NURS 535 Practice Exam Questions with
Verified Answers
Describe the physiologic response and clinical manifestations of pain and its relation to the
sympathetic-adrenal-medullary system stress response. - ✔✔If an individual is exposed to pain
and they perceive this pain as stressful, the adrenal medulla secretes adrenaline (hormone).
Adrenaline leads to the arousal of the sympathetic nervous system and reduced activity in the
parasympathetic nervous system. Once the painful threat is over, the parasympathetic branch
takes control and brings the body back to homeostasis.
Potential changes in the body r/t adrenaline: ↑HR, Pulse, and BP; ↓ digestion; and ↑ sweating
(diaphoresis)
Biological Syndrome of Stress
What are the 3 structural changes? - ✔✔1. Adrenal Gland Cortex enlargement
2. Atrophy of thymus gland and other lymphoid structures
3. Development of bleeding ulcers in stomach and duodenal lining
Homeostasis - ✔✔Physiologic regulation around an unchanging set point
Stable or Remaining the same
Allostasis - ✔✔Long-term or chronic exaggerated responses to stress
Proposes physiologic systems are dynamic & capable of changing set-points after exposure to
stress
Ability to successfully adjust to challenges
,Allostatic Overload - ✔✔Chronic over-activation of adaptive regulatory physiologic systems that
increases susceptibility to disease
Exaggerated pathophysiologic responses to stress
What is stress? - ✔✔Transactional or interactional concept - it is not necessarily the event but
how we perceive and react to the event that produces stress.
The state of affairs arising when a person relates to situations in a certain way.
A person experiences stress when a demand (real or imagined) exceeds a person's coping
abilities.
Allostatic load - ✔✔The individualized cumulative effects of stressors that exist in people's lives
and influence their physiologic responses.
Under conditions of allostatic overload, the parasympathetic system may (increase, decrease)
its restraint of the sympathetic system resulting in (increased, decreased) inflammatory
responses. - ✔✔decrease, increased
What are the 3 key mediators and biomarkers of allostatic overload? - ✔✔1. glucocorticoid
cortisol
2. catecholamines (released from the sympathetic nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) - ✔✔the sum of all nonspecific reactions of the body to
prolonged systemic stress, comprising of 3 successive stages → Alarm Stage; The Stage of
Resistance; and The Stage of Exhaustion
, Alarm Stage - ✔✔First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation - ✔✔Second stage of the GAS, during which the body
adapts to and uses resources to cope with a stressor.
Mobilization contributes to "Fight or Flight"
When does the Stage of Resistance or Adaptation begin? - ✔✔Begins when the actions of
Cortisol, norepinephrine and epinephrine all start to go to work doing their respective jobs.
The Stage of Exhaustion (Allostatic Overload) - ✔✔Third stage of the general adaptation
syndrome.
Stress continues; adaptation unsuccessful.
Continuous stress causes the progressive breakdown of compensating mechanisms (acquired
adaptations) and homeostasis. Exhaustion marks the onset of certain diseases.
The body's ability to resist stress becomes depleted; illness, disease, and even death may occur.
Causing impairment of the immune response, heart failure, and kidney failure, leading to death.
Hypothalamic-Pituitary-Adrenal (HPA) axis - ✔✔Stress (+) → Hypothalamus (+) [Release CRH] →
Anterior Pituitary Gland [Releases ACTH] → Adrenal Gland [Releases Cortisol] → Via Negative
Feedback Cortisol goes to hypothalamus and Anterior Pituitary Gland to halt the release of
hormones
Verified Answers
Describe the physiologic response and clinical manifestations of pain and its relation to the
sympathetic-adrenal-medullary system stress response. - ✔✔If an individual is exposed to pain
and they perceive this pain as stressful, the adrenal medulla secretes adrenaline (hormone).
Adrenaline leads to the arousal of the sympathetic nervous system and reduced activity in the
parasympathetic nervous system. Once the painful threat is over, the parasympathetic branch
takes control and brings the body back to homeostasis.
Potential changes in the body r/t adrenaline: ↑HR, Pulse, and BP; ↓ digestion; and ↑ sweating
(diaphoresis)
Biological Syndrome of Stress
What are the 3 structural changes? - ✔✔1. Adrenal Gland Cortex enlargement
2. Atrophy of thymus gland and other lymphoid structures
3. Development of bleeding ulcers in stomach and duodenal lining
Homeostasis - ✔✔Physiologic regulation around an unchanging set point
Stable or Remaining the same
Allostasis - ✔✔Long-term or chronic exaggerated responses to stress
Proposes physiologic systems are dynamic & capable of changing set-points after exposure to
stress
Ability to successfully adjust to challenges
,Allostatic Overload - ✔✔Chronic over-activation of adaptive regulatory physiologic systems that
increases susceptibility to disease
Exaggerated pathophysiologic responses to stress
What is stress? - ✔✔Transactional or interactional concept - it is not necessarily the event but
how we perceive and react to the event that produces stress.
The state of affairs arising when a person relates to situations in a certain way.
A person experiences stress when a demand (real or imagined) exceeds a person's coping
abilities.
Allostatic load - ✔✔The individualized cumulative effects of stressors that exist in people's lives
and influence their physiologic responses.
Under conditions of allostatic overload, the parasympathetic system may (increase, decrease)
its restraint of the sympathetic system resulting in (increased, decreased) inflammatory
responses. - ✔✔decrease, increased
What are the 3 key mediators and biomarkers of allostatic overload? - ✔✔1. glucocorticoid
cortisol
2. catecholamines (released from the sympathetic nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) - ✔✔the sum of all nonspecific reactions of the body to
prolonged systemic stress, comprising of 3 successive stages → Alarm Stage; The Stage of
Resistance; and The Stage of Exhaustion
, Alarm Stage - ✔✔First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation - ✔✔Second stage of the GAS, during which the body
adapts to and uses resources to cope with a stressor.
Mobilization contributes to "Fight or Flight"
When does the Stage of Resistance or Adaptation begin? - ✔✔Begins when the actions of
Cortisol, norepinephrine and epinephrine all start to go to work doing their respective jobs.
The Stage of Exhaustion (Allostatic Overload) - ✔✔Third stage of the general adaptation
syndrome.
Stress continues; adaptation unsuccessful.
Continuous stress causes the progressive breakdown of compensating mechanisms (acquired
adaptations) and homeostasis. Exhaustion marks the onset of certain diseases.
The body's ability to resist stress becomes depleted; illness, disease, and even death may occur.
Causing impairment of the immune response, heart failure, and kidney failure, leading to death.
Hypothalamic-Pituitary-Adrenal (HPA) axis - ✔✔Stress (+) → Hypothalamus (+) [Release CRH] →
Anterior Pituitary Gland [Releases ACTH] → Adrenal Gland [Releases Cortisol] → Via Negative
Feedback Cortisol goes to hypothalamus and Anterior Pituitary Gland to halt the release of
hormones
