Nokea
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.
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What statement should guide the nurses response?
- A. She should not worry; it was stress related and her regular blood pressure is good.
- B. The first blood pressure was part of a simple stress response; our long-term blood pressure is controlled by negative feedback systems.
- C. Blood pressure is only one measure of hypertension; she should review this with the doctor and plan to recheck it on a regular basis.
- D. The respiratory infection is the probably the cause of the elevated blood pressure, and, with treatment, her blood pressure should remain normal.
Correct Answer: B
Rationale: A simple stress response will temporarily elevate a blood pressure and heart rate. Long-term blood pressure response is controlled by negative feedback systems. For a science teacher, this would be an appropriate level of teaching/learning and would serve to promote health. The nurse would be incorrect in assuming the patients blood pressure is good based on only two blood pressure readings. The stress of a respiratory infection could account for the elevated blood pressure, but assuring the patient that, with treatment, her blood pressure will return to normal may not be true.
How should you best understand the concept of coping when attempting to meet this patients needs?
- A. Coping is a physiologic measure used to deal with change, and he will physically adapt.
- B. Coping is composed of the physiologic and psychological processes that people use to adapt to change.
- C. Coping is the human need for faith and hope, both of which create change.
- D. Coping is a social strategy that is used to deal with change and loss.
Correct Answer: B
Rationale: Indicators of stress and the stress response include both subjective and objective measures. They are psychological, physiologic, or behavioral and reflect social behaviors and thought processes. The physiologic and psychological processes that people use to adapt to stress are the essence of the coping process. Coping is both a physiologic and psychological process used to adapt to change.
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.
When planning this patients care, which of the following statements regarding acute inflammation should you recognize?
- A. Inflammation is essentially synonymous with infection.
- B. Inflammation may impair the healing process.
- C. Inflammation is a defensive reaction intended to remove an offending agent.
- D. Inflammation inhibits the release of histamines in the tissues.
Correct Answer: C
Rationale: Inflammation is a defensive reaction intended to remove an offending agent and prepare the site for repair. Inflammation is not the same as infection, it does not impair the healing process, and it does not inhibit the release of histamines in the tissues.
Which factor would the nurse identify as most important in determining health status?
- A. Gender
- B. Ethnicity
- C. Social class
- D. Interfamilial relationships
Correct Answer: C
Rationale: The single most important factor for determining health status is social class and, within a social class, the research suggests that the major factor influencing health is level of education. This factor supersedes the importance of ethnicity, gender, or interfamilial relationships.