Chapter 37 Stress and Coping Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationale

1. A nurse is caring for a patient who is newly diagnosed with cancer. The patient is quiet, withdrawn, and states, “I just don’t have the strength to fight this.” Which response by the nurse demonstrates effective support of the patient’s coping process? A. “You need to stay strong and fight through this.” B. “It’s normal to feel overwhelmed. Can you tell me more about what you’re experiencing?” C. “Try not to think negatively. Focus on the positives.” D. “You should consider speaking to other cancer patients who are doing better.” Correct Answer: B Rationale: Therapeutic communication that encourages expression of feelings supports emotional coping. Option B provides a supportive environment for open discussion. ________________________________________ 2. According to the General Adaptation Syndrome (GAS), what is the first stage of the body’s response to stress? A. Resistance stage B. Exhaustion stage C. Alarm stage D. Recovery stage Correct Answer: C Rationale: The alarm stage is the initial physiological response to stress, characterized by activation of the fight-or-flight response. ________________________________________ 3. A patient experiencing prolonged stress may show signs of exhaustion. Which assessment finding best indicates the exhaustion stage of GAS? A. Elevated blood pressure and pulse B. Heightened mental alertness C. Decreased immune function and fatigue D. Increased energy and restlessness Correct Answer: C Rationale: The exhaustion stage results in impaired immunity, fatigue, and reduced coping ability due to prolonged stress. ________________________________________ 4. A college student tells the nurse that stress from school is affecting her sleep and concentration. Which coping strategy should the nurse encourage first? A. Prescription medication for anxiety B. Avoidance of academic responsibilities C. Time management and relaxation techniques D. Isolation from friends for quiet time Correct Answer: C Rationale: Promoting healthy coping strategies like time management and relaxation can reduce stress without adverse effects. ________________________________________ 5. A nurse is teaching a patient about deep breathing to reduce stress. Which instruction is most appropriate? A. “Hold your breath for 10 seconds before exhaling.” B. “Breathe rapidly to release tension quickly.” C. “Take slow, deep breaths in through your nose and out through your mouth.” D. “Try to ignore your breathing pattern and focus on a thought.” Correct Answer: C Rationale: Deep breathing exercises involve slow, controlled inhalation and exhalation to activate the parasympathetic nervous system and reduce stress. ________________________________________ 6. A hospitalized patient becomes agitated and irritable after receiving news of a poor prognosis. The nurse recognizes this behavior as: A. Denial B. Displacement C. Regression D. Reaction formation Correct Answer: B Rationale: Displacement is a defense mechanism where emotions are redirected from the original source to a safer target. ________________________________________ 7. During a health history, a patient states, “I feel like I’m always under pressure and can’t relax.” Which priority question should the nurse ask to assess the patient’s stress level? A. “Have you ever tried counseling before?” B. “What coping methods do you use when you feel stressed?” C. “Why do you think you feel this way?” D. “Do you get enough sleep each night?” Correct Answer: B Rationale: Understanding the patient's current coping mechanisms helps the nurse assess effectiveness and guide interventions. ________________________________________ 8. Which patient is at highest risk for ineffective coping? A. A widower who participates in a grief support group B. A teenager using exercise to relieve school-related stress C. A woman recently laid off who reports frequent alcohol use D. A nurse using journaling to process workplace burnout Correct Answer: C Rationale: Using substances such as alcohol is a maladaptive coping mechanism and indicates a higher risk for ineffective coping. ________________________________________ 9. What physiological change is most commonly associated with the body’s acute stress response? A. Decreased blood glucose B. Pupil constriction C. Increased heart rate D. Decreased respiratory rate Correct Answer: C Rationale: The acute stress response activates the sympathetic nervous system, increasing heart rate and cardiac output.