Nokea
To what type of stressor has this patient been exposed?
- A. Physiologic
- B. Psychosocial
- C. Physical
- D. Psychiatric
Correct Answer: C
Rationale: Physical stressors include cold, heat, and chemical agents; physiologic stressors include pain and fatigue. A chemical spill is neither a psychiatric nor a psychosocial phenomenon.
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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.
Which of the following statements should underlie the nurses care planning for this patient?
- A. The patient and spouse should seek counseling to ease their transition.
- B. The patient will have better coping skills being in a stable relationship.
- C. Happy events do not normally cause stress.
- D. Marriage causes transition, which has the potential to cause stress.
Correct Answer: D
Rationale: Transition can contribute to stress, even if the transition is a positive change. The third group of stressors has been studied most extensively and concerns relatively infrequent situations that directly affect people. This category includes the influence of life events such as death, birth, marriage, divorce, and retirement. Counseling is not necessarily indicated.
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.
To what would you attribute this phenomenon?
- A. Cortisol levels are decreasing.
- B. Endocrine activity has increased.
- C. The patient is adapting to noxious stressors.
- D. The sympathetic response has been activated.
Correct Answer: C
Rationale: Selye developed a theory of adaptation to biologic stress that he named the general adaptation syndrome (GAS), which has three phases: alarm, resistance, and exhaustion. During the alarm phase, the sympathetic fight-or-flight response is activated with release of catecholamines and the onset of the adrenocorticotropic hormone (ACTH) adrenal cortical response. The alarm reaction is defensive and anti-inflammatory but self-limited. Because living in a continuous state of alarm would result in death, people move into the second stage, resistance. During the resistance stage, adaptation to the noxious stressor occurs, and cortisol activity is still increased.
What pathophysiological process has occurred as a result of the submersion?
- A. Atrophy of brain cells
- B. Cellular lysis
- C. Hypoxia to the brain
- D. Necrosis to the brain
Correct Answer: C
Rationale: The length of time different tissues can survive without oxygen varies. The brain will become hypoxic in 3 to 6 minutes. The other options are incorrect because submersion injuries do not cause atrophy to brain cells right away; submersion injuries also do not cause cellular lysis or necrosis to the brain.