J
Mary Townsend (9th Edition, 2017)
TESBANK J
,Chapter 01. The Concep of Stress Adaptation J
Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unemployed. This
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situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the
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nurse evaluate this 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 threat of
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stress-related illness. J
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of
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coping resources 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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The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-
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Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or
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more, indicates high stress in a clients life. However, positive coping mechanisms and strong social support can
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limit susceptibility to stress-related illnesses.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
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Psychosocial Integrity J
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.NURSINGTB.COM
J Maybe Ill look into pursuing an art degree. How should the
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nurse characterize the clients appraisal of the job loss stressor?
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A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
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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:
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Psychosocial Integrity J
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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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:
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Psychosocial Integrity J
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this
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occurs, which stage of stress is the student most likely experiencing?
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A. Alarm reaction stage J J
B. Stage of resistance J J
C. Stage of exhaustion J J
D. Fight-or-flight stage J
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At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been
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depleted. Diseases of adaptation occur more frequently in this stage.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
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Psychosocial Integrity J
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The
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clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing
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response?
A. Teenagers! They dont know a thing about real stress. J J J J J J J J
B. Stress occurs only when there is a loss.
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C. When you are in poor physical condition, yNoU
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caSnIN
t eGxTpBer.C
J ieOncMe psychological well-being.
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D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
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Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a
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physiological change. J
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
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Psychosocial Integrity J
6. A bright student confides in the school nurse about conflicts related to attending college or working to add
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needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to
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the student at this time?
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A. Meditation
B. Problem-solving training J
C. Relaxation
D. Journaling
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The student must assess his or her situation and determine the best course of action. Problem-solving training, by
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providing structure and objectivity, can assist in decision making.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
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Psychosocial Integrity J
, 7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has
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difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the
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clinic nurse. Which is the most appropriate nursing intervention?
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A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
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B. Complete the problem-solving process for the client. J J J J J J
C. Work through the problem-solving process with the client.
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D. Encourage the client to keep a journal. J J J J J J
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During times of high anxiety and stress, clients will need more assistance in problem-solving and decision
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making.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
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Psychosocial Integrity J
8. A school nurse is assessing a distraught female high school student who is overly concerned because her
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parents cant afford horseback riding lessons. How should the nurse interpret the students reaction to her
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perceived problem? J
A. The problem is endangering her well-being.
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B. The problem is personally relevant to her.
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C. The problem is based on immaturity.
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D. The problem is exceeding her capacity to cN
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Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or
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event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that
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other adolescents experience.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
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Psychosocial Integrity J
9. Meditation has been shown to be an effective stress management technique. When meditation is effective,
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what should a nurse expect to assess?
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A. An achieved state of relaxation
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B. An achieved insight into ones feelings
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C. A demonstration of appropriate role behaviors
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D. An enhanced ability to problem-solve
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Meditation produces relaxation by creating a special state of consciousness through focused concentration.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
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Psychosocial Integrity J
10. A distraught, single, first-time mother cries and asks a nurse, How can I go to work if I cant afford
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childcare? What is the nurses initial action in assisting the client with the problem-solving process?
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