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What would occur during adulthood in the GAS?
- A. Stressful events occur and resistance or adaption occurs.
- B. Successful avoidance of stressful life events leaves the body vulnerable.
- C. The accumulation of lifes stressors causes resistance to fall.
- D. Vulnerability leads to eventual death.
Correct Answer: A
Rationale: Selye compared the general adaptation syndrome with the life process. During childhood, too few encounters with stress occur to promote the development of adaptive functioning, and children are vulnerable. During adulthood, a number of stressful events occur, and people develop resistance or adaptation. During the later years, the accumulation of lifes stressors and wear and tear on the organism again decrease peoples ability to adapt, so resistance falls, and, eventually, death occurs.
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How should you best respond if it is found that the patients health patterns are not achieving their goals?
- A. Seek ways to promote balance in the patient.
- B. Refer the patient to social work.
- C. Identify alternative models of health care.
- D. Provide insight into the patients physiological failings.
Correct Answer: A
Rationale: The nurse has a significant role and responsibility in identifying the health patterns of the patient receiving care. If those patterns are not achieving physiologic, psychological, and social balance, the nurse is obligated, with the assistance and agreement of the patient, to seek ways to promote balance. The nurse is not obligated to refer to social work, identify alternative forms of care, or provide insight into the physiologic failings of the system if the patients health patterns are not achieving their goals.
What would be the most appropriate nursing intervention?
- A. Put the primary onus for planning care on the patient herself.
- B. Assess and provide constructive outlets for anger and hostility.
- C. Assess the patients sources of social support.
- D. Encourage an attitude of realistic hope to help her deal with helpless feelings.
Correct Answer: D
Rationale: By encouraging an attitude of realistic hope, the patient will be empowered. This allows the patient to explore her feelings and bring about more effective coping patterns. The onus for care planning should not lie with the patient. The nursing diagnosis is related to feeling of helplessness, not anger and hostility. Social support is necessary, but does not directly address the feeling of helplessness.
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.
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.
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.