Nokea
Cortisol is released in response to a patient's prolonged stress. Which initial effect would the nurse expect to result from the increased cortisol level?
- A. Diuresis and electrolyte imbalance
- B. Focused and alert mental status
- C. Drowsiness and lethargy
- D. Restlessness and anxiety
Correct Answer: B
Rationale: Cortisol is the primary stress hormone and is released in response to prolonged stress. Cortisol helps supply cells with amino acids and fatty acids for energy supply, as well as diverting glucose from muscles for use by the brain. As a result, the brain stays alert and focused. The distractors present effects that would not be expected.
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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.
A professor's 4-year-old child has a temperature of 101.6°F, diarrhea, and complains of stomach pain. The professor is scheduled to teach three classes today. Which actions by the professor demonstrate effective parenting? (Select all that apply.)
- A. Telephoning a grandparent to stay with the child at home for the day
- B. Telephoning a colleague to teach his classes and staying home with the sick child
- C. Taking the child to the university and keeping the child in a private office for the day
- D. Taking the child to a day care center and hoping day care workers will not notice the child is sick
- E. Giving the child one dose of ibuprofen (Motrin) and taking the child to the day care center
Correct Answer: A,B
Rationale: The correct responses demonstrate fulfillment of the role as a parent. The distractors indicate the professor has not cared for the sick child in an effective way. Taking the child to a day care center exposes other children to a potential infection. Taking the child to one's office does not keep the child comfortable or provide for the child while the professor is teaching.
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.
A nurse assesses the health status of veterans of the war in Afghanistan. Screening will be a priority for signs and symptoms of which health problems? (Select all that apply.)
- A. Schizophrenia
- B. Eating disorder
- C. Traumatic brain injury
- D. Seasonal affective disorder
- E. Posttraumatic stress disorder
Correct Answer: C,E
Rationale: TBI and PTSD each occur in approximately 20% of soldiers who experienced combat. Some soldiers have both problems. The incidence of disorders identified in the distractors would be expected to parallel the general population.