TEST BANK for Davis Advantage for
Townsend's Psychiatric Mental Health
Nursing, 11E by Karyn
Exam
Practice Test: Stress Adaptation (Chapter 1)
1. A nurse is caring for a client who has just received news of a job layoff. The client is pacing,
breathing rapidly, and says, "I cannot think straight." Which response best reflects the body's
immediate stress reaction?
A. The parasympathetic system decreases alertness to conserve energy
B. The sympathetic nervous system activates the fight-or-flight response
C. The hypothalamus suppresses all autonomic activity
D. The immune system immediately increases serotonin production
Correct Answer: B
Rationale: Acute stress triggers the sympathetic nervous system, producing increased heart rate, rapid
breathing, and heightened alertness. This is the body's immediate protective response to perceived
threat. Option A is incorrect because the parasympathetic system promotes rest, not acute arousal.
Option C is incorrect because the hypothalamus helps initiate the stress response, not suppress it.
Option D is incorrect because serotonin production is not the immediate hallmark of acute stress.
Teaching Point: Acute stress activates the sympathetic nervous system for rapid protection.
2. A nursing student asks the instructor about the purpose of the "fight-or-flight" response during
stress. Which response by the instructor is most accurate?
A. It eliminates emotional responses to stressful situations
B. It prepares the body to respond to perceived threats
C. It suppresses the autonomic nervous system during stress
D. It occurs only in individuals with anxiety disorders
Correct Answer: B
Rationale: The fight-or-flight response is a biologic adaptation that prepares the body to respond to
danger or threat through physiologic changes such as increased heart rate and alertness. Option A is
incorrect because emotional responses are not eliminated. Option C is incorrect because the autonomic
nervous system is activated, not suppressed. Option D is incorrect because this response occurs in all
individuals, not only those with anxiety disorders.
3. A nursing student says, "Stress is only caused by major crises like death or divorce." Which response
by the instructor is best?
,A. "That is correct because stress only comes from severe events"
B. "Stress can result from any demand that requires adjustment"
C. "Stress is always harmful and leads to illness"
D. "Stress is mainly a sign of poor coping and weak character"
Correct Answer: B
Rationale: Stress may come from major crises or everyday demands such as deadlines, noise, or role
changes. Stress depends on the demands placed on the person and their perception of them. Option A is
incorrect because stress is not limited to severe events. Option C is incorrect because stress is not
always harmful; some stress can motivate and improve performance. Option D is incorrect because
stress is not a moral failing or character weakness.
Teaching Point: Stress can arise from both major life events and everyday demands.
4. A client and nurse discuss how the client handles exam stress. The client says, "I used to panic, but
now I tell myself I have studied and I can do this." This change reflects which stress concept?
A. The event is irrelevant
B. The event is benign-positive
C. The event is a manageable challenge
D. The client has no stress
Correct Answer: C
Rationale: When a person believes they have resources to meet a demand, the stressor may be viewed
as a challenge rather than a threat. Positive self-talk reflects a shift toward challenge appraisal. Option A
is incorrect because the client clearly sees the event as meaningful. Option B is incorrect because benign
means no consequence, which is not consistent with exam stress. Option D is incorrect because the
client acknowledges past panic and current coping—this does not mean the client has no stress.
Teaching Point: Perceived coping ability can shift stress from threat to challenge.
5. A client under chronic work stress reports frequent headaches, poor sleep, and stomach discomfort.
The nurse recognizes these as which type of stress response?
A. Purely emotional symptoms unrelated to stress
B. Common physical manifestations of prolonged stress
C. Evidence that the client is exaggerating symptoms
D. Signs that stress has no effect on the body
Correct Answer: B
Rationale: Chronic stress often affects multiple body systems and can contribute to sleep disruption,
muscle tension, headaches, and gastrointestinal distress. Stress is both a psychological and physiological
phenomenon. Option A is incorrect because physical symptoms are directly related to stress. Option C is
incorrect because these are genuine manifestations of stress, not exaggeration. Option D is incorrect
because stress has significant effects on the body.
Teaching Point: Prolonged stress commonly appears as body tension and sleep disturbance.
, 6. An unemployed college graduate is experiencing severe anxiety over not finding a job and has
difficulty with independent problem-solving. Which is the most appropriate nursing intervention?
A. Encourage the graduate to ignore the stress
B. Complete the problem-solving process for the graduate
C. Work through the problem-solving process with the graduate
D. Encourage the graduate to avoid all decisions right now
Correct Answer: C
Rationale: During times of high anxiety and stress, clients will need more assistance in problem-solving
and decision making. Working through the process collaboratively provides support while building skills.
Option A is incorrect because ignoring stress does not solve the problem. Option B is incorrect because
completing the process for the client fosters dependence. Option D is incorrect because avoiding
decisions can worsen helplessness.
Teaching Point: Reduce overwhelm by breaking stress into one manageable step with client
involvement.
7. A client with test anxiety says, "I feel calmer when I study with one trusted classmate instead of
alone." Which nursing interpretation is best?
A. The client is demonstrating a social support coping resource
B. The client is showing complete dependence
C. The client is avoiding the stressor
D. The client is using maladaptive denial
Correct Answer: A
Rationale: Social support can buffer stress and improve coping. Using a trusted peer is a healthy
strategy when it supports problem-solving and emotional regulation. Option B is incorrect because
seeking support is not necessarily dependence. Option C is incorrect because studying with a peer does
not mean avoiding the stressor. Option D is incorrect because this is not denial; the client is actively
preparing.
Teaching Point: Support systems can reduce stress and strengthen coping.
8. Which client statement should alert a nurse that a client may be responding maladaptively to
stress?
A. "I've found that avoiding contact with others helps me cope"
B. "I really enjoy journaling; it's my private time"
C. "I signed up for a yoga class this week"
D. "I made an appointment to meet with a therapist"
Correct Answer: A
Rationale: Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress.
It can prevent learning appropriate coping skills and can prevent access to needed support systems.
Options B, C, and D are all adaptive coping strategies that promote wellness and stress management.
Townsend's Psychiatric Mental Health
Nursing, 11E by Karyn
Exam
Practice Test: Stress Adaptation (Chapter 1)
1. A nurse is caring for a client who has just received news of a job layoff. The client is pacing,
breathing rapidly, and says, "I cannot think straight." Which response best reflects the body's
immediate stress reaction?
A. The parasympathetic system decreases alertness to conserve energy
B. The sympathetic nervous system activates the fight-or-flight response
C. The hypothalamus suppresses all autonomic activity
D. The immune system immediately increases serotonin production
Correct Answer: B
Rationale: Acute stress triggers the sympathetic nervous system, producing increased heart rate, rapid
breathing, and heightened alertness. This is the body's immediate protective response to perceived
threat. Option A is incorrect because the parasympathetic system promotes rest, not acute arousal.
Option C is incorrect because the hypothalamus helps initiate the stress response, not suppress it.
Option D is incorrect because serotonin production is not the immediate hallmark of acute stress.
Teaching Point: Acute stress activates the sympathetic nervous system for rapid protection.
2. A nursing student asks the instructor about the purpose of the "fight-or-flight" response during
stress. Which response by the instructor is most accurate?
A. It eliminates emotional responses to stressful situations
B. It prepares the body to respond to perceived threats
C. It suppresses the autonomic nervous system during stress
D. It occurs only in individuals with anxiety disorders
Correct Answer: B
Rationale: The fight-or-flight response is a biologic adaptation that prepares the body to respond to
danger or threat through physiologic changes such as increased heart rate and alertness. Option A is
incorrect because emotional responses are not eliminated. Option C is incorrect because the autonomic
nervous system is activated, not suppressed. Option D is incorrect because this response occurs in all
individuals, not only those with anxiety disorders.
3. A nursing student says, "Stress is only caused by major crises like death or divorce." Which response
by the instructor is best?
,A. "That is correct because stress only comes from severe events"
B. "Stress can result from any demand that requires adjustment"
C. "Stress is always harmful and leads to illness"
D. "Stress is mainly a sign of poor coping and weak character"
Correct Answer: B
Rationale: Stress may come from major crises or everyday demands such as deadlines, noise, or role
changes. Stress depends on the demands placed on the person and their perception of them. Option A is
incorrect because stress is not limited to severe events. Option C is incorrect because stress is not
always harmful; some stress can motivate and improve performance. Option D is incorrect because
stress is not a moral failing or character weakness.
Teaching Point: Stress can arise from both major life events and everyday demands.
4. A client and nurse discuss how the client handles exam stress. The client says, "I used to panic, but
now I tell myself I have studied and I can do this." This change reflects which stress concept?
A. The event is irrelevant
B. The event is benign-positive
C. The event is a manageable challenge
D. The client has no stress
Correct Answer: C
Rationale: When a person believes they have resources to meet a demand, the stressor may be viewed
as a challenge rather than a threat. Positive self-talk reflects a shift toward challenge appraisal. Option A
is incorrect because the client clearly sees the event as meaningful. Option B is incorrect because benign
means no consequence, which is not consistent with exam stress. Option D is incorrect because the
client acknowledges past panic and current coping—this does not mean the client has no stress.
Teaching Point: Perceived coping ability can shift stress from threat to challenge.
5. A client under chronic work stress reports frequent headaches, poor sleep, and stomach discomfort.
The nurse recognizes these as which type of stress response?
A. Purely emotional symptoms unrelated to stress
B. Common physical manifestations of prolonged stress
C. Evidence that the client is exaggerating symptoms
D. Signs that stress has no effect on the body
Correct Answer: B
Rationale: Chronic stress often affects multiple body systems and can contribute to sleep disruption,
muscle tension, headaches, and gastrointestinal distress. Stress is both a psychological and physiological
phenomenon. Option A is incorrect because physical symptoms are directly related to stress. Option C is
incorrect because these are genuine manifestations of stress, not exaggeration. Option D is incorrect
because stress has significant effects on the body.
Teaching Point: Prolonged stress commonly appears as body tension and sleep disturbance.
, 6. An unemployed college graduate is experiencing severe anxiety over not finding a job and has
difficulty with independent problem-solving. Which is the most appropriate nursing intervention?
A. Encourage the graduate to ignore the stress
B. Complete the problem-solving process for the graduate
C. Work through the problem-solving process with the graduate
D. Encourage the graduate to avoid all decisions right now
Correct Answer: C
Rationale: During times of high anxiety and stress, clients will need more assistance in problem-solving
and decision making. Working through the process collaboratively provides support while building skills.
Option A is incorrect because ignoring stress does not solve the problem. Option B is incorrect because
completing the process for the client fosters dependence. Option D is incorrect because avoiding
decisions can worsen helplessness.
Teaching Point: Reduce overwhelm by breaking stress into one manageable step with client
involvement.
7. A client with test anxiety says, "I feel calmer when I study with one trusted classmate instead of
alone." Which nursing interpretation is best?
A. The client is demonstrating a social support coping resource
B. The client is showing complete dependence
C. The client is avoiding the stressor
D. The client is using maladaptive denial
Correct Answer: A
Rationale: Social support can buffer stress and improve coping. Using a trusted peer is a healthy
strategy when it supports problem-solving and emotional regulation. Option B is incorrect because
seeking support is not necessarily dependence. Option C is incorrect because studying with a peer does
not mean avoiding the stressor. Option D is incorrect because this is not denial; the client is actively
preparing.
Teaching Point: Support systems can reduce stress and strengthen coping.
8. Which client statement should alert a nurse that a client may be responding maladaptively to
stress?
A. "I've found that avoiding contact with others helps me cope"
B. "I really enjoy journaling; it's my private time"
C. "I signed up for a yoga class this week"
D. "I made an appointment to meet with a therapist"
Correct Answer: A
Rationale: Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress.
It can prevent learning appropriate coping skills and can prevent access to needed support systems.
Options B, C, and D are all adaptive coping strategies that promote wellness and stress management.
