Test Bank - Psychiatric Mental Health Nursing by Mary
Townsend (9th Edition, 2017)
,Chapter 01. The Concept of Stress Adaptation
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unem
ployed. This situation has resulted in a 6-
month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this cli
ent data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant t
hreat of stress-related illness.
C. Susceptibility to stress-
related physical or psychological illness cannot be estimated without knowledge of coping resources an
d available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences an
d the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-
score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms
and strong social support can limit susceptibility to stress-related illnesses.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
2. A physically and emotionally healthy client has just been fired. During a routine office visit he stat
es to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree.
How should the NURSINGTB.COM
nurse characterize the clients appraisal of job loss stressor?
the
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.
ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can p
,revent learning appropriate coping skills and can prevent access to needed support systems.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester
. When this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage
ANS: C
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy ha
s been depleted. Diseases of adaptation occur more frequently in this stage.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
5. A school nurse is assessing a female high school student who is overly concerned about her appearan
ce. The clients mother states, Thats not something to be stressed about! Which is the most approp
riate nursing response?
A. Teenagers! They dont know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, yNo Uu Rc aS nI Nt eGxTpB
wd w d er.C
ieO
ncMe psychological well-being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-
esteem can be as stressful as a physiological change.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Nee
d:
Psychosocial Integrity
6. A bright student confides in the school nurse about conflicts related to attending college or working
to add needed financial support to the family. Which coping strategy is most appropriate for the nurse
to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANS: B
The student must assess his or her situation and determine the best course of action. Problem-
solving training, by providing structure and objectivity, can assist in decision making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Nee
d:
Psychosocial Integrity
Townsend (9th Edition, 2017)
,Chapter 01. The Concept of Stress Adaptation
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unem
ployed. This situation has resulted in a 6-
month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this cli
ent data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant t
hreat of stress-related illness.
C. Susceptibility to stress-
related physical or psychological illness cannot be estimated without knowledge of coping resources an
d available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences an
d the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-
score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms
and strong social support can limit susceptibility to stress-related illnesses.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
2. A physically and emotionally healthy client has just been fired. During a routine office visit he stat
es to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree.
How should the NURSINGTB.COM
nurse characterize the clients appraisal of job loss stressor?
the
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.
ANS: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can p
,revent learning appropriate coping skills and can prevent access to needed support systems.
, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester
. When this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage
ANS: C
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy ha
s been depleted. Diseases of adaptation occur more frequently in this stage.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
5. A school nurse is assessing a female high school student who is overly concerned about her appearan
ce. The clients mother states, Thats not something to be stressed about! Which is the most approp
riate nursing response?
A. Teenagers! They dont know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, yNo Uu Rc aS nI Nt eGxTpB
wd w d er.C
ieO
ncMe psychological well-being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
ANS: D
Stress can be physical or psychological in nature. A perceived threat to self-
esteem can be as stressful as a physiological change.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Nee
d:
Psychosocial Integrity
6. A bright student confides in the school nurse about conflicts related to attending college or working
to add needed financial support to the family. Which coping strategy is most appropriate for the nurse
to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANS: B
The student must assess his or her situation and determine the best course of action. Problem-
solving training, by providing structure and objectivity, can assist in decision making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Nee
d:
Psychosocial Integrity
