Nokea
The nurse recognizes these changes as being attributable to what response?
- A. Part of the limbic system response
- B. Sympathetic nervous response
- C. Hypothalamic-pituitary response
- D. Local adaptation syndrome
Correct Answer: B
Rationale: The sympathetic nervous system responds rapidly to stress; norepinephrine is released at nerve ending causing the organs to respond (i.e., heart rate increases, eyes dilate, and blood pressure increases). The limbic system is a mediator of emotions and behavior that are critical to survival during times of stress. The hypothalamic-pituitary response regulates the cortisol-induced metabolic effect that results in elevated blood sugars during stressful situations. Local adaptation syndrome is a tissue-specific inflammatory reaction.
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What is the most appropriate nursing diagnosis for this patient?
- A. Self-esteem disturbance related to late diagnosis
- B. Ineffective individual coping related to reluctance to seek care
- C. Altered family process related to inability to obtain treatment
- D. Ineffective denial related to reluctance to seek care
Correct Answer: B
Rationale: Ineffective individual coping is the inability to assess our own stressors and then make choices to access appropriate resources. In this case, the patient was unable to access health care even when she was aware the disorder could be life-threatening. Self-esteem Disturbance, Altered Family Process, and Ineffective Denial are all nursing diagnoses that are often associated with breast cancer, but the patients ineffective individual coping has created a significant safety risk and is, therefore, the most appropriate nursing diagnosis.
What is most important for the nurses to know about these coping behaviors?
- A. They are effective, but alternative, coping behaviors.
- B. They do not directly influence stress in the body.
- C. They are adaptive behaviors.
- D. They increase the risk of illness.
Correct Answer: D
Rationale: Coping processes that include the use of alcohol or drugs to reduce stress increase the risk of illness. The use of drugs and alcohol as a means to reduce stress are not effective coping behaviors. They are maladaptive behaviors, even though they have a short-term effect on stress.
Which factor would the nurse identify as most important in determining health status?
- A. Gender
- B. Ethnicity
- C. Social class
- D. Interfamilial relationships
Correct Answer: C
Rationale: The single most important factor for determining health status is social class and, within a social class, the research suggests that the major factor influencing health is level of education. This factor supersedes the importance of ethnicity, gender, or interfamilial relationships.
What statement should guide the nurses response?
- A. She should not worry; it was stress related and her regular blood pressure is good.
- B. The first blood pressure was part of a simple stress response; our long-term blood pressure is controlled by negative feedback systems.
- C. Blood pressure is only one measure of hypertension; she should review this with the doctor and plan to recheck it on a regular basis.
- D. The respiratory infection is the probably the cause of the elevated blood pressure, and, with treatment, her blood pressure should remain normal.
Correct Answer: B
Rationale: A simple stress response will temporarily elevate a blood pressure and heart rate. Long-term blood pressure response is controlled by negative feedback systems. For a science teacher, this would be an appropriate level of teaching/learning and would serve to promote health. The nurse would be incorrect in assuming the patients blood pressure is good based on only two blood pressure readings. The stress of a respiratory infection could account for the elevated blood pressure, but assuring the patient that, with treatment, her blood pressure will return to normal may not be true.
How would the nurse practitioner explain this condition to the patient?
- A. Hyperplasia is the abnormal decrease in cell and organ size and is a precursor to cancer.
- B. Hyperplasia is an abnormal increase in new cells and is reversible with the stimulus for cell growth removed.
- C. Hyperplasia is the change in appearance of the thyroid due to a chronic irritation and will reverse with the stimulus removed.
- D. Hyperplasia is a cancerous growth and will be removed surgically.
Correct Answer: B
Rationale: Hyperplasia is an increase in the number of new cells in an organ or tissue. This is due to increased mitotic stimulation from the additional cell division, and this, in turn, enlarges the tissue. Hyperplasia is reversible when the stimulus for cell growth is removed. Hyperplasia is the increase in the number of new cells, not a change in size or appearance. Hyperplasia is the increase in the number of new cells, which may or may not be cancerous growth.