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NURS 535 Exam #1 Questions and
Answers Latest 2026
Describe the physiologic response and clinical
manifestations of pain and its relation to the
sympathetic-adrenal-medullary system stress response.
Ans: 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? Ans: 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 Ans: Physiologic regulation around an
unchanging set point
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, 2 | Page
Stable or Remaining the same
Allostasis Ans: 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 Ans: Chronic over-activation of
adaptive regulatory physiologic systems that increases
susceptibility to disease
Exaggerated pathophysiologic responses to stress
What is stress? Ans: 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 Ans: 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
© 2025 All rights reserved
, 3 | Page
(increased, decreased) inflammatory responses. Ans:
decrease, increased
What are the 3 key mediators and biomarkers of
allostatic overload? Ans: 1. glucocorticoid cortisol
2. catecholamines (released from the sympathetic
nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) Ans: 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 Ans: First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation Ans: 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?
Ans: 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) Ans: Third
stage of the general adaptation syndrome.
© 2025 All rights reserved
, 4 | Page
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 Ans: 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
The release of cortisol causes a number of changes that
help the body deal with stress.
When cortisol levels in the blood get high, this is sensed
by receptors in areas of the brain (like the hippocampus
& hypothalamus) which leads to the shutting off of the
stress response via negative feedback mechanism.
Compare and Contrast the sympathetic-adrenal-
medullary system activation to the hypothalamic-
pituitary-adrenal (HPA) axis response that is activated
during the stage of resistance (adaptation). Ans: When a
stress response is triggered, it sends signals to two other
© 2025 All rights reserved
NURS 535 Exam #1 Questions and
Answers Latest 2026
Describe the physiologic response and clinical
manifestations of pain and its relation to the
sympathetic-adrenal-medullary system stress response.
Ans: 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? Ans: 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 Ans: Physiologic regulation around an
unchanging set point
© 2025 All rights reserved
, 2 | Page
Stable or Remaining the same
Allostasis Ans: 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 Ans: Chronic over-activation of
adaptive regulatory physiologic systems that increases
susceptibility to disease
Exaggerated pathophysiologic responses to stress
What is stress? Ans: 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 Ans: 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
© 2025 All rights reserved
, 3 | Page
(increased, decreased) inflammatory responses. Ans:
decrease, increased
What are the 3 key mediators and biomarkers of
allostatic overload? Ans: 1. glucocorticoid cortisol
2. catecholamines (released from the sympathetic
nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) Ans: 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 Ans: First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation Ans: 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?
Ans: 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) Ans: Third
stage of the general adaptation syndrome.
© 2025 All rights reserved
, 4 | Page
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 Ans: 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
The release of cortisol causes a number of changes that
help the body deal with stress.
When cortisol levels in the blood get high, this is sensed
by receptors in areas of the brain (like the hippocampus
& hypothalamus) which leads to the shutting off of the
stress response via negative feedback mechanism.
Compare and Contrast the sympathetic-adrenal-
medullary system activation to the hypothalamic-
pituitary-adrenal (HPA) axis response that is activated
during the stage of resistance (adaptation). Ans: When a
stress response is triggered, it sends signals to two other
© 2025 All rights reserved
