TEST BANK SOLUTIONS-MORGAN KARYN PSYCHIATRIC MENTAL HEALTH NURSING 11TH EDITION/NEWEST WITH NGN NCLEX EXAM

Chapter 1. The Concept of Stress Adaptation Morgan: Psychiatric Mental Health Nursing 11e Test Bank with NCLEX NGN 2024 Exam with Answers and Rationale MULTIPLE CHOICE 1. A client has experienced the death of a close family member and at the same time becomes unemployed. The client’s 6-month score on the Recent Life Changes Questionnaire is 110. The nurse: 1. Understands the client is at risk of significant stress-related illness. 2. Determines the client is not at risk of significant stress-related illness. 3. Needs further assessment of the client’s coping skills to determine susceptibility to stress-related illness. 4. Recognizes the client may view the losses as challenges and perceive them as opportunities. ANS: 3 Chapter: Chapter 1, The Concept of Stress Adaptation Objective: Explain the relationship between stress and diseases of adaptation. Page: 5 Heading: Stress as an Environmental Event Integrated Processes: Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress and Coping Difficulty: Moderate Feedback 1. This is incorrect. Assessment is the first step of the nursing process. The nurse should assess the client’s coping skills and available support before determining susceptibility to stress-related physical and psychological illnesses. The Recent Life Changes Questionnaire is an expanded version of 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 client’s life and susceptibility to stress-related illness. 2. This is incorrect. Assessment is the first step in the nursing process. The nurse should assess the client’s coping skills and available support before determining the client’s perception of the current stresses. A 6-month score of 300 or more or a year score total of 500 or more on the Recent Life Changes Questionnaire indicates high stress in a client’s life and susceptibility to stress-related physical and psychological illness. 3. This is correct. Assessment is the first step in the nursing process. The nurse should assess the client’s coping skills and available support before determining susceptibility to stress-related physical and psychological illness. A 6-month score of 300 or more or a year score of 500 or more indicates high stress in a client’s life and risk of significant stress-related physical and psychological illness. 4. This is incorrect. Assessment is the first step in the nursing process. The nurse should assess the client’s coping skills and available support before determining susceptibility to stress-related illness. A 6-month score of 300 or more or a year score total of 500 or more on the Recent Life Changes Questionnaire indicates high stress in a client’s life and susceptibility to significant stress-related physical and psychological illness. CON: Stress and Coping 2. A physically and emotionally healthy client has just been fired. During a routine office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll consider pursuing an art degree.” The nurse determines the client perceives the stressor of his job loss as: 1. Irrelevant 2. Harm or loss 3. Threatening 4. A challenge ANS: 4 Chapter: Chapter 1, The Concept of Stress Adaptation Objective: Discuss adaptive coping strategies in the management of stress. Page: 7 Heading: Stress as a Transaction Between the Individual and the Environment > Individual’s Perception of the Event > Primary Appraisal Integrated Processes: Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress and Coping Difficulty: Easy Feedback 1. This is incorrect. An irrelevant perception is one where the event holds no significance for the individual. 2. This is incorrect. A harm or loss appraisal refers to damage or loss already experienced by the individual. 3. This is incorrect. A threatening appraisal is perceived as anticipated harms or losses. 4. This is correct. The client’s statement indicates he perceives the loss of his job as a challenge and an opportunity for growth, demonstrated by his statement to consider an art degree. CON: Stress and Coping CON: Stress 3.Which of the following is a stage in the general adaptation syndrome? 1. Journaling thoughts and feelings 2. Adapting to and overcoming a stressor 3. Primary appraisal 4. Spending time with a pet ANS: 2 Chapter: Chapter 1, The Concept of Stress Adaptation Objective: Discuss adaptive coping strategies in the management of stress. Page: 3 Heading: Stress as a Biological Response Integrated Processes: Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Stress and Coping Difficulty: Easy Feedback 1. This is incorrect. Journaling thoughts and feelings is a positive adaptive coping mechanism but is not a stage in the general adaptation syndrome. 2. This is correct. Adapting to and overcoming a stressor is the stage of resistance in the general adaptation syndrome defined by Selye. 3. This is incorrect. Primary appraisal is a concept of stress defined by Lazarus and Folkman in 1984. 4. This is incorrect. Spending time with a pet is a positive adaptive coping mechanism but is not a stage in the general adaptation syndrome. CON: Stress and Coping 4. A nursing student comes down with a sinus infection toward the end of every semester. Which stage of stress is the student most likely experiencing when this occurs? 1. Alarm reaction 2. Resistance 3. Exhaustion 4. Fight or flight ANS: 3 Chapter: Chapter 1, The Concept of Stress Adaptation Objective: Explain the relationship between stress and diseases of adaptation. Page: 3 Heading: Stress as a Biological Response Integrated Processes: Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Stress and Coping Difficulty: Easy Feedback 1. This is incorrect. At the alarm reaction stage, physiological responses of the fight-or-flight syndrome are initiated. 2. This is incorrect. At the stage of resistance, the individual uses the physiological responses of the first stage as a defense in an attempt to adapt to the stressor. Physiological symptoms may disappear. 3. This is correct. At the stage of exhaustion, the student’s exposure to stress has been prolonged, and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. 4. This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction stage. CON: Stress and Coping 5. A school nurse is assessing a high school student who is overly concerned about her appearance. The client’s parent states, “That’s not something to be stressed about!” Which response by the nurse is best? 1. “Teenagers don’t truly understand stress.” 2. “Why are you so concerned about your appearance?” 3. “You surely know that isn’t something to be concerned with.” 4. “I understand you feel stressed about this; tell me more about your stress.” ANS: 4 Chapter: Chapter 1, The Concept of Stress Adaptation Objective: Describe the core concept of stress as an environmental event. Page: 6-7 Heading: Stress as a Transaction Between the Individual and the Environment Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress and Coping Difficulty: Moderate Feedback 1. This is incorrect. This response is judgmental and nontherapeutic. This response minimizes the student’s concerns. 2. This is incorrect. This response puts the student in a defensive position to justify her feelings. It is nontherapeutic. 3. This is incorrect. This is a nontherapeutic response that minimizes the student’s feelings. This does not allow the student to verbalize her concerns. 4. This is correct. Determination of an event as stressful depends on the individual’s cognitive appraisal of the situation, which is an individual’s evaluation of the personal significance of the event or occurrence. Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. This response recognizes the situation and helps to explore the situation. CON: Stress and Coping 6. A student confides in the school nurse that he is feeling stress about deciding whether to go to college or work to provide needed income for his family. Which is the best approach by the nurse to assist the student? 1. Teach the student meditation techniques. 2. Assist the student with problem-solving strategies. 3. Suggest relaxation methods for the student.