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A nurse designs a plan of exercise for a patient experiencing stress. What rationale should the nurse cite when presenting this plan to the treatment team?
- A. Exercise will stimulate endorphins and improve the patient's feelings of well-being.
- B. Exercise prevents damage from overstimulation of the sympathetic nervous system.
- C. Exercise detoxifies the body by removing metabolic wastes and other toxins.
- D. Exercise will prevent exacerbation of the stress by the limbic system.
Correct Answer: A
Rationale: Exercise is a stress reduction strategy that stimulates endorphins and improves patient's feelings of well-being. The other options are not accurate.
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As part of the stress response, the HPA axis is stimulated. Which structures make up this system?
- A. Hippocampus, parietal lobe, and amygdala
- B. Hypothalamus, pituitary gland, and adrenal glands
- C. Hind brain, pyramidal nervous system, and anterior cerebrum
- D. Hepatic artery, parasympathetic nervous system, and acoustic nerve
Correct Answer: B
Rationale: As part of the physiological response of stress, the hypothalamus stimulates the HPA axis, which is made up of the hypothalamus, pituitary gland, and adrenal glands.
Which scenario best demonstrates an example of eustress?
- A. A child loses a beloved family pet.
- B. A single male prepares to take a 1-week vacation to a tropical island with a group of close friends.
- C. A couple receives a bank notice there were insufficient funds in their account for a recent rent payment.
- D. A married female receives notification that their current employer is experiencing financial problems and some workers will be terminated.
Correct Answer: B
Rationale: Eustress is beneficial stress; it motivates people to develop skills they need to solve problems and meet personal goals. Positive life experiences produce eustress. Going on a tropical vacation is an exciting, relaxing experience and an example of eustress. Losing the family pet, worrying about employment security, and having financial problems are examples of distress, a negative experience that drains energy and can lead to significant emotional problems.
A patient diagnosed with liver failure has been on the transplant waiting list 8 months. The patient says, 'Why is it taking so long to have the surgery? Maybe I'm meant to die for all the bad things I've done.' The nurse should document the patient's comment in which section of the assessment?
- A. Physical
- B. Spiritual
- C. Financial
- D. Psychological
Correct Answer: B
Rationale: Stress can be evident in a person's spirituality. This patient's comment indicates questioning of one's place in the universe and consequences for wrongdoing, both are elements of spirituality. Stress can be related to psychological, physical, or psychosocial well-being, but spirituality is the best answer.
A family member asks the nurse, 'Do you think stress and physical illness are connected? Since my father's death, my mother has had shingles and the flu, but she's usually not one who gets sick.' Which answer by the nurse best reflects current knowledge about long term effects of stress?
- A. It is probably a coincidence. Emotions and physical responses travel on different tracts of the nervous system.'
- B. You may be paying more attention to your mother since your father died and noticing more things such as minor illnesses.'
- C. So far, research on emotions or stress and becoming ill more easily is unclear. We do not know for sure if there is a link.'
- D. Negative emotions and stress may interfere with the body's ability to protect itself and can increase the likelihood of infection.'
Correct Answer: D
Rationale: The correct answer best explains the research. Research supports a link between negative emotions and/or prolonged stress and impaired immune system functioning. Activation of the immune system signals the central nervous system to initiate myriad responses to stress. Prolonged stress suppresses the immune system and lowers resistance to infections.
A person with a fear of heights drives across a high bridge. Which structure will stimulate a response from the autonomic nervous system?
- A. Thalamus
- B. Parietal lobe
- C. Hypothalamus
- D. Pituitary gland
Correct Answer: C
Rationale: The individual will find this experience stressful. The hypothalamus functions as the command-and-control center when receiving stressful signals. The hypothalamus responds to signals of stress by engaging the autonomic nervous system. The parietal lobe is responsible for the interpretation of other sensations. The thalamus processes messages associated with pain and wakefulness. The pituitary gland may be involved in other aspects of the person's response but would not stimulate the autonomic nervous system.