Nokea
What should you encourage the patient to consider?
- A. Improve his nutritional intake.
- B. Make an appointment at a wellness clinic.
- C. Walk on a daily basis.
- D. Increase his interaction with his social network.
Correct Answer: D
Rationale: Social networks can reduce stress by providing the individual with a positive social identity, emotional support, material aide, information, and new social contacts. Changes to diet and activity may be beneficial, but social interaction is known to be of particular benefit. Attendance at a wellness clinic may or may not be beneficial, and does not involve social interaction.
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What factors does the nurse know impact the processes of inflammation, repair, and replacement? Select all that apply.
- A. Severity of the injury
- B. Social relationships
- C. Condition of the host
- D. Familial support
- E. Nature of the injury
Correct Answer: A,C,E
Rationale: The condition of the host, the environment, and the nature and severity of the injury affect the processes of inflammation, repair, and replacement. The patients social relationships and familial support do not directly affect the processes of inflammation, repair, and replacement.
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.
In a state of chronic arousal, what can happen within the body?
- A. Blood pressure decreases.
- B. Serum glucose levels drop.
- C. Arteriosclerosis may develop.
- D. Tissue necrosis may occur.
Correct Answer: C
Rationale: If the sympathetic-adrenal-medullary response is prolonged or excessive, a state of chronic arousal develops that may lead to high (not low) blood pressure, arteriosclerotic changes, and cardiovascular disease. If the production of ACTH is prolonged or excessive, behavior patterns of withdrawal and depression are seen. In addition, the immune response is decreased, and infections and tumors may develop.
What would the nurse recognize as the longest-acting phase of the womans physiologic response to stress and its cause?
- A. Sympathetic-adrenal-medullary response caused by persistent stress
- B. Hypothalamic-pituitary response caused by acute stress
- C. Sympathetic-adrenal-medullary response caused by acute stress
- D. Hypothalamic-pituitary response caused by persistent stress
Correct Answer: D
Rationale: The longest-acting phase of the physiologic response, which is more likely to occur in persistent stress, involves the hypothalamic-pituitary pathway, not the sympathetic-adrenal-medullary pathway.
Which of the following constitute negative feedback loops? Select all that apply.
- A. Serum glucose levels
- B. Acid-base balance
- C. Temperature
- D. Blood clotting
- E. Labor onset
Correct Answer: A,B,C
Rationale: These mechanisms work by sensing deviations from a predetermined set point or range of adaptability and triggering a response aimed at offsetting the deviation. Blood pressure, acid-base balance, blood glucose level, body temperature, and fluid and electrolyte balance are examples of functions regulated through such compensatory mechanisms. Coagulation and labor onset are results of positive feedback loops.