Nokea
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.
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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.
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.
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.
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.
When do compensatory mechanisms occur in the human body?
- A. According to a diurnal cycle
- B. When needed
- C. Continuously
- D. Sporadically
Correct Answer: C
Rationale: The concept of the cell as existing on a continuum of function and structure includes the relationship of the cell to compensatory mechanisms, which occur continuously in the body to maintain the steady state.