Nokea
A nurse is assessing a patient and uses the Recent Life Changes Questionnaire as part of the assessment. The nurse determines that the patient has experienced major life crisis with which score on the questionnaire?
- A. 150
- B. 250
- C. 350
- D. 450
Correct Answer: D
Rationale: The Recent Life Changes Questionnaire (based on the Holmes-Rahe Stress Scale) indicates a major life crisis with a score of 300 or higher, with 450 reflecting significant stress. Lower scores (150, 250) suggest moderate stress, and 350 is borderline but not definitive.
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After teaching a group of students about appraisal and the stress response, the instructor determines that additional teaching is needed when the students identify which of the following as part of the primary appraisal?
- A. Relevance of the goal
- B. Consistency of goal with values
- C. Personal commitment
- D. Outcome explanation
Correct Answer: D
Rationale: Primary appraisal involves evaluating the relevance (A), consistency with values (B), and personal commitment (C) to a stressor. Outcome explanation (D) is part of secondary appraisal, assessing coping options, indicating a need for further teaching.
A nurse is performing an assessment interview with a patient. The patient tells the nurse that he has a type A personality. Based on the nurse?s interpretation, the nurse would expect which behavior by the patient?
- A. Appearing relaxed and easygoing throughout the interview
- B. Wanting the interview to be over as quickly as possible
- C. Being pleased with the overall pace of the interview
- D. Speaking slowly, requiring time to consider his answers
Correct Answer: B
Rationale: Type A personality is characterized by impatience, competitiveness, and urgency, so the patient would likely want the interview to end quickly. Relaxed behavior, satisfaction with pace, or slow responses are more typical of Type B personalities.
A nurse has completed an assessment of a patient who is experiencing significant stress. The assessment revealed intense anger and acting out behaviors along with statements of negative emotions. Which nursing diagnosis would be most appropriate?
- A. Disturbed thought processes
- B. Low self-esteem
- C. Hopelessness
- D. Ineffective coping
Correct Answer: D
Rationale: Intense anger, acting out, and negative emotions indicate ineffective coping, as the patient struggles to manage stress adaptively. Disturbed thought processes, low self-esteem, and hopelessness may be present but are less directly tied to the described behaviors.
While leading a student class presentation about general adaptation syndrome and its stages, which of the following would the student describe as the final stage?
- A. Perception of a threat
- B. Use of coping mechanisms
- C. Physiologic response
- D. Exhaustion
Correct Answer: D
Rationale: In Selye?s general adaptation syndrome, the final stage is exhaustion, where resources are depleted if stress persists. Perception of a threat, coping mechanisms, and physiologic response occur earlier in the alarm and resistance stages.
The nurse is caring for a patient with chronic stress for the past month because of job loss and financial difficulties. When evaluating the patient?s assessment findings, the nurse would anticipate finding an elevated antibody titer to which of the following?
- A. Herpes simplex viruses
- B. Herpes zoster viruses
- C. Acquired immune deficiency viruses
- D. Influenza viruses
Correct Answer: A
Rationale: Chronic stress suppresses immunity, increasing reactivation of latent herpes simplex viruses, leading to elevated antibody titers. Herpes zoster may reactivate, but HSV is more common. AIDS and influenza are not directly linked to stress-induced immune changes.