Nokea
A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor?
- A. Irrelevant
- B. Harm/loss
- C. Threatening
- D. Challenging
Correct Answer: D
Rationale: The correct answer is D: Challenging. The client's statement indicates a positive reframing of the job loss as an opportunity for personal growth. This suggests that the client views the situation as a challenge to adapt and pursue a new path. This perspective aligns with the concept of stress as a potential source of growth and development, known as the challenge appraisal.
Summary:
A: Irrelevant - The client's statement demonstrates relevance to his future plans, making this choice incorrect.
B: Harm/loss - The client's positive outlook does not reflect a perception of harm or loss, making this choice incorrect.
C: Threatening - The client's statement does not convey a perception of threat, making this choice incorrect.
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A client refuses to go on a cruise to the Bahamas with his spouse because of fearing that the cruise ship will sink and all will drown. Using a cognitive theory perspective, the nurse should use which of these statements to explain to the spouse the etiology of this fear?
- A. Your spouse may be unable to resolve internal conflicts, which result in projected anxiety.
- B. Your spouse may be experiencing a distorted and unrealistic appraisal of the situation.
- C. Your spouse may have a genetic predisposition to overreacting to potential danger.
- D. Your spouse may have high levels of brain chemicals that may distort thinking.
Correct Answer: B
Rationale: The correct answer is B: Your spouse may be experiencing a distorted and unrealistic appraisal of the situation. This aligns with cognitive theory, which focuses on how our thoughts and perceptions influence our emotions and behaviors. In this case, the client's fear of the cruise ship sinking is likely based on an irrational and exaggerated belief rather than a realistic assessment of the situation.
Choice A is incorrect because it focuses on internal conflicts, which may not be directly related to the client's fear of the cruise ship sinking. Choice C is incorrect as genetic predisposition alone is unlikely to explain the specific fear of the cruise ship sinking. Choice D is incorrect as it suggests a biological basis for the fear, whereas cognitive theory emphasizes the role of thoughts and perceptions.
When an individuals stress response is sustained over a long period of time, which physiological effect of the endocrine system should a nurse anticipate?
- A. Decreased resistance to disease
- B. Increased libido
- C. Decreased blood pressure
- D. Increased inflammatory response
Correct Answer: A
Rationale: The correct answer is A: Decreased resistance to disease. Prolonged stress can weaken the immune system, making individuals more susceptible to illnesses. Chronic stress suppresses immune functions, leading to decreased resistance to diseases. The other choices are incorrect because increased libido (B) and decreased blood pressure (C) are not typical physiological effects of sustained stress. While stress can lead to increased inflammatory response (D), the primary concern with chronic stress is its negative impact on the immune system, making choice A the most appropriate answer in this context.
A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, Should I seek psychiatric help for my mother? Which is an appropriate nursing reply?
- A. My mother also worries unnecessarily. I think it is part of the aging process.
- B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.
- C. From what you have told me, you should get her to a psychiatrist as soon as possible.
- D. Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.
Correct Answer: B
Rationale: The correct answer is B because it provides a clear and accurate explanation of when anxiety is considered abnormal. It states that anxiety is abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning. This response shows understanding of the situation and suggests seeking professional help based on specific criteria.
Choice A is incorrect as it dismisses the concerns as part of the aging process without addressing the possibility of abnormal anxiety. Choice C is incorrect as it jumps to the conclusion of seeking psychiatric help without evaluating the level of anxiety or impairment. Choice D is incorrect as it oversimplifies anxiety treatment by suggesting it can only be treated with medications, ignoring the importance of therapy and other interventions.
After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, You are incompetent! Which is the nurses best response?
- A. Do you believe that I was the cause of your blood test being canceled?
- B. I see that you are upset, but I feel uncomfortable when you swear at me.
- C. Have you ever thought about ways to express anger appropriately?
- D. Ill give you some space. Let me know if you need anything.
Correct Answer: B
Rationale: The correct answer is B: "I see that you are upset, but I feel uncomfortable when you swear at me." This response acknowledges the client's emotion while setting a boundary against inappropriate behavior. It demonstrates empathy towards the client's feelings without condoning the swearing. It also communicates the nurse's discomfort with the behavior, which can help in de-escalating the situation.
A: Choice A deflects responsibility and may come off as defensive, not addressing the client's emotions directly.
C: Choice C shifts the focus away from the client's immediate distress and may not be well-received in the heat of the moment.
D: Choice D, while giving space, doesn't address the behavior directly and may not effectively address the client's emotions or the impact of their actions on the nurse.
A nurse concludes that a restless, agitated client is manifesting a fight-or-flight response. The nurse should associate this response with which neurotransmitter?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
Correct Answer: C
Rationale: The correct answer is C, Norepinephrine. During the fight-or-flight response, the sympathetic nervous system is activated, leading to the release of norepinephrine. Norepinephrine increases heart rate, blood pressure, and alertness, preparing the body to either fight or flee from a perceived threat. Dopamine (A) is more related to reward and pleasure. Serotonin (B) is involved in regulating mood and emotions. Cortisol (D) is a stress hormone, not a neurotransmitter involved in the fight-or-flight response.