Complete Test Bank With Answers
Sample Questions Posted Below
| 1. |
The nurse is caring for a client who works as a doctor in a general hospital. He complains about the stressful condition of his job. Lately, he has become increasingly susceptible to colds, headaches, muscular tension, excessive tiredness, and many other symptoms. At what stage of stress is the client? |
| A) |
Alarm stage |
| B) |
Exhaustion stage |
| C) |
Resistance stage |
| D) |
Secondary stage |
| Ans: |
B |
|
Feedback: |
|
The client is in the exhaustion stage when one or more adaptive/resistive mechanisms can no longer protect the person experiencing a stressor; this results in exhaustion. The effects of stress-related neurohormones suppress the immune system and the body is open to various ailments. In the alarm stage, the person is prepared for a fight-or-flight response. In the resistance stage, the client’s body is returned to the homeostasis state. Consequently, one or more organs or physiologic processes may eventually lead to increased vulnerability to stress-related disorders or progression to the stage of exhaustion. The secondary stage is not a stage related to stress. |
| 2. |
A client visits a health care facility a few months after his wife’s death. The client is quite depressed and feels very lonely. The nurse tactfully asks him to confront the reality and helps him to brainstorm some useful ways of dealing with his loss. What type of strategy is the nurse following in this case? |
| A) |
Nontherapeutic coping strategy |
| B) |
Therapeutic coping strategy |
| C) |
Negative coping strategy |
| D) |
Sensory manipulation strategy |
| Ans: |
B |
|
Feedback: |
|
Therapeutic coping strategies usually help the person to acquire insight, gain confidence to confront reality, and develop emotional maturity. People use nontherapeutic coping strategies such as mind- and mood-altering substances, hostility and aggression, excessive sleep, avoidance of conflict, and abandonment of social activities. Sensory manipulation involves altering moods, feelings, and physiologic responses by stimulating pleasure centers in the brain using sensory stimuli. Negative coping strategies may provide immediate temporary relief from a stressor, but they eventually cause problems. |
| 3. |
A nurse is trying to calm a client who is highly agitated after being involved in an accident. The client escaped with minor bruises from the accident. What should the nurse do in order to calm the agitated client? |
| A) |
Administer sedatives to calm the nerves. |
| B) |
Ask family members to take him for a vacation. |
| C) |
Help him identify ways that the outcome could have been worse. |
| D) |
Advise him to file a claim on his accident insurance. |
| Ans: |
C |
|
Feedback: |
|
The nurse, using alternative thinking techniques, should explain to the client that the situation could have been worse. Alternative thinking techniques are those that facilitate a change in a person’s perceptions from negative to positive. Sedatives have a temporary effect in calming a person, but reframing the mind is a better way of coping with the stress. Advising the client to claim insurance would be inappropriate in this case and would not alleviate the client’s agitation and stress. |
| 4. |
A client visits a health care facility with complaints of work-related stress that alters her mood when she comes home. At the nurse’s suggestion, the client states that she is open making changes to her home décor to include vibrant colors and bright lighting, and listen to soothing music when she returns home. Which stress-reducing technique is the nurse following in this case? |
| A) |
Sensory manipulation technique |
| B) |
Alternative thinking technique |
| C) |
Nontherapeutic technique |
| D) |
Alternative behavior technique |
| Ans: |
A |
|
Feedback: |
|
The nurse is using a sensory manipulation technique. Sensory manipulation involves altering moods, feelings, and physiologic responses by stimulating pleasure centers in the brain using sensory stimuli. For example, certain colors, full-spectrum lighting in the home and workplace, music, and food help change a person’s mood. Alternative thinking techniques are those that facilitate a change in a person’s perceptions from negative to positive. A behavioral technique for modifying stress is to take control rather than become immobilized by stress. Nontherapeutic techniques would involve using mind- and mood-altering substances, which are not appropriate in this case. |
| 5. |
A teenage boy has been admitted for rehabilitation following a head injury. His parents explain that he is not able to interpret what they say and so is not able to speak clearly. The boy is also not able to remember what he is taught during educational sessions. What should the nurse conclude about the part of the brain that is likely affected in this case? |
| A) |
The cortex is affected. |
| B) |
The subcortex is affected. |
| C) |
The mid-brain is affected. |
| D) |
The brainstem is affected. |
| Ans: |
A |
|
Feedback: |
|
The cortex is considered the higher-functioning portion of the brain. It enables people to think abstractly, use and understand language, accumulate and store memories, and make decisions about information received. Therefore, the nurse can conclude that the client’s cortex is affected. The subcortex consists of the structures in the mid-brain and brainstem. The subcortical structures are primarily responsible for regulating and maintaining physiologic activities that promote survival. They regulate breathing, heart contraction, blood pressure, body temperature, sleep, appetite, and stimulation and inhibition of hormone production. |
| 6. |
A young-adult client visits the medical unit with his father for his scheduled checkup. The client’s father has been recently diagnosed with hypertension. The nurse suggests that the client gets his blood pressure regularly checked to avoid possible problems. What level of prevention is the nurse following in this case? |
| A) |
Primary level |
| B) |
Secondary level |
| C) |
General guidance level |
| D) |
Tertiary level |
| Ans: |
B |
|
Feedback: |
|
The nurse is following secondary prevention, which includes screening for risk factors and providing a means for early diagnosis of disease. An example is regularly measuring the blood pressure of a client with a family history of hypertension. Primary prevention involves eliminating the potential for illness before it occurs. Tertiary prevention minimizes the consequences of a disorder through aggressive rehabilitation or appropriate management of the disease. Note that there is no general guidance level of prevention. |
| 7. |
A child is receiving care ongoing stress, a problem that has been causing her to avoid going to school. How should the nurse first attempt to treat the child? |
| A) |
Teach the child the importance of being happy and unstressed. |
| B) |
Administer therapy that alters the child’s mood and feelings. |
| C) |
Administer antidepressants to counter stress. |
| D) |
Find the factors that have caused stress in the child. |
| Ans: |
D |
|
Feedback: |
|
The nurse in this case should try to find the factors that have caused stress and depression in the child. The nurse should calmly talk to the child and find the reason for her avoiding going to school. The child will not likely understand the importance of being happy and unstressed, and this approach is simplistic and usually ineffective. Administering therapies or antidepressants is premature and likely beyond the nurse’s scope of practice. |
| 8. |
A 35-year-old client is stressed because he is having problems with his superiors at work. The client says that he had an argument about his salary. He has become very anxious and has started consuming large amounts of caffeine very frequently. He also suffers from insomnia and gets angry quickly. Which of the following techniques should the nurse promote to help the client? |
| A) |
Nontherapeutic coping strategy |
| B) |
Negative coping strategy |
| C) |
Therapeutic coping strategy |
| D) |
Sensory manipulation strategy |
| Ans: |
C |
|
Feedback: |
|
Therapeutic coping strategies usually help the person to acquire insight, gain confidence to confront reality, and develop emotional maturity. Maladaptation results when people use nontherapeutic coping strategies such as mind- and mood-altering substances, hostility and aggression, excessive sleep, avoidance of conflict, and abandonment of social activities. Sensory manipulation involves altering moods, feelings, and physiologic responses by stimulating pleasure centers in the brain using sensory stimuli. Negative coping strategies may provide immediate temporary relief from a stressor, but they eventually cause problems. |
| 9. |
When discussing his life, a client tells the nurse that he is always doing small, petty jobs for everyone and he is not happy about it. Because of this, he is feeling stressed and has been getting into fights with his wife. What should the nurse suggest to help the client overcome this problem? |
| A) |
Change jobs. |
| B) |
Avoid people who dump tasks on him. |
| C) |
Take control of the situation. |
| D) |
Avoid doing petty jobs. |
| Ans: |
C |
|
Feedback: |
|
A behavioral technique for modifying stress is to take control rather than become immobilized. This is also known as alternative behavior. Another behavioral approach to reduce stress is to sometimes say “no,” in order to avoid becoming overwhelmed and more stressed. Changing jobs or avoiding the person or the petty jobs would not help and may be unrealistic responses. |
| 10. |
When discussing his concerns with the nurse, the client discloses that when he comes home from work, he plays with his pet ferret and this makes him feel relaxed. His friends make fun of him because of this, however. The nurse explains that this is perfectly normal and is not a cause of worry. In this case, how is the client relieving stress? |
| A) |
By adopting an alternative lifestyle |
| B) |
By adopting alternative behaviors |
| C) |
By adopting alternative thinking |
| D) |
By adopting alternative hobbies |
| Ans: |
A |
|
Feedback: |
|
In alternative lifestyles, people with pets find it soothing and relaxing to stroke and touch an animal that responds affectionately, regardless of a person’s age, physical characteristics, or accomplishments. Pets seem to improve a person’s feelings of self-worth in a way that extends to human relationships as well. Alternative thinking techniques are those that facilitate a change in a person’s perceptions from negative to positive. Alternative behaviors are behavioral techniques for modifying stress, which encourage one to take control rather than become immobilized. Making choices and pursuing actions promote self-confidence over feeling victimized. |
| 11. |
A client who is an intravenous drug user visits a health care facility for treatment. During counseling, he discloses that he initially took drugs because it helped him deal with stressful situations. The nurse recognizes that he is not using an effective coping strategy to overcome his stress-related problems. What kind of strategy has the client used in this case? |
| A) |
Nontherapeutic coping strategy |
| B) |
Therapeutic coping strategy |
| C) |
Stress-reduction strategy |
| D) |
Antidepressant strategy |
| Ans: |
A |
|
Feedback: |
|
The client has used nontherapeutic coping strategies such as mind- and mood-altering substances to cope with stress. Negative coping strategies may provide immediate temporary relief from a stressor, but they eventually cause problems. Therapeutic coping strategies usually help the person to acquire insight, gain confidence to confront reality, and develop emotional maturity. Also, the client has not used an antidepressant strategy. |
| 12. |
A client who tends to volunteer to complete major assignments but forgets to complete his work is stressed because of this and approaches the nurse for help. The nurse suggests that the client prioritize the work, complete the difficult part of the work first, and delegate the rest of the work to colleagues. In this case, what technique is the nurse asking the client to follow? |
| A) |
Alternative lifestyle |
| B) |
Alternative behaviors |
| C) |
Alternative thinking |
| D) |
Negative technique |
| Ans: |
B |
|
Feedback: |
|
Alternative behaviors means behavioral approaches that help to reduce stress, including prioritizing what needs to be accomplished and initially attending to that which is most important or difficult. Less important activities may be postponed or delegated to others. Alternative thinking techniques are those that facilitate a change in a person’s perceptions from negative to positive. People prone to stress can make a conscious effort to improve their diet, become more physically active, cultivate humor, and take scheduled breaks throughout the day for leisure, power naps, or listening to uplifting music. A negative technique may provide immediate temporary relief from a stressor, but it will eventually cause problems. |
| 13. |
A client, while driving, hit a small child crossing the road but the child emerged unharmed. The client feels very much stressed and is depressed when thinking of his action. Which of the following techniques should the nurse implement in this case? |
| A) |
Alternative thinking |
| B) |
Alternative behaviors |
| C) |
Alternative lifestyles |
| D) |
Adaptive activities |
| Ans: |
A |
|
Feedback: |
|
Alternative thinking techniques are those that facilitate a change in a person’s perceptions from negative to positive. Reframing helps a person to analyze a stressful situation from various perspectives and ultimately conclude that the situation is not as bad as it once seemed. Alternative behavior is a technique for modifying stress by taking control rather than becoming immobilized. Making choices and pursuing actions promotes self-confidence over feeling victimized. |
| 14. |
A nurse is working with a client whose current symptoms are attributable to high levels of norepinephrine. Which of the following functions does norepinephrine perform? |
| A) |
Stabilizes mood and regulates temperature |
| B) |
Promotes coordinated movement |
| C) |
Heightens arousal and increases energy |
| D) |
Transmits sensation of pain |
| Ans: |
C |
|
Feedback: |
|
Norepinephrine heightens arousal and increases energy. Acetylcholine and dopamine promote coordinated movement. Serotonin stabilizes mood, induces sleep, and regulates the temperature of a person. Substance P transmits the sensation of pain, whereas endorphins and enkephalins interrupt the transmission of substance P and promote a sense of well-being. |
| 15. |
A nurse is assessing a client with stress-related problems. Which of the following factors most significantly influences a person’s responses to stressors? |
| A) |
Eating habits |
| B) |
Social support |
| C) |
Economic status |
| D) |
Personal hygiene |
| Ans: |
B |
|
Feedback: |
|
A person’s response to stressors depends on social support, intensity of the stressor, number of stressors, duration of the stressor, physical health status, life experiences, coping strategies, personal beliefs, attitudes, and values. A person’s response to stressors is independent of education, eating habits, economic status, or personal hygiene. |
| 16. |
A nurse is caring for a client whose family members disagree on the best course of treatment for the client’s cancer. How should the nurse best alleviate the stress on the client and family members? |
| A) |
Advocate on behalf of the client to others. |
| B) |
Discourage family from interacting with the client. |
| C) |
Avoid referring the client directly. |
| D) |
Avoid discussing the client’s condition with client’s family. |
| Ans: |
A |
|
Feedback: |
|
The nurse should advocate on behalf of the client to others. If need be, the nurse should refer the client and his family to organizations or people who provide assistance. The nurse should keep the client and the client’s family informed about the client’s condition and encourage the family members to interact with the client. |
| 17. |
A nurse is assessing an obese teenager who is unhappy and stressed out because she has not lost weight despite working out at the gym. The physician asks the nurse to try the modeling intervention for stress management for the client. Which of the following actions should the nurse perform when adhering to the modeling intervention? |
| A) |
Ask the client to discontinue her exercise regimen |
| B) |
Introduce the client to someone who has successfully lost weight |
| C) |
Ask the client to identify the reasons for her eating |
| D) |
Ask the client to undergo liposuction surgery |
| Ans: |
B |
|
Feedback: |
|
The nurse should introduce the client to a person who demonstrates a positive attitude or behavior as this promotes the ability to learn an adaptive response. The nurse should not ask the client to discontinue her exercise regime or undergo liposuction surgery as that could lead to further medical complications. Assessing the reasons for the client’s eating habits is not a component of the modeling intervention. |
| 18. |
A nurse is working with a client whose quality of life is impacted by the presence of numerous comorbid health problems. The nurse is aware that the client’s body is attempting to maintain homeostasis, a process that primarily involves which of the following? |
| A) |
Minimizing the body’s exposure to external influences |
| B) |
Maximizing the serum levels of hormones |
| C) |
Ensuring a stable level of blood glucose |
| D) |
Responding appropriately to internal and external influences |
| Ans: |
D |
|
Feedback: |
|
Homeostasis is dependent on the body maintaining constancy by adjusting and readjusting in response to changes in the internal and external environment that foster disequilibrium. This does not always involve a stable blood glucose level or high levels of hormones. As well, homeostasis is not dependent on minimizing exposure to external influences, though this may often be necessary. |
| 19. |
A nurse is planning the care of a client who will soon begin radiotherapy for the treatment of breast cancer. The nurse has been identifying interventions that are rooted in the notion of holism, which states that: |
| A) |
Interactions between the mind and the body can profoundly influence health. |
| B) |
An individual’s medical diagnosis has local, but not systemic, effects. |
| C) |
Most physical illnesses do not require pharmacologic interventions or surgery. |
| D) |
A client’s illness affects friends and family in the same way that the client is affected. |
| Ans: |
A |
|
Feedback: |
|
Holism is the foundation of two commonly held beliefs: (1) both the mind and the body directly influence humans, and (2) the relationship between the mind and the body can potentially sustain health as well as cause illness. This does not necessarily mean that the medical interventions are unnecessary or that others are affected in the same way as the client. Holism does not preclude the presence of systemic effects of disease. |
| 20. |
A client is receiving treatment in the intensive care unit for sepsis, a systemic infection that poses a grave threat to his body’s homeostasis. The body is adapting to numerous threats, a process that primarily involves the integration of what body systems? Select all that apply. |
| A) |
Central nervous system |
| B) |
Autonomic nervous system |
| C) |
Endocrine system |
| D) |
Cerebellar system |
| E) |
Integumentary system |
| Ans: |
A, B, C |
|
Feedback: |
|
Neurotransmitters mediate homeostatic adaptive responses by coordinating functions of the central nervous system, autonomic nervous system, and endocrine system. The cerebellum controls balance, which is only peripherally involved in adaptation. The integumentary system (skin and associated structures) is not a major contributor to adaptation. |
| 21. |
A client who has been dealing with numerous physical, interpersonal, and financial stressors appears to be experiencing the final stage of Selye’s general adaptation syndrome (GAS). Individuals in the final stage of the GAS are likely to experience what? |
| A) |
Resumption of normal life roles |
| B) |
Resolution of normal hormone levels |
| C) |
Increased susceptibility to illness |
| D) |
Increased stamina |
| Ans: |
C |
|
Feedback: |
|
The stage of exhaustion is the last phase in the GAS. It occurs when one or more adaptive or resistive mechanisms are no longer able to protect the person experiencing a stressor. Consequently, the person is vulnerable to illness. This stage of the GAS is not associated with the adoption of normal life roles or increased stamina. Hormone levels are abnormal in the exhaustion stage. |
| 22. |
A client has been admitted to the emergency department following a motorcycle accident and is experiencing major physiological and psychological stressors during this period. What sign or symptom may be attributable to the parasympathetic effects of stress? |
| A) |
Increased muscle tone |
| B) |
Increased perspiration |
| C) |
Increased bronchoconstriction |
| D) |
Increased heart rate |
| Ans: |
C |
|
Feedback: |
|
Contraction of the bronchial muscles is associated with the parasympathetic stress response. Increased heart rate, muscle tone, and perspiration are characteristics of sympathetic stress effects. |
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