress and Coping

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

The Concept of Stress and Coping

 

1) After a mammogram, a client is told that she needs a fine needle aspirate of a breast mass. What demonstrates that the client is engaging in a primary appraisal of the stressful situation?

1. A) The client holds her breath while the nurse is talking.
2. B) The client sits in the dressing room and cries.
3. C) The client asks the nurse if she has cancer.
4. D) The client schedules the procedure in 6 weeks, which is the earliest possible appointment.

Answer:  C

Explanation:  A) In primary appraisal, the client assesses the potential for benefit, harm, loss, threat, or challenge in a situation. The client asking the nurse if she has cancer is engaging in a primary appraisal. The client holding her breath while the nurse is talking is evaluating coping resources and options. This is a secondary appraisal. The client who sits in the dressing room and cries is applying a coping resource. This is coping. The client who schedules the procedure at the earliest possible appointment is engaging in reappraisal, which is an ongoing reinterpretation of the situation based on new information.

1. B) In primary appraisal, the client assesses the potential for benefit, harm, loss, threat, or challenge in a situation. The client asking the nurse if she has cancer is engaging in a primary appraisal. The client holding her breath while the nurse is talking is evaluating coping resources and options. This is a secondary appraisal. The client who sits in the dressing room and cries is applying a coping resource. This is coping. The client who schedules the procedure at the earliest possible appointment is engaging in reappraisal, which is an ongoing reinterpretation of the situation based on new information.
2. C) In primary appraisal, the client assesses the potential for benefit, harm, loss, threat, or challenge in a situation. The client asking the nurse if she has cancer is engaging in a primary appraisal. The client holding her breath while the nurse is talking is evaluating coping resources and options. This is a secondary appraisal. The client who sits in the dressing room and cries is applying a coping resource. This is coping. The client who schedules the procedure at the earliest possible appointment is engaging in reappraisal, which is an ongoing reinterpretation of the situation based on new information.
3. D) In primary appraisal, the client assesses the potential for benefit, harm, loss, threat, or challenge in a situation. The client asking the nurse if she has cancer is engaging in a primary appraisal. The client holding her breath while the nurse is talking is evaluating coping resources and options. This is a secondary appraisal. The client who sits in the dressing room and cries is applying a coping resource. This is coping. The client who schedules the procedure at the earliest possible appointment is engaging in reappraisal, which is an ongoing reinterpretation of the situation based on new information.

Page Ref: 1898

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  1. Summarize the physiologic response to stress and the psychodynamics of coping.

2) A client says that learning how to use the blood glucose machine will have to wait until holiday events are planned first. Which cognitive indication of stress is the client demonstrating?

1. A) Problem solving
2. B) Suppression
3. C) Self-control
4. D) Structuring

Answer:  B

Explanation:  A) The client is demonstrating suppression, which is the conscious and willful act of putting a thought or feeling out of mind. The client is focusing on other needs and not the need to learn how to use the blood glucose machine. Problem solving involves thinking through the threatening situation, using specific steps to arrive at a solution. Structuring is the arrangement or manipulation of a situation so that threatening events do not occur. Self-control is assuming a manner and facial expression that convey a sense of being in control or in charge.

1. B) The client is demonstrating suppression, which is the conscious and willful act of putting a thought or feeling out of mind. The client is focusing on other needs and not the need to learn how to use the blood glucose machine. Problem solving involves thinking through the threatening situation, using specific steps to arrive at a solution. Structuring is the arrangement or manipulation of a situation so that threatening events do not occur. Self-control is assuming a manner and facial expression that convey a sense of being in control or in charge.
2. C) The client is demonstrating suppression, which is the conscious and willful act of putting a thought or feeling out of mind. The client is focusing on other needs and not the need to learn how to use the blood glucose machine. Problem solving involves thinking through the threatening situation, using specific steps to arrive at a solution. Structuring is the arrangement or manipulation of a situation so that threatening events do not occur. Self-control is assuming a manner and facial expression that convey a sense of being in control or in charge.
3. D) The client is demonstrating suppression, which is the conscious and willful act of putting a thought or feeling out of mind. The client is focusing on other needs and not the need to learn how to use the blood glucose machine. Problem solving involves thinking through the threatening situation, using specific steps to arrive at a solution. Structuring is the arrangement or manipulation of a situation so that threatening events do not occur. Self-control is assuming a manner and facial expression that convey a sense of being in control or in charge.

Page Ref: 1904

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  2. Examine the relationship between stress and coping and other concepts/systems.

 

3) A client worries every day about personal health and that they may not have enough medication should the weather take a turn for the worse. The nurse is concerned that the client might be developing which of the following?

1. A) Generalized anxiety disorder
2. B) Phobia
3. C) Obsessive-compulsive disorder
4. D) Panic disorder

Answer:  A

Explanation:  A) Generalized anxiety disorder is excessive worry about everyday problems, with the anxiety being more intense than the situation warrants. The client is demonstrating signs of generalized anxiety disorder. A phobia is an intense, persistent, irrational fear of a simple thing or social situation that compels the individual to avoid the stressor that elicits the fear. Panic disorder is a sudden attack of terror, accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. Obsessive-compulsive disorder is characterized by obsessive thoughts and compulsive repetitive behaviors formed in response to the obsessive thoughts to lower the level of anxiety experienced.

1. B) Generalized anxiety disorder is excessive worry about everyday problems, with the anxiety being more intense than the situation warrants. The client is demonstrating signs of generalized anxiety disorder. A phobia is an intense, persistent, irrational fear of a simple thing or social situation that compels the individual to avoid the stressor that elicits the fear. Panic disorder is a sudden attack of terror, accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. Obsessive-compulsive disorder is characterized by obsessive thoughts and compulsive repetitive behaviors formed in response to the obsessive thoughts to lower the level of anxiety experienced.
2. C) Generalized anxiety disorder is excessive worry about everyday problems, with the anxiety being more intense than the situation warrants. The client is demonstrating signs of generalized anxiety disorder. A phobia is an intense, persistent, irrational fear of a simple thing or social situation that compels the individual to avoid the stressor that elicits the fear. Panic disorder is a sudden attack of terror, accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. Obsessive-compulsive disorder is characterized by obsessive thoughts and compulsive repetitive behaviors formed in response to the obsessive thoughts to lower the level of anxiety experienced.
3. D) Generalized anxiety disorder is excessive worry about everyday problems, with the anxiety being more intense than the situation warrants. The client is demonstrating signs of generalized anxiety disorder. A phobia is an intense, persistent, irrational fear of a simple thing or social situation that compels the individual to avoid the stressor that elicits the fear. Panic disorder is a sudden attack of terror, accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. Obsessive-compulsive disorder is characterized by obsessive thoughts and compulsive repetitive behaviors formed in response to the obsessive thoughts to lower the level of anxiety experienced.

Page Ref: 1908

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  3. Identify commonly occurring alterations in coping and their related therapies.

4) Which assessment finding or findings indicate to the nurse that a client is experiencing stress?

Select all that apply.

1. A) Chewing on a finger nail
2. B) Checking cellular phone
3. C) Reading a magazine
4. D) Talking with others
5. E) Tapping foot

Answer:  A, E

Explanation:  A) The client is experiencing both behavioral (nail chewing) and physical (foot tapping) indications of stress. Reading a magazine, checking a phone, and talking with others are not indications of stress.

1. B) The client is experiencing both behavioral (nail chewing) and physical (foot tapping) indications of stress. Reading a magazine, checking a phone, and talking with others are not indications of stress.
2. C) The client is experiencing both behavioral (nail chewing) and physical (foot tapping) indications of stress. Reading a magazine, checking a phone, and talking with others are not indications of stress.
3. D) The client is experiencing both behavioral (nail chewing) and physical (foot tapping) indications of stress. Reading a magazine, checking a phone, and talking with others are not indications of stress.
4. E) The client is experiencing both behavioral (nail chewing) and physical (foot tapping) indications of stress. Reading a magazine, checking a phone, and talking with others are not indications of stress.

Page Ref: 1912

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  4. Differentiate common assessment procedures used to examine stress levels and coping mechanisms across the life span.

 

5) The nurse suspects that a healthy client could be experiencing stress because of which laboratory result?

1. A) Serum sodium of 142 mEq/L
2. B) Serum glucose of 165 mg/dL
3. C) Serum potassium of 4.0 mEq/L
4. D) Serum calcium of 10.2 mEq/L

Answer:  B

Explanation:  A) Laboratory tests are not routinely done to evaluate anxiety because observation is faster and more accurate. However, they may be necessary to rule out medical conditions that can cause anxiety. The elevated blood glucose level could indicate that the client is experiencing stress because of an increase in adrenal function. One physiological indicator of stress is an increase in blood glucose because of the release of glucocorticoids and gluconeogenesis. The other laboratory values are within normal limits.

1. B) Laboratory tests are not routinely done to evaluate anxiety because observation is faster and more accurate. However, they may be necessary to rule out medical conditions that can cause anxiety. The elevated blood glucose level could indicate that the client is experiencing stress because of an increase in adrenal function. One physiological indicator of stress is an increase in blood glucose because of the release of glucocorticoids and gluconeogenesis. The other laboratory values are within normal limits.
2. C) Laboratory tests are not routinely done to evaluate anxiety because observation is faster and more accurate. However, they may be necessary to rule out medical conditions that can cause anxiety. The elevated blood glucose level could indicate that the client is experiencing stress because of an increase in adrenal function. One physiological indicator of stress is an increase in blood glucose because of the release of glucocorticoids and gluconeogenesis. The other laboratory values are within normal limits.
3. D) Laboratory tests are not routinely done to evaluate anxiety because observation is faster and more accurate. However, they may be necessary to rule out medical conditions that can cause anxiety. The elevated blood glucose level could indicate that the client is experiencing stress because of an increase in adrenal function. One physiological indicator of stress is an increase in blood glucose because of the release of glucocorticoids and gluconeogenesis. The other laboratory values are within normal limits.

Page Ref: 1906

Cognitive Level:  Understanding

Client Need:  Physiological Integrity

Nursing Process:  Assessment

Learning Outcome:  4. Differentiate common assessment procedures used to examine stress levels and coping mechanisms across the life span.