Nokea
The nurse is preparing to care for a patient under severe stress resulting from caring for her elderly aunt diagnosed with leukemia. When assessing the patient?s psychological domain, which question would the nurse ask first?
- A. Let?s talk about what you have been feeling.
- B. Tell me about your depressed moods.
- C. How long have you been caring for your aunt?
- D. Are you feeling overwhelmed by caring for your aunt?
Correct Answer: A
Rationale: Starting with an open-ended question like 'Let?s talk about what you have been feeling' allows exploration of the patient?s psychological state broadly, establishing rapport. Specific questions about depression, duration, or feeling overwhelmed are more focused and better suited for later.
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During an interview, a patient states, 'I feel so guilty, and I?m so ashamed of what I did.' The nurse interprets this as which of the following?
- A. Negative emotion
- B. Positive emotion
- C. Borderline emotion
- D. Nonemotion
Correct Answer: A
Rationale: Guilt and shame are negative emotions, reflecting distress or self-criticism. Positive emotions involve joy or pride, borderline emotion is not a standard term, and nonemotion implies no emotional response, which does not apply.
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.
After interviewing a patient about social supports, the nurse determines that the patient is experiencing emotional support from these social supports based on which statement?
- A. I?m glad I have someone that I can talk to.
- B. The person who cut my lawn was great!
- C. I received a small community grant for groceries.
- D. The senior center gave me a booklet about my medications.
Correct Answer: A
Rationale: The statement 'I?m glad I have someone that I can talk to' directly indicates emotional support through interpersonal connection. Lawn care, grants, and booklets reflect instrumental or informational support, not emotional.
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.
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.