NURS 223 Exam #1 Stress &
Adaptation
The elderly client, with a history of congestive heart failure, is upset following the death
of her husband yesterday. The practitioner observes the client for which of the
following?
a) Arrhythmias
b) Anemia
c) Renal failure
d) Cerebrovascular accident - CORRECT ANSWER-Arrhythmias
For people with limited coping abilities, either because of physical or mental health, the
acute stress response may be detrimental. For people with preexisting heart disease
the overwhelming sympathetic behaviors associated with stress can lead to
arrhythmias. The other options are not stimulated by the sympathetic response.
A client is experiencing stress as a nurse prepares to insert a peripheral intravenous
catheter into his forearm. The client's locus ceruleus (LC) is consequently producing
which of the following hormones?
a) Norepinephrine (NE)
b) Corticotropin-releasing factor (CRF)
c) Adrenocorticotropic hormone (ACTH)
d) Antidiuretic hormone (ADH) - CORRECT ANSWER-Norepinephrine (NE)
The LC is densely populated with neurons that produce norepinephrine (NE); it does not
produce CRF, ADH, or ACTH.
The client has expressed a desire to explore stress-reducing strategies for chronic
migraines. The provider explains one technique that involves electronic monitoring of
physiologic responses to stress with immediate feedback. This is known as which of the
following?
a) Imagery
b) Biofeedback
c) Music therapy
d) Progressive muscle relaxation - CORRECT ANSWER-Biofeedback
Biofeedback is a technique in which a person learns to control physiologic functioning. It
involves electronic monitoring of one or more physiologic responses to stress with
immediate feedback of the specific response.
A client asks, "Why do I keep getting these cold sores on my lips? Am I kissing people
too much?" The nurse will base her response by saying:
a) "Have you been going outside with a wet head?"
, b) "Maybe you should stay away from crowds for the next few weeks."
c) "Have you been forgetting to wash your hands after going to the restroom?"
d) "These sores usually develop when you are not sleeping well or are emotionally
upset." - CORRECT ANSWER-"These sores usually develop when you are not sleeping
well or are emotionally upset."
Herpes simplex virus type 1 infection (i.e., cold sores) often develops during periods of
inadequate rest, fever, ultraviolet radiation exposure, and emotional upset. The resident
herpes virus is kept in check by body defenses, probably T lymphocytes, until a
stressful event occurs that causes suppression of the immune system. You do not catch
cold sores by not washing after the restroom. The other responses about going out with
a wet head or staying away from crowds have no bearing to the development of cold
sores.
A nurse is caring for an adolescent with posttraumatic stress syndrome. The patient
reports having difficulty concentrating and has an increased startle reflex. The nurse's
documentation includes the presence of which of the following?
a) Hyperarousal
b) Intrusion
c) Shell shock
d) Resistance - CORRECT ANSWER-Hyperarousal
The nurse should document the presence of hyperarousal, defined as the presence of
increased irritability, difficulty concentrating, exaggerated startle reflex, increased
vigilance, and/or concern over safety in a patient with posttraumatic stress syndrome.
A health care provider suspects a client has developed posttraumatic stress disorder
(PTSD). Select the necessary criterion to validate the diagnosis.
a) At least 1 month of clinically significant distress affecting a person after witnessing or
experiencing a traumatic event that affects other parts of his or her life
b) A functional magnetic resonance imaging (MRI) scan that demonstrates that a client
has decreased reactivity of the amygdala and hippocampus after a traumatic event
c) An impaired deficit of memory and concentration for greater than a 6-month period
after a traumatic event has occurred
d) A positron emission tomography (PET) scan that demonstrates that a client has
decreased reactivity of the anterior cingulated and orbitofrontal areas after a traumatic
event - CORRECT ANSWER-At least 1 month of clinically significant distress affecting a
person after witnessing or experiencing a traumatic event that affects other parts of his
or her life
The triad of symptoms of intrusion, avoidance, and hyperarousal that characterize
PTSD must be present together for at least 1 month, and the disorder must have
caused clinically significant distress or impairment in social, occupational, and other
areas of functioning.
Adaptation
The elderly client, with a history of congestive heart failure, is upset following the death
of her husband yesterday. The practitioner observes the client for which of the
following?
a) Arrhythmias
b) Anemia
c) Renal failure
d) Cerebrovascular accident - CORRECT ANSWER-Arrhythmias
For people with limited coping abilities, either because of physical or mental health, the
acute stress response may be detrimental. For people with preexisting heart disease
the overwhelming sympathetic behaviors associated with stress can lead to
arrhythmias. The other options are not stimulated by the sympathetic response.
A client is experiencing stress as a nurse prepares to insert a peripheral intravenous
catheter into his forearm. The client's locus ceruleus (LC) is consequently producing
which of the following hormones?
a) Norepinephrine (NE)
b) Corticotropin-releasing factor (CRF)
c) Adrenocorticotropic hormone (ACTH)
d) Antidiuretic hormone (ADH) - CORRECT ANSWER-Norepinephrine (NE)
The LC is densely populated with neurons that produce norepinephrine (NE); it does not
produce CRF, ADH, or ACTH.
The client has expressed a desire to explore stress-reducing strategies for chronic
migraines. The provider explains one technique that involves electronic monitoring of
physiologic responses to stress with immediate feedback. This is known as which of the
following?
a) Imagery
b) Biofeedback
c) Music therapy
d) Progressive muscle relaxation - CORRECT ANSWER-Biofeedback
Biofeedback is a technique in which a person learns to control physiologic functioning. It
involves electronic monitoring of one or more physiologic responses to stress with
immediate feedback of the specific response.
A client asks, "Why do I keep getting these cold sores on my lips? Am I kissing people
too much?" The nurse will base her response by saying:
a) "Have you been going outside with a wet head?"
, b) "Maybe you should stay away from crowds for the next few weeks."
c) "Have you been forgetting to wash your hands after going to the restroom?"
d) "These sores usually develop when you are not sleeping well or are emotionally
upset." - CORRECT ANSWER-"These sores usually develop when you are not sleeping
well or are emotionally upset."
Herpes simplex virus type 1 infection (i.e., cold sores) often develops during periods of
inadequate rest, fever, ultraviolet radiation exposure, and emotional upset. The resident
herpes virus is kept in check by body defenses, probably T lymphocytes, until a
stressful event occurs that causes suppression of the immune system. You do not catch
cold sores by not washing after the restroom. The other responses about going out with
a wet head or staying away from crowds have no bearing to the development of cold
sores.
A nurse is caring for an adolescent with posttraumatic stress syndrome. The patient
reports having difficulty concentrating and has an increased startle reflex. The nurse's
documentation includes the presence of which of the following?
a) Hyperarousal
b) Intrusion
c) Shell shock
d) Resistance - CORRECT ANSWER-Hyperarousal
The nurse should document the presence of hyperarousal, defined as the presence of
increased irritability, difficulty concentrating, exaggerated startle reflex, increased
vigilance, and/or concern over safety in a patient with posttraumatic stress syndrome.
A health care provider suspects a client has developed posttraumatic stress disorder
(PTSD). Select the necessary criterion to validate the diagnosis.
a) At least 1 month of clinically significant distress affecting a person after witnessing or
experiencing a traumatic event that affects other parts of his or her life
b) A functional magnetic resonance imaging (MRI) scan that demonstrates that a client
has decreased reactivity of the amygdala and hippocampus after a traumatic event
c) An impaired deficit of memory and concentration for greater than a 6-month period
after a traumatic event has occurred
d) A positron emission tomography (PET) scan that demonstrates that a client has
decreased reactivity of the anterior cingulated and orbitofrontal areas after a traumatic
event - CORRECT ANSWER-At least 1 month of clinically significant distress affecting a
person after witnessing or experiencing a traumatic event that affects other parts of his
or her life
The triad of symptoms of intrusion, avoidance, and hyperarousal that characterize
PTSD must be present together for at least 1 month, and the disorder must have
caused clinically significant distress or impairment in social, occupational, and other
areas of functioning.
