,GCN|NUR 256 Exam 2 | Mental Health Nursing |
1. A client who recently lost their job reports feeling overwhelmed but continues to function at work
and home. According to stress response theory, which physiological response is most likely occurring
during this initial phase?
A) Exhaustion of adaptive energy reserves
B) Activation of the sympathetic nervous system
C) Suppression of the immune system
D) Permanent structural changes to the brain
Correct Answer: Activation of the sympathetic nervous system
Rationale: The alarm phase of the General Adaptation Syndrome involves activation of the
sympathetic nervous system, triggering the fight-or-flight response. Exhaustion occurs later if stress
continues. Immune suppression and brain changes are not characteristic of the initial alarm phase.
2. A nurse is teaching stress management to a group of clients. Which recommendation is supported
by evidence as an effective stress reducer?
A) Limiting sleep to 5 hours per night to increase productivity
B) Consuming caffeinated beverages to maintain alertness
C) Engaging in 20 minutes of exercise per day
D) Avoiding all social interactions during stressful periods
Correct Answer: Engaging in 20 minutes of exercise per day
Rationale: Regular exercise (20 minutes daily or 150 minutes per week) is an evidence-based stress
reducer. Sleep should be 7-9 hours, caffeine should be reduced, and social support is protective during
stress.
3. A client is learning progressive muscle relaxation. Which statement best describes the mechanism
of this technique?
A) It increases sympathetic nervous system activity
,B) It focuses attention on a peaceful mental image
C) It involves tensing and relaxing muscle groups sequentially
D) It uses electronic devices to provide physiological feedback
Correct Answer: It involves tensing and relaxing muscle groups sequentially
Rationale: Progressive relaxation involves systematically tensing and then relaxing muscle groups to
reduce physical tension. Guided imagery focuses on mental images, biofeedback uses electronic
devices, and the technique actually decreases sympathetic activity.
4. A nurse is assessing a client's response to a traumatic event. Which physiological finding is most
consistent with the alarm phase of the General Adaptation Syndrome?
A) Decreased heart rate
B) Increased blood pressure
C) Decreased respiratory rate
D) Suppressed immune function
Correct Answer: Increased blood pressure
Rationale: The alarm phase triggers sympathetic activation, resulting in increased heart rate, blood
pressure, and respiratory rate. Immune suppression occurs later during the resistance and exhaustion
phases.
5. A client with generalized anxiety disorder reports excessive worry about work performance. The
nurse understands that this worry is most characteristic of which level of anxiety?
A) Mild anxiety
B) Moderate anxiety
C) Severe anxiety
D) Panic-level anxiety
Correct Answer: Mild anxiety
, Rationale: Mild anxiety is associated with heightened awareness and the use of coping mechanisms
such as keeping busy to manage discomfort. Moderate anxiety narrows the perceptual field, severe
anxiety causes significant dysfunction, and panic-level anxiety results in loss of control.
6. A client experiencing a panic attack reports depersonalization and a fear of dying. The nurse
recognizes these symptoms as characteristic of which condition?
A) Generalized anxiety disorder
B) Panic disorder
C) Social anxiety disorder
D) Obsessive-compulsive disorder
Correct Answer: Panic disorder
Rationale: Panic disorder is characterized by recurrent panic attacks with symptoms including
depersonalization, fear of dying, and feelings of impending doom. GAD involves chronic worry, social
anxiety involves fear of scrutiny, and OCD involves obsessions and compulsions.
7. A nurse is caring for a client with a specific phobia of driving. Which nursing intervention is most
appropriate?
A) Encouraging the client to avoid driving at all costs
B) Teaching the client relaxation techniques to use when driving
C) Prescribing a benzodiazepine for daily use
D) Telling the client that the fear is irrational
Correct Answer: Teaching the client relaxation techniques to use when driving
Rationale: For specific phobias, teaching relaxation techniques helps the client manage anxiety when
exposed to the feared stimulus. Avoidance reinforces the fear, prescribing medication is outside
nursing scope, and telling the client the fear is irrational is dismissive.
1. A client who recently lost their job reports feeling overwhelmed but continues to function at work
and home. According to stress response theory, which physiological response is most likely occurring
during this initial phase?
A) Exhaustion of adaptive energy reserves
B) Activation of the sympathetic nervous system
C) Suppression of the immune system
D) Permanent structural changes to the brain
Correct Answer: Activation of the sympathetic nervous system
Rationale: The alarm phase of the General Adaptation Syndrome involves activation of the
sympathetic nervous system, triggering the fight-or-flight response. Exhaustion occurs later if stress
continues. Immune suppression and brain changes are not characteristic of the initial alarm phase.
2. A nurse is teaching stress management to a group of clients. Which recommendation is supported
by evidence as an effective stress reducer?
A) Limiting sleep to 5 hours per night to increase productivity
B) Consuming caffeinated beverages to maintain alertness
C) Engaging in 20 minutes of exercise per day
D) Avoiding all social interactions during stressful periods
Correct Answer: Engaging in 20 minutes of exercise per day
Rationale: Regular exercise (20 minutes daily or 150 minutes per week) is an evidence-based stress
reducer. Sleep should be 7-9 hours, caffeine should be reduced, and social support is protective during
stress.
3. A client is learning progressive muscle relaxation. Which statement best describes the mechanism
of this technique?
A) It increases sympathetic nervous system activity
,B) It focuses attention on a peaceful mental image
C) It involves tensing and relaxing muscle groups sequentially
D) It uses electronic devices to provide physiological feedback
Correct Answer: It involves tensing and relaxing muscle groups sequentially
Rationale: Progressive relaxation involves systematically tensing and then relaxing muscle groups to
reduce physical tension. Guided imagery focuses on mental images, biofeedback uses electronic
devices, and the technique actually decreases sympathetic activity.
4. A nurse is assessing a client's response to a traumatic event. Which physiological finding is most
consistent with the alarm phase of the General Adaptation Syndrome?
A) Decreased heart rate
B) Increased blood pressure
C) Decreased respiratory rate
D) Suppressed immune function
Correct Answer: Increased blood pressure
Rationale: The alarm phase triggers sympathetic activation, resulting in increased heart rate, blood
pressure, and respiratory rate. Immune suppression occurs later during the resistance and exhaustion
phases.
5. A client with generalized anxiety disorder reports excessive worry about work performance. The
nurse understands that this worry is most characteristic of which level of anxiety?
A) Mild anxiety
B) Moderate anxiety
C) Severe anxiety
D) Panic-level anxiety
Correct Answer: Mild anxiety
, Rationale: Mild anxiety is associated with heightened awareness and the use of coping mechanisms
such as keeping busy to manage discomfort. Moderate anxiety narrows the perceptual field, severe
anxiety causes significant dysfunction, and panic-level anxiety results in loss of control.
6. A client experiencing a panic attack reports depersonalization and a fear of dying. The nurse
recognizes these symptoms as characteristic of which condition?
A) Generalized anxiety disorder
B) Panic disorder
C) Social anxiety disorder
D) Obsessive-compulsive disorder
Correct Answer: Panic disorder
Rationale: Panic disorder is characterized by recurrent panic attacks with symptoms including
depersonalization, fear of dying, and feelings of impending doom. GAD involves chronic worry, social
anxiety involves fear of scrutiny, and OCD involves obsessions and compulsions.
7. A nurse is caring for a client with a specific phobia of driving. Which nursing intervention is most
appropriate?
A) Encouraging the client to avoid driving at all costs
B) Teaching the client relaxation techniques to use when driving
C) Prescribing a benzodiazepine for daily use
D) Telling the client that the fear is irrational
Correct Answer: Teaching the client relaxation techniques to use when driving
Rationale: For specific phobias, teaching relaxation techniques helps the client manage anxiety when
exposed to the feared stimulus. Avoidance reinforces the fear, prescribing medication is outside
nursing scope, and telling the client the fear is irrational is dismissive.
