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What does the nurse know about the probable cause of this patients hypertension?
- A. Prolonged or unrelenting suffering can cause physical illness.
- B. Physical illness is always caused by prolonged stress.
- C. The elderly are at increased risk for hypertension due to stress.
- D. Stress always exacerbates the physiologic processes of the elderly.
Correct Answer: A
Rationale: When a person endures prolonged or unrelenting suffering, the outcome is frequently the development of a stress-related illness. Physical illness is not always caused by prolonged stress. The elderly population is not the only population at increased risk for hypertension due to stress. Stress does not always exacerbate the physiologic processes of the elderly. This is an absolute statement, and true absolutes are rare.
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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.
What is an example of a bodily function that restores homeostasis by negative feedback when conditions shift out of normal range?
- A. Body temperature
- B. Pupil dilation
- C. Diuresis
- D. Blood clotting
Correct Answer: A
Rationale: Negative feedback mechanisms throughout the body monitor the internal environment and restore homeostasis when conditions shift out of normal range. Body temperature, blood pressure, and acid-base balances are examples of functions regulated by these compensatory mechanisms. Blood clotting in the body involves positive feedback mechanisms. Pupil dilation and diuresis are not modulated by negative feedback mechanisms.
Which of the patients actions best demonstrates adaptively coping?
- A. Becoming controlling
- B. Reprioritizing needs and roles
- C. Using benzodiazepines as ordered
- D. Withdrawing
Correct Answer: B
Rationale: Adaptive ways of coping included seeking information, reprioritizing needs and roles, lowering expectations, making compromises, comparing oneself to others, planning activities to conserve energy, taking things one step at a time, listening to ones body, and using self-talk for encouragement. Becoming controlling or withdrawing are not ways to cope adaptively. Benzodiazepines are sometimes indicated, but these are not considered to be an adaptive coping behavior.
How should you best understand the concept of coping when attempting to meet this patients needs?
- A. Coping is a physiologic measure used to deal with change, and he will physically adapt.
- B. Coping is composed of the physiologic and psychological processes that people use to adapt to change.
- C. Coping is the human need for faith and hope, both of which create change.
- D. Coping is a social strategy that is used to deal with change and loss.
Correct Answer: B
Rationale: Indicators of stress and the stress response include both subjective and objective measures. They are psychological, physiologic, or behavioral and reflect social behaviors and thought processes. The physiologic and psychological processes that people use to adapt to stress are the essence of the coping process. Coping is both a physiologic and psychological process used to adapt to change.
What principle of stress and adaptation should be integrated into the nurses plan of care for this patient?
- A. Adaptation often fails during stressful events and results in homeostasis.
- B. Stress is a part of all lives, and, eventually, this young woman will adapt.
- C. Acute anxiety and depression can be adaptations that alleviate stress in some individuals.
- D. An accumulation of stressors can disrupt homeostasis and result in disease.
Correct Answer: D
Rationale: Four conceptsâ??constancy, homeostasis, stress, and adaptationâ??are key to the understanding of steady state. Homeostasis is maintained through emotional, neurologic, and hormonal measures; stressors create pressure for adaptation. Sometimes too many stressors disrupt homeostasis, and, if adaptation fails, the result is disease. If a person is overwhelmed by stress, he or she may never adapt. Acute anxiety and depression are frequently associated with stress.