Exam (elaborations)
Chapter 32 Stress and Coping
- Course
- Fundamentals of Nursing
- Institution
- Oxford College Of Emory University
Chapter 32 Stress and Coping
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DAWITChapter 32: Stress and Coping
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3RD Edition
MULTIPLE CHOICE
1. The nurse knows the one theory explaining the variation in response to stress among
individuals is identified by which term?
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 OBJ: 32.1 TOP: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity NOT: Concepts: Stress
2. The nurse is caring for a patient with a new diagnosis of diabetes type 2. Which statement
indicates a negative coping response?
a. ―I will look up informatioNn oR
n thI
e InG
ternB
et.aC
bouM
t diabetes.‖
b. ―I will join a support groupU
.‖ S N T O
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 OBJ: 32.1 TOP: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity NOT: Concepts: Coping
3. The nurse is caring for a patient who is undergoing a major cardiac procedure. When the
patient complains of a racing heart and nausea, the nurse recognizes these complaints as part
of what hormone response?
a. Sense of coherence
b. Stress appraisal
c. Fight or flight
d. Sympathoadrenal response
ANS: C
, DAWIT
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 OBJ: 32.2 TOP: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity NOT: Concepts: Coping
4. When the nurse measures the patient‘s blood glucose levels after an acute myocardial
infarction (MI), the nurse knows this action is based on which rationale?
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 OBJ: 32N .2URSINGTT OBP:.C
ImOplM
ementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity NOT: Concepts: Coping
5. The nurse is teaching a patient about the difference between mild anxiety and moderate
anxiety. Which statement by the patient indicates a need for further education?
a. ―Mild anxiety can help me remember things.‖
b. ―Moderate anxiety will narrow my focus.‖
c. ―Mild anxiety will help me be creative.‖
d. ―Moderate anxiety will increase my perception.‖
ANS: D
Moderate anxiety narrows a person‘s focus, dulls perception, and may challenge a person to
pay attention or use appropriate problem-solving skills. Mild anxiety can be motivational,
foster creativity, and increase a person‘s ability to think clearly.
DIF: Analyzing OBJ: 32.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity NOT: Concepts: Stress and Coping
6. The nurse is providing discharge instructions for a patient with multiple sclerosis. Which
discharge instruction is aimed at preventing a future exacerbation?
a. Engage in some form of exercise as tolerated.
b. Avoid highly stressful situations.
c. Check your skin regularly for pressure sores.
d. Eat a diet with lots of fiber.
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