Test Bank: Stress and Disease Huether: Understanding Pathophysiology 7th Edition,100% CORRECT

Test Bank: Stress and Disease Huether: Understanding Pathophysiology , 7th Edition MULTIPLE CHOICE 1. A female student is driving to school when another driver nearly hits her. Her heart begins beating harder and faster as she becomes aroused and scared. Which of the following stages of the general adaptation syndrome is she experiencing? a. Alarm stage b. Stage of resistance c. Adaptation d. Exhaustion ANS: A The alarm stage, the initial reaction, is manifested by arousal of the body’s defenses that prepare the body to fight or flee from threat. This stage involves the secretion of hormones and catecholamines to support physiologic/metabolic activity and boosts the immune system to thwart infection. The stage of resistance/adaptation is the second step as the body attempts to sustain the challenge. Exhaustion marks the breakdown of compensatory mechanisms, when the response can no longer be sustained. 2. Exhaustion occurs if stress continues and is not successful. a. flight or fight response b. alarm c. adaptation d. arousal ANS: C NURSINGKING.COM Exhaustion occurs if adaptation is not successful. The alarm stage is the emergency reaction that prepares the body to fight or flee from threat. Arousal occurs as the stress is recognized. 3. A student arrives at school to find that he/she has an exam for which he/she is unprepared. Which physiologic response would be expected? a. Decreased lipolysis b. Bronchoconstriction c. Decreased cortisol release d. Increased glucagon release ANS: D The student would experience increased glucagon release to supply the increased glucose requirements. Increased lipolysis and bronchodilation would occur, not constriction. The student would experience increased cortisol release. 4. A 10-year-old female is arriving at a national spelling bee contest. Her heart starts beating faster and harder, and she begins to sweat. Which of the following is she experiencing? a. Anticipatory response b. Homeostasis c. Reactive response d. Exhaustion stage ANS: A Anticipation of experiencing these events produces a physiologic stress response. Homeostasis is a steady-state. Reactive response occurs following a stressful event. Exhaustion stage is the final stage of the stressful response when the body can no longer sustain the response. 5. Which of the following hormones enhances myocardial contractility? a. Oxytocin b. Prolactin c. Epinephrine d. Somatotropin ANS: C Epinephrine enhances myocardial contractility. Oxytocin activates receptors in the uterus. Prolactin does not activate adrenergic receptors. Somatotropin activates protein and carbohydrate metabolism. 6. A 35-year-old male is diagnosed with a hormone-secreting tumor of the adrenal medulla. He experiences elevated blood pressure and increased anxiety. Which of the following hormones is the predominant one released by the tumor? a. Antidiuretic hormone b. Acetylcholine c. Norepinephrine d. Cortisol ANS: C Norepinephrine regulates blood pressure and promotes arousal, increased vigilance, increased anxiety, and other protective NemUoRtiSoInaNl GreKspIoNnsGe.s.CAOnMtidiuretic hormone regulates urine output. Acetylcholine will not result in an increase in blood pressure. Cortisol regulates glucocorticoids. 7. Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include: a. epinephrine and aldosterone. b. norepinephrine and cortisol. c. epinephrine and norepinephrine. d. cortisol and aldosterone. ANS: C The catecholamines are epinephrine and norepinephrine. Neither aldosterone nor cortisol is a catecholamine. 8. A nurse recalls that stress-induced stimulation of the adrenal cortex causes it to secrete: a. estrogen. b. cortisol. c. parathyroid hormone. d. adrenocorticotropin hormone (ACTH). ANS: B The adrenal cortex secretes cortisol, not estrogen, parathyroid hormone, or ACTH. 9. Stress-induced catecholamine release from the adrenal medulla may result in: a. decreased blood flow to the brain. b. elevated blood pressure. c. decreased glycogen synthesis. d. decreased muscle contraction. ANS: B Catecholamine release results in elevated blood pressure as a result of vasoconstriction. Catecholamine release results in increased blood flow to the brain and increased glucose production. Catecholamine release results in increased muscle contraction. 10. When a patient is diagnosed with a hormone-secreting tumor of the adrenal cortex, which physiologic response would be expected? a. Decreased blood pressure b. Increased incidence of gastric ulcers c. Increased lipogenesis of extremities d. Decreased gastric secretion ANS: B Increased release of cortisol leads to increased gastric secretions, and therefore an increased incidence of gastric ulcers. Hypertension is a result of increased cortisol. The increase of gastric secretions causes lipolysis, not lipogenesis. 11. When assessing the effects of elevated -endorphins in a patient, which of the following should the nurse monitor? a. Peripheral vasoconstriction b. Hyperglycemia c. Pain inhibition d. Decreased immune cell acNtiUvRitySINGKING.COM ANS: C Elevated -endorphins activate endorphin (opiate) receptors on peripheral sensory nerves, leading to pain relief or analgesia. None of the other options result from the effects of elevated -endorphins. 12. After teaching about coping, which information indicates a correct understanding? Coping is best defined as the process of: a. adjusting to disease. b. preventing psychological distress. c. mediating anger. d. managing stressful challenges. ANS: D Coping is the process of managing, not adjusting to, stressful challenges that tax the individual’s resources. Coping is not preventing psychological distress, nor does it mediate anger. MULTIPLE RESPONSE 1. When teaching about the stress-age syndrome, what information should the nurse include? (Select all that apply.) a. Decreased cortisol secretion b. Decreased thyroxine c. Immunodepression d. Increased catecholamine secretion e. Hypercoagulation of the blood f. Free-radical damage ANS: B, C, D, E, F The stress-age syndrome includes alterations in the excitability of structures of the limbic system and hypothalamus; rise of the blood concentration of catecholamines, ADH, ACTH, and cortisol; decrease in testosterone, thyroxine, and others; alterations of opioid peptides; immunodepression and pattern of chronic inflammation; alterations in lipoproteins; hypercoagulation of the blood; and free-radical damage of cells. 2. When a patient uses repression to deal with psychological stress, which of the following assessment findings should the nurse monitor for? (Select all that apply.) a. Decreased monocyte counts b. Increased eosinophil counts c. Decreased serum glucose d. Increased pulse rates e. Increased medication reactions ANS: A, B, E Repression is associated with lower monocyte counts, higher eosinophil counts, higher serum glucose, and more self-reported medication reactions in medical outpatients. It is not associated with increased pulse rates and glucose increases, rather than decreases. NURSINGKING.COM