Chapter 5 Stress and Inflammatory Responses
1. A nurse is meeting with a young woman who has recently lost her job after moving
with her husband to a new city. She describes herself as being anxious and pretty
depressed. What principle of stress and adaptation should be integrated into the
nurse's plan of care for this patient?
A) Adaptation often fails during stressful events and results in homeostasis. B)
Stress is a part of all lives, and, eventually, this young woman will adapt.
C) Acute anxiety and depression can be adaptations that alleviate stress in some
individuals.
D) An accumulation of stressors can disrupt homeostasis and result in disease. Ans:
D
Feedback:
Four concepts constancy, homeostasis, stress, and adaptation are key to the
understanding of steady state. Homeostasis is maintained through emotional,
neurologic, and hormonal measures; stressors create pressure for adaptation.
Sometimes
too many stressors disrupt homeostasis, and, if adaptation fails, the result is disease. If
a person is overwhelmed by stress, he or she may never adapt. Acute anxiety and
depression are frequently associated with stress.
2. You are the nurse caring for an adult patient who has just received a diagnosis of
prostate cancer. The patient states that he will ìnever be able to cope with this
situation.î How should you best understand the concept of coping when attempting to
meet this patient's needs?
A) Coping is a physiologic measure used to deal with change, and he will physically
adapt.
,B) Coping is composed of the physiologic and psychological processes that people
use to adapt to change.
C) Coping is the human need for faith and hope, both of which create change.
D) Coping is a social strategy that is used to deal with change and loss. Ans: B
Feedback:
Indicators of stress and the stress response include both subjective and objective
measures. They are psychological, physiologic, or behavioral and reflect social
behaviors and thought processes. The physiologic and psychological processes that
people use to adapt to stress are the essence of the coping process. Coping is both a
physiologic and psychological process used to adapt to change. Coping is a personal
process used to adapt to change.
3. The nurse is with a patient who has learned that he has glioblastoma multiforme,
a brain tumor associated with an exceptionally poor prognosis. His heart rate
increases, his eyes dilate, and his blood pressure increases. The nurse recognizes these
changes as being attributable to what response?
A) Part of the limbic system response
B) Sympathetic nervous response
C) Hypothalamic-pituitary response
D) Local adaptation syndrome
Ans: B
Feedback:
The sympathetic nervous system responds rapidly to stress; norepinephrine is released
at nerve ending causing the organs to respond (i.e., heart rate increases, eyes dilate,
and blood pressure increases). The limbic system is a mediator of emotions and
behavior that are critical to survival during times of stress. The hypothalamic-pituitary
response regulates the cortisol-induced metabolic effect that results in elevated blood
, sugars during stressful situations. Local adaptation syndrome is a tissue-specific
inflammatory reaction.
4. You are the nurse caring for a 72-year-old woman who is recovering from a
hemicolectomy on the postsurgical unit. The surgery was very stressful and prolonged,
and you note on the chart that her blood sugars are elevated, yet diabetes does not
appear in her previous medical history. To what do you attribute this elevation in
blood sugars?
A) It is a temporary result of increased secretion of antidiuretic hormone. B) She
must have had diabetes prior to surgery that was undiagnosed.
C) She has suffered pancreatic trauma during her abdominal surgery.
D) The blood sugars are probably a result of the ìfight-or-flightî reaction.
Ans: D
Feedback:
During stressful situations, ACTH stimulates the release of cortisol from the adrenal
gland, which creates protein catabolism releasing amino acids and stimulating the liver
to convert amino acids to glucose; the result is elevated blood sugars. Antidiuretic
hormone is released during stressful situations and stimulates reabsorption of water in
the distal and collecting tubules of the kidney. Assuming the patient had diabetes prior
to surgery demonstrates a lack of understanding of stress-induced hyperglycemia. No
evidence presented in the question other than elevated blood sugars would support a
diagnosis of diabetes.
1. A nurse is meeting with a young woman who has recently lost her job after moving
with her husband to a new city. She describes herself as being anxious and pretty
depressed. What principle of stress and adaptation should be integrated into the
nurse's plan of care for this patient?
A) Adaptation often fails during stressful events and results in homeostasis. B)
Stress is a part of all lives, and, eventually, this young woman will adapt.
C) Acute anxiety and depression can be adaptations that alleviate stress in some
individuals.
D) An accumulation of stressors can disrupt homeostasis and result in disease. Ans:
D
Feedback:
Four concepts constancy, homeostasis, stress, and adaptation are key to the
understanding of steady state. Homeostasis is maintained through emotional,
neurologic, and hormonal measures; stressors create pressure for adaptation.
Sometimes
too many stressors disrupt homeostasis, and, if adaptation fails, the result is disease. If
a person is overwhelmed by stress, he or she may never adapt. Acute anxiety and
depression are frequently associated with stress.
2. You are the nurse caring for an adult patient who has just received a diagnosis of
prostate cancer. The patient states that he will ìnever be able to cope with this
situation.î How should you best understand the concept of coping when attempting to
meet this patient's needs?
A) Coping is a physiologic measure used to deal with change, and he will physically
adapt.
,B) Coping is composed of the physiologic and psychological processes that people
use to adapt to change.
C) Coping is the human need for faith and hope, both of which create change.
D) Coping is a social strategy that is used to deal with change and loss. Ans: B
Feedback:
Indicators of stress and the stress response include both subjective and objective
measures. They are psychological, physiologic, or behavioral and reflect social
behaviors and thought processes. The physiologic and psychological processes that
people use to adapt to stress are the essence of the coping process. Coping is both a
physiologic and psychological process used to adapt to change. Coping is a personal
process used to adapt to change.
3. The nurse is with a patient who has learned that he has glioblastoma multiforme,
a brain tumor associated with an exceptionally poor prognosis. His heart rate
increases, his eyes dilate, and his blood pressure increases. The nurse recognizes these
changes as being attributable to what response?
A) Part of the limbic system response
B) Sympathetic nervous response
C) Hypothalamic-pituitary response
D) Local adaptation syndrome
Ans: B
Feedback:
The sympathetic nervous system responds rapidly to stress; norepinephrine is released
at nerve ending causing the organs to respond (i.e., heart rate increases, eyes dilate,
and blood pressure increases). The limbic system is a mediator of emotions and
behavior that are critical to survival during times of stress. The hypothalamic-pituitary
response regulates the cortisol-induced metabolic effect that results in elevated blood
, sugars during stressful situations. Local adaptation syndrome is a tissue-specific
inflammatory reaction.
4. You are the nurse caring for a 72-year-old woman who is recovering from a
hemicolectomy on the postsurgical unit. The surgery was very stressful and prolonged,
and you note on the chart that her blood sugars are elevated, yet diabetes does not
appear in her previous medical history. To what do you attribute this elevation in
blood sugars?
A) It is a temporary result of increased secretion of antidiuretic hormone. B) She
must have had diabetes prior to surgery that was undiagnosed.
C) She has suffered pancreatic trauma during her abdominal surgery.
D) The blood sugars are probably a result of the ìfight-or-flightî reaction.
Ans: D
Feedback:
During stressful situations, ACTH stimulates the release of cortisol from the adrenal
gland, which creates protein catabolism releasing amino acids and stimulating the liver
to convert amino acids to glucose; the result is elevated blood sugars. Antidiuretic
hormone is released during stressful situations and stimulates reabsorption of water in
the distal and collecting tubules of the kidney. Assuming the patient had diabetes prior
to surgery demonstrates a lack of understanding of stress-induced hyperglycemia. No
evidence presented in the question other than elevated blood sugars would support a
diagnosis of diabetes.
