Nokea
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.
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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.
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 could the nurse do to help the patient?
- A. Refer him to a consciousness-raising group.
- B. Refer him to a psychiatrist.
- C. Refer him to a support group.
- D. Refer him to a church or temple.
Correct Answer: C
Rationale: Being a member of a group with similar problems or goals has a releasing effect on a person that promotes freedom of expression and exchange of ideas. Psychiatry may or may not be necessary. Spiritual assessment would necessarily precede any referral to a specific religious setting. Consciousness-raising groups are not known to be a common source of social support.
What positive outcome of providing the patient with information should the nurse expect?
- A. Increased concentration
- B. Decreased depression levels
- C. Sharing of personal details
- D. Building interdependent relationships
Correct Answer: A
Rationale: Giving patients information also reduces the emotional response so that they can concentrate and solve problems more effectively. Educating the patient does not decrease depression levels or build interpersonal relationships. Educating the patient does not mean sharing of personal details.
To what do you attribute this elevation in blood sugars?
- A. It is a temporary result of increased secretion of antidiuretic hormone.
- B. She must have had diabetes prior to surgery that was undiagnosed.
- C. She has suffered pancreatic trauma during her abdominal surgery.
- D. The blood sugars are probably a result of the fight-or-flight reaction.
Correct Answer: D
Rationale: During stressful situations, ACTH stimulates the release of cortisol from the adrenal gland, which creates protein catabolism releasing amino acids and stimulating the liver to convert amino acids to glucose; the result is elevated blood sugars. Antidiuretic hormone is released during stressful situations and stimulates reabsorption of water in the distal and collecting tubules of the kidney. Assuming the patient had diabetes prior to surgery demonstrates a lack of understanding of stress-induced hyperglycemia. No evidence presented in the question other than elevated blood sugars would support a diagnosis of diabetes.