Nokea
Which of the following is an immediate physiologic response to stress the nurse would expect this patient to experience?
- A. Vasodilation of peripheral blood vessels
- B. Increased blood pressure
- C. Decrease in blood glucose levels
- D. Pupil constriction
Correct Answer: B
Rationale: An initial response to stress, as seen by the fight-or-flight response, is an increase in the patients heart rate and blood pressure. Vasoconstriction leads to the increase in blood pressure. Blood glucose levels increase, supplying more readily available energy, and pupils dilate.
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What pathophysiological process has occurred as a result of the submersion?
- A. Atrophy of brain cells
- B. Cellular lysis
- C. Hypoxia to the brain
- D. Necrosis to the brain
Correct Answer: C
Rationale: The length of time different tissues can survive without oxygen varies. The brain will become hypoxic in 3 to 6 minutes. The other options are incorrect because submersion injuries do not cause atrophy to brain cells right away; submersion injuries also do not cause cellular lysis or necrosis to the brain.
You should be aware that the oxygen demands of the patients body would change in which direction and why?
- A. Increase due to an increase in metabolism
- B. Decrease due to a decrease in metabolism
- C. Increase due to a decrease in metabolism
- D. Decrease due to an increase in metabolism
Correct Answer: A
Rationale: When a persons temperature is elevated, hypermetabolism occurs, and the respiratory rate, heart rate, and basal metabolic rate increase. The other options are incorrect because oxygen demands would not decrease and they would not increase due to a decrease in metabolism.
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.
What do you know is occurring with this young woman?
- A. The mediating process is occurring.
- B. The patient is experiencing an expected level of denial.
- C. The patients awareness of her stress makes it more acute.
- D. The patient is emotionally overwhelmed.
Correct Answer: A
Rationale: After recognizing a stressor, a person consciously or unconsciously reacts to manage the situation. This is termed the mediating process. Nothing in the scenario indicates the patient is either in denial or feeling overwhelmed. Awareness of stress does not necessarily exacerbate it.