1|P a g e
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,2|P a g e
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, Chapter 01. The Concept of Stress Adaptation M br br br br br br br
ultiple Choice br
1. A client has experienced the death of a close family member and at the same time becomes u
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nemployed. This situation has resulted in a 6- br br br br br br br
month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate t
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his client data?
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A. The client is experiencing severe distress and is at risk for physical and psychological illness.
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B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant t
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hreat of stress-related illness.
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C. Susceptibility to stress- br br
related physical or psychological illness cannot be estimated without knowledge of coping reso
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urces and available supports.
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D. The client may view these losses as challenges and perceive them as opportunities.
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ANS: C br
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences an
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d the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-
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score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms and
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strong social support can limit susceptibility to stress-related illnesses.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychos
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ocial Integrity br
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a
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nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should t
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he nurse characterize the clients appraisal of the job loss stressor?
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A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging b
ANS: D
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The client perceives the situation of job loss as a challenge and an opportunity for growth.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Ps
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ychosocial Integrity br
3|P a g e
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, 3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
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A. Ive found that avoiding contact with others helps me cope.
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B. I really enjoy journaling; its my private time.
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C. I signed up for a yoga class this week.
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D. I made an appointment to meet with a therapist.
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ANS: A br
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent
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learning appropriate coping skills and can prevent access to needed support systems.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychos
br br br br br br br br br br br br br
ocial Integrity br
4|P a g e
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br br br br br
,2|P a g e
br br br br br
, Chapter 01. The Concept of Stress Adaptation M br br br br br br br
ultiple Choice br
1. A client has experienced the death of a close family member and at the same time becomes u
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nemployed. This situation has resulted in a 6- br br br br br br br
month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate t
br br br br br br br br br br br br br br br
his client data?
br br
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
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B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant t
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hreat of stress-related illness.
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C. Susceptibility to stress- br br
related physical or psychological illness cannot be estimated without knowledge of coping reso
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urces and available supports.
br br br
D. The client may view these losses as challenges and perceive them as opportunities.
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ANS: C br
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences an
br br br br br br br br br br br br br br br
d the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-
br br br br br br br br br br br br br br br br
score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms and
br br br br br br br br br br br br br br br br br
strong social support can limit susceptibility to stress-related illnesses.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychos
br br br br br br br br br br br br br
ocial Integrity br
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a
br br br br br br br br br br br br br br br br br br
nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should t
br br br br br br br br br br br br br br br br br br br br
he nurse characterize the clients appraisal of the job loss stressor?
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A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging b
ANS: D
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The client perceives the situation of job loss as a challenge and an opportunity for growth.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Ps
br br br br br br br br br br br br br
ychosocial Integrity br
3|P a g e
br br br br br
, 3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
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A. Ive found that avoiding contact with others helps me cope.
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B. I really enjoy journaling; its my private time.
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C. I signed up for a yoga class this week.
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D. I made an appointment to meet with a therapist.
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ANS: A br
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent
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learning appropriate coping skills and can prevent access to needed support systems.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychos
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ocial Integrity br
4|P a g e
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