Chapter 06 Homeostasis, Stress, and Adaptation

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Chapter 06  Homeostasis, Stress, and Adaptation

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. A nurse is meeting with a young woman who has recently lost her mother and her job and has moved with her husband to a new city. She is complaining of acute anxiety and depression. What does the nurse knows that would be helpful to this patient?
A) Adaptation often fails during stressful events and results in homeostasis.

B) Stress is a part of our lives, and, eventually, this young woman will adapt.
C) Acute anxiety and depression are seldom associated with stress.
D) Sometimes too many stressors disrupt homeostasis, and, if adaptation fails, the result is disease.

Ans: D
Chapter: 6
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 1
Page and Header: 79, Fundamental Concepts

Feedback: Four concepts — constancy, homeostasis, stress, and adaptation — are key to the understanding of steady state. Homeostasis is maintained through emotional, neurologic, and

hormonal measures; stressors create pressure for adaptation. Sometimes too many stressors disrupt homeostasis, and, if adaptation fails, the result is disease. Option A is incorrect; when adaptation fails, the result is disease. Option B is incorrect; if a person is overwhelmed by stress, she may never adapt. Option C is incorrect; acute anxiety and depression are frequently associated with stress.

2. You are the nurse caring for a patient who has just been diagnosed with cancer. The patient states that he will “never be able to cope with this situation.” What are you aware that coping is? A) Coping is a physiologic measure used to deal with change, and he will physically adapt.
B) Coping is the physiologic and psychological processes that people use to adapt to change. C) Coping is the human need for faith and hope, which create change.

D) Coping is a social measure used to deal with change and loss.

Ans: B
Chapter: 6
Client Needs: D-4
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Nursing Process Objective: 2
Page and Header: 79, Fundamental Concepts

Feedback: Indicators of stress and the stress response include both subjective and objective measures. They are psychological, physiologic, or behavioral and reflect social behaviors and thought processes. The physiologic and psychological processes that people use to adapt to stress are the essence of the coping process. Option A is incorrect; coping is both a physiologic and psychological process. Option C is incorrect; coping is a process used to adapt to change. Option D is incorrect; coping is a personal process used to adapt to change.

3. The nurse is with a young patient who has just been informed of his terminal illness. His heart rate increases, his eyes dilate, and his blood pressure increases. The nurse recognizes this response as what?
A) Part of the limbic system response

B) Sympathetic nervous response C) Hypothalamic-pituitary response D) Local adaptation syndrome

Ans: B
Chapter: 6
Client Needs: A-1

Cognitive Level: Application Difficulty: Easy
Integrated Process: Nursing Process Objective: 3

Page and Header: 82, Overview of Stress

Feedback: The sympathetic nervous system responds rapidly to stress; norepinephrine is released at nerve ending causing the organs to respond (i.e., heart rate increases, eyes dilate, and blood pressure increases). Option A is incorrect; the limbic system is a mediator of emotions and behavior that are critical to survival during times of stress. Option C is incorrect; the hypothalamic-pituitary response regulates the cortisol-induced metabolic effect that results in elevated blood sugars during stressful situations. Option D is incorrect; local adaptation syndrome is a tissue-specific inflammatory reaction.

4. You are the nurse caring for a 72-year-old female who is recovering from abdominal surgery on the medical-surgical unit. The surgery was very stressful and prolonged, and you note on the chart that her blood sugars are elevated, yet she has not been diagnosed with diabetes. To what do you attribute this elevation in blood sugars?

A) It is a result of antidiuretic hormone.
B) She must have had diabetes prior to surgery.
C) She has become a diabetic from the abdominal surgery.
D) The blood sugars are probably a result of the “fight-or-flight” reaction.

Ans: D
Chapter: 6
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 4
Page and Header: 83, Overview of Stress

Feedback: During stressful situations, ACTH stimulates the release of cortisol from the adrenal gland, which creates protein catabolism releasing amino acids and stimulating the liver to convert amino acids to glucose; the result is elevated blood sugars. Option A is incorrect; antidiuretic hormone is released during stressful situations and stimulates reabsorption of water in the distal and collecting tubules of the kidney. Option B is incorrect; assuming the patient had diabetes prior to surgery demonstrates a lack of understanding of stress-induced hyperglycemia. Option C is incorrect; there is no evidence presented in the question other than elevated blood sugars that would support a diagnosis of diabetes.

5. A young female science teacher arrives at the health center with a respiratory infection; she tells the nurse that she does not like to “go to a doctor” and is feeling anxious about “being here.” When the nurse checks her blood pressure, it is elevated along with her heart rate. The nurse rechecks her blood pressure about 10 minutes later and it is normal. The patient asks the nurse if she should be concerned that she may have hypertension. What is the nurse’s best response?

A) She should not worry; it was stress related and her regular blood pressure is good.
B) The first blood pressure was part of a simple stress response; our long-term blood pressure is controlled by negative feedback systems.
C) Blood pressure is only one measure of hypertension; she should review this with the doctor and plan to recheck it on a regular basis.
D) The respiratory infection is the probably the cause of the elevated blood pressure, and, with treatment, her blood pressure should remain normal.

Ans: B
Chapter: 6
Client Needs: B
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Teaching/Learning Objective: 6
Page and Header: 84, Overview of Stress

Feedback: A simple stress response will temporarily elevate a blood pressure and heart rate. Long-term blood pressure response is controlled by negative feedback systems.
For a science teacher, this would be an appropriate level of teaching/learning and would serve to promote health. Option A is incorrect; the nurse is assuming her blood pressure in good based on only two blood pressure readings. Option C is incorrect; the nurse has given the patient a vague answer without rationale. Option D is incorrect; the stress of a respiratory infection could account for the elevated blood pressure, but assuring the patient that with treatment her blood pressure will return to normal may not be true.

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