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Which of the following statements should underlie the nurses care planning for this patient?
- A. The patient and spouse should seek counseling to ease their transition.
- B. The patient will have better coping skills being in a stable relationship.
- C. Happy events do not normally cause stress.
- D. Marriage causes transition, which has the potential to cause stress.
Correct Answer: D
Rationale: Transition can contribute to stress, even if the transition is a positive change. The third group of stressors has been studied most extensively and concerns relatively infrequent situations that directly affect people. This category includes the influence of life events such as death, birth, marriage, divorce, and retirement. Counseling is not necessarily indicated.
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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.
What is most important for the nurses to know about these coping behaviors?
- A. They are effective, but alternative, coping behaviors.
- B. They do not directly influence stress in the body.
- C. They are adaptive behaviors.
- D. They increase the risk of illness.
Correct Answer: D
Rationale: Coping processes that include the use of alcohol or drugs to reduce stress increase the risk of illness. The use of drugs and alcohol as a means to reduce stress are not effective coping behaviors. They are maladaptive behaviors, even though they have a short-term effect on stress.
What principle of stress and adaptation should be integrated into the nurses plan of care for this patient?
- A. Adaptation often fails during stressful events and results in homeostasis.
- B. Stress is a part of all lives, and, eventually, this young woman will adapt.
- C. Acute anxiety and depression can be adaptations that alleviate stress in some individuals.
- D. An accumulation of stressors can disrupt homeostasis and result in disease.
Correct Answer: D
Rationale: Four conceptsâ??constancy, homeostasis, stress, and adaptationâ??are key to the understanding of steady state. Homeostasis is maintained through emotional, neurologic, and hormonal measures; stressors create pressure for adaptation. Sometimes too many stressors disrupt homeostasis, and, if adaptation fails, the result is disease. If a person is overwhelmed by stress, he or she may never adapt. Acute anxiety and depression are frequently associated with stress.
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 will be included in the nurses intervention?
- A. The use of progressive tensing and relaxing of muscles to release tension in each muscle group
- B. Using a positive self-image to increase and intensify physical exercise, which decreases stress
- C. The mindful use of a word, phrase, or visual, which allows oneself to be distracted and temporarily escape from stressful situations
- D. The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations
Correct Answer: C
Rationale: Guided imagery is the mindful use of a word, phrase, or visual image to distract oneself from distressing situations or consciously taking time to relax or reenergize. Guided imagery does not involve muscle relaxation, positive self-image, or humor.