Nokea
You know that this fathers cognitive appraisal has led to what?
- A. Harm/loss feelings
- B. Feelings of challenge
- C. A positive adjustment to the possible loss of his children
- D. The development of negative emotions
Correct Answer: D
Rationale: The appraisal process contributes to the development of an emotion. Negative emotions, such as fear and anger, accompany harm/loss appraisals, and positive emotions accompany challenge. Harm and challenge are not feelings, so the corresponding options are incorrect. There is nothing in the scenario that indicates that the father is making a positive adjustment to the possible loss of his children.
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To what type of stressor has this patient been exposed?
- A. Physiologic
- B. Psychosocial
- C. Physical
- D. Psychiatric
Correct Answer: C
Rationale: Physical stressors include cold, heat, and chemical agents; physiologic stressors include pain and fatigue. A chemical spill is neither a psychiatric nor a psychosocial phenomenon.
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.
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.
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.
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.