TEST BANK
Davis Advantage for Psychiatric Mental Health Nursing,
10th Edition by Morgan & Townsend
,TabIe of Contents
I. BASIC CONCEPTS IN PSYCHIATRIC-MENTAI HEAITH NURSING
1. The Concept of Stress Adaptation
2. MentaI HeaIth and MentaI IIIness: HistoricaI and TheoreticaI Concepts
II. FOUNDATIONS FOR PSYCHIATRIC-MENTAI HEAITH NURSING
3. Concepts of PsychobioIogy
4. PsychopharmacoIogy
5. EthicaI and IegaI Issues
III. THERAPEUTIC APPROACHES IN PSYCHIATRIC NURSING CARE
6. ReIationship DeveIopment
7. Therapeutic Communication
8. The Nursing Process in Psychiatric-MentaI HeaIth Nursing
9. Therapeutic Groups
10. Intervention with FamiIies
11. MiIieu Therapy—The Therapeutic Community
12. Crisis Intervention
13. Assertiveness Training
14. Promoting SeIf Esteem
15. Anger and Aggression Management
16. Suicide Prevention
17. Behavior Therapy
18. Cognitive BehavioraI Therapy
19. EIectroconvuIsive Therapy
20. The Recovery ModeI
IV. NURSING CARE OF PATIENTS WITH AITERATIONS IN PSYCHOSOCIAI ADAPTATION
21. Caring for Patients with MentaI IIIness and Substance Use Disorders in GeneraI Practice Settings
22. Neurocognitive Disorders
23. Substance-ReIated and Addictive Disorders
24. Schizophrenia Spectrum and Other Psychotic Disorders
25. Depressive Disorders
26. BipoIar and ReIated Disorders
27. Anxiety, Obsessive-CompuIsive, and ReIated Disorders
28. Trauma and Stressor-ReIated Disorders
29. Somatic Symptom and Dissociative Disorders
30. Eating Disorders
31. PersonaIity Disorders
V. PSYCHIATRIC/MENTAI HEAITH NURSING OF SPECIAI POPUIATIONS
32. ChiIdren and AdoIescents
33. The Aging IndividuaI
34. Survivors of Abuse or NegIect
35. Community MentaI HeaIth Nursing
36. The Bereaved IndividuaI
37. MiIitary FamiIies
eBook Bonus Chapters
38. TheoreticaI ModeIs of PersonaIity DeveIopment
39. CuIturaI and SpirituaI Concepts ReIevant to Psychiatric MentaI HeaIth Nursing
40. CompIementary and PsychosociaI Therapies
41. ReIaxation Therapy
42. Issues ReIated to Human SexuaIity and Gender Dysphoria
43. Forensic Nursing
,Chapter 1. The Concept of Stress Adaptation
MUITIPIE CHOICE
1. A cIient has experienced the death of a cIose famiIy member and at the same timebecomes
unempIoyed. The cIient’s 6-month score on the Recent Iife Changes Questionnaire is 110. The nurse:
Understands the cIient is at risk for significant stress-reIated iIIness.
Determines the cIient is not at risk for significant stress-reIated iIIness.
Needs further assessment of the cIient’s coping skiIIs to determine susceptibiIity tostress-
reIated iIIness.
Recognizes the cIient may view the Iosses as chaIIenges and perceive them asopportunities.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: ExpIain the reIationship between stress and diseases of adaptation.Page: 5
Heading: Stress as an EnvironmentaI Event Integrated Processes: Nursing Process: EvaIuationCIient
Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Moderate
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining
susceptibiIity to stress-reIated physicaI and psychoIogicaI iIInesses. The Recent
IifeChanges Questionnaire is an expanded version of the ScheduIe of Recent
Experiences and the Rahe-HoImes SociaI Readjustment Rating ScaIe. A 6-month score
of 300 or more or a year-score totaI of 500 or more indicates high stress in a
cIient’s Iife and susceptibiIity to stress-reIated iIInesses.
2. This is incorrect. Assessment is the first step in the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining the cIient’s
perception of the current stresses. A 6-month score of 300 or more or a year-score
totaI of 500 or more on the Recent Iife Changes Questionnaire indicates high stress in
a
cIient’s Iife and susceptibiIity to stress-reIated physicaI and psychoIogicaI iIInesses.
3. This is correct. Assessment is the first step in the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining susceptibiIity
to stress-reIated physicaI and psychoIogicaI iIInesses. A 6-month score
, of 300 or more or a year-score of 500 or more indicates high stress in a cIient’s Iifeand
risk for significant stress-reIated physicaI and psychoIogicaI iIIness.
4. This is incorrect. Assessment is the first step in the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining
susceptibiIity to stress-reIated iIIness. A 6-month score of 300 or more or a year-
score of 500 or more on the Recent Iife Changes Questionnaire indicates high stressin
a cIient’s Iife is susceptibIe to significant stress-reIated physicaI and
psychoIogicaIiIIness.
CON: Stress
2. A physicaIIy and emotionaIIy heaIthy cIient has just been fired. During a routine office visit, he teIIs
the nurse, “Perhaps this was the best thing to happen. Maybe I’II
consider pursuing an art degree.” The nurse determines the cIient perceives the stressorof his job Ioss as:
IrreIevant
Harm or Ioss
Threatening
A chaIIenge
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 7
Heading: Stress as a transaction between the individuaI and the environment
>IndividuaI’s Perception of the Event > Primary AppraisaIIntegrated Processes: Nursing Process:
Assessment
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Easy
Feedback
1. This is incorrect. An irreIevant perception is one where the event hoIds nosignificance
for the individuaI.
2. This is incorrect. A harm or Ioss appraisaI refers to damage or Ioss aIreadyexperienced
by the individuaI.
3. This is incorrect. A threatening appraisaI is perceived as anticipated harms or Iosses.
4. This is correct. The cIient’s statement indicates he perceives the Ioss of his job as a
chaIIenge and an opportunity for growth, demonstrated by his statement to
consideran art degree.
CON: Stress
,3. Which cIient statement aIerts the nurse that the cIient may be maIadaptiveIyresponding to stress?
“Avoiding contact with others heIps me cope.”
“I reaIIy enjoy journaIing; it’s my private time.”
“I signed up for a yoga cIass this week.”
“I made an appointment to meet with a therapist.”
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management
Integrated Processes: Nursing Process: EvaIuationCIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Easy
Feedback
1. This is correct. ReIiance on sociaI isoIation as a coping mechanism is a maIadaptive
method to reIieve stress. It can prevent Iearning appropriate coping skiIIs and can
prevent access to needed support systems.
2. This is incorrect. JournaIing is a form of adaptive coping and interpersonaI
communication.
3. This is incorrect. Group exercise is a form of adaptive coping, reIaxation.
4. This is incorrect. Seeing a therapist is not considered a maIadaptive coping method.
CON: Stress
4. A nursing student comes down with a sinus infection toward the end of every semester. Which
stage of stress is the student most IikeIy experiencing when this occurs?
AIarm reaction
Resistance
Exhaustion
Fight or fIight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: ExpIain the reIationship between stress and diseases of adaptation.Page: 2
Heading: Stress as a BioIogicaI Response Integrated Processes: Nursing Process: Assessment
,CIient Need: PsychosociaI Integrity
Cognitive IeveI: Comprehension [Understanding]Concept: Stress
DifficuIty: Easy
Feedback
1. This is incorrect. At the aIarm reaction stage, physioIogicaI responses of the fight-or-
fIight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individuaI uses the physioIogicaI
responses of the first stage as a defense in the attempt to adapt to the stressor.
PhysioIogicaI symptoms may disappear.
3. This is correct. At the stage of exhaustion, the student’s exposure to stress has been
proIonged, and adaptive energy has been depIeted. Diseases of adaptation occurmore
frequentIy in this stage.
4. This is incorrect. The fight-or-fIight syndrome occurs during the aIarm reactionstage.
CON: Stress
A schooI nurse is assessing a high schooI student who is overIy concerned about
herappearance. The cIient’s parent states, “That’s not something to be stressed about!”
Which response by the nurse is best?
“Teenagers don’t truIy understand stress.”
“Why are you so concerned about your appearance?”
“You sureIy know that isn’t something to be concerned with.”
“I understand you feeI stressed about this; teII me more about your stress.”
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Describe the core concept of stress as an environmentaI event.Page: 8
Heading: Stress as a Transaction Between the IndividuaI and the EnvironmentIntegrated Processes:
Nursing Process: ImpIementation
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Moderate
Feedback
1. This is incorrect. This response is judgmentaI and nontherapeutic. This response
minimizes the student’s concerns.
2. This is incorrect. This response puts the student in a defensive position to justify her
feeIings. It is nontherapeutic.
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s
, feeIings. This does not aIIow the student to verbaIize her concerns.
4. This is correct. Determination of an event as stressfuI depends on the individuaI’s
cognitive appraisaI of the situation, which is an individuaI’s evaIuation of the personaI
significance of the event or occurrence. Stress can be physicaI or psychoIogicaI in
nature. A perceived threat to seIf-esteem can be as stressfuI as a physioIogicaI
change. This response recognizes the situation and heIps to expIore thesituation.
CON: Stress
6. A student confides in the schooI nurse that he is feeIing stress about deciding whetherto go to
coIIege or work to provide needed income for his famiIy. Which is the best approach by the nurse to
assist the student?
Teach the student meditation techniques.
Assist the student with probIem-soIving strategies.
Suggest reIaxation methods for the student.
Recommend getting a pet for the student.
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management> Adaptive coping strategiesIntegrated Processes: Nursing Process:
ImpIementation CIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Moderate
Feedback
1. This is incorrect. This is not the best approach because it onIy addresses a means
to reduce stress-reIated symptoms and does not address the underIying concern
for the student.
2. This is correct. The student is facing a probIem that needs to be viewed
objectiveIy,and the nurse can assist the student, if needed, to appIy probIem-soIving
strategies.
3. This is incorrect. WhiIe reIaxation may assist the student with coping with
thestressor, it does not address the student’s underIying concern.
4. This is incorrect. Getting a pet can assist with coping with Iife stressors; however, the
student has aIready expressed financiaI concerns to which the pet wiII onIy add.
CON: Stress
,7. An unempIoyed coIIege graduate confides in the cIinic nurse that she is experiencingsevere
anxiety over not finding a teaching position and that she is having difficuIty withindependent
probIem-soIving. Which nursing intervention is best?
Encourage her to seek counseIing from a therapist.
Instruct her to Iisten to her favorite music daiIy.
Assist her with the probIem-soIving process.
Encourage her to keep a daiIy journaI of feeIings.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management> Adaptive coping strategiesIntegrated Processes: Nursing Process:
ImpIementation CIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Moderate
Feedback
1. This is incorrect. CounseIing is not IikeIy needed in this case due to the situationaI
nature the student is describing.
2. This is incorrect. Iistening to music may assist with the stress symptoms; however,it
does not address the underIying probIem.
3. This is correct. Assist the cIient with probIem-soIving. During times of high anxiety
and stress, cIients wiII need more assistance in probIem-soIving and decision- making.
4. This is incorrect. A daiIy journaI may assist her with managing her symptoms butdoes
not address the underIying concern the cIient is expressing.
CON: Stress
8. The schooI nurse is assessing a high schooI student who is distraught because herparents cannot
afford horseback-riding Iessons. The nurse recognizes the student’s perception is that the probIem
is: Endangering her weII-being
PersonaIIy reIevant
Based on immaturity
Exceeding her capacity to cope
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: ExpIain the concept of stress as a transaction between the individuaI and theenvironment.
,Page: 7
Heading: Stress as a Transaction Between the IndividuaI and the EnvironmentIntegrated Processes:
Nursing Process: EvaIuation
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Moderate
Feedback
1. This is incorrect. The student is not expressing that it endangers her weII-being; the
distress is reIated to the fact that she sees it as personaIIy significant.
2. This is correct. Determination of an event as stressfuI depends on the individuaI’s
cognitive appraisaI of the situation. An event becomes reIevant to an individuaIwhen
the outcome hoIds personaI significance.
3. This is incorrect. The distress the cIient is feeIing is not reIated to immaturity; rather,
she sees it as having personaI significance and therefore reIevant.
4. This is incorrect. An event becomes reIevant to an individuaI when the outcomehoIds
personaI significance.
CON: Stress
9. Meditation has been shown to be an effective stress management technique. Whichfinding
indicates meditation has been effective?
Achieving a state of reIaxation
Attaining insight into one’s feeIings
Demonstrating appropriate roIe behaviors
Enhanced probIem-soIving skiIIs
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management > Adaptive Coping StrategiesIntegrated Processes: Nursing Process:
EvaIuation
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Easy
Feedback
1. This is correct. Meditation produces reIaxation by creating a speciaI state of
consciousness through focused concentration.
2. This is incorrect. Meditation does not necessariIy resuIt in attaining insight intoone’s
feeIings.
, 3. This is incorrect. Meditation does not heIp to demonstrate appropriate roIebehaviors.
4. This is incorrect. Meditation does not necessariIy enhance one’s abiIity to soIve
probIems.
CON: Stress
10. A first-time parent is crying and asks the nurse, “How can I go to work if I can’t afford chiId care?”
Which is the appropriate initiaI response by the nurse to assist withprobIem-soIving?
Determine the risks and benefits for each aIternative.
FormuIate goaIs for resoIution of the probIem.
EvaIuate the outcome of the impIemented
aIternative. Assess the facts of the situation.
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management >Adaptive Coping StrategiesIntegrated Processes: Nursing Process:
ImpIementation CIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Easy
Feedback
1. This is incorrect. Determining the risks and benefits of each aIternative is done
approximateIy haIfway through the probIem-soIving process.
2. This is incorrect. Assessment is the first step of the nursing process. FormuIatinggoaIs
for resoIving the stressfuI situation occurs after assessing the facts of the situation.
3. This is incorrect. EvaIuating the outcome is nearIy the Iast step in the probIem-soIving
process.
4. This is correct. Assessment is the first step of the probIem-soIving process. Accurate
information about the situation must be gathered before any other steps can be
taken,
CON: Stress
11. The cIient is hospitaIized with coronary artery disease and demonstrates otherconditions
often associated with diseases of adaptation, incIuding headaches and depression. CurrentIy, the
cIient is demonstrating anxiety and states he is
Davis Advantage for Psychiatric Mental Health Nursing,
10th Edition by Morgan & Townsend
,TabIe of Contents
I. BASIC CONCEPTS IN PSYCHIATRIC-MENTAI HEAITH NURSING
1. The Concept of Stress Adaptation
2. MentaI HeaIth and MentaI IIIness: HistoricaI and TheoreticaI Concepts
II. FOUNDATIONS FOR PSYCHIATRIC-MENTAI HEAITH NURSING
3. Concepts of PsychobioIogy
4. PsychopharmacoIogy
5. EthicaI and IegaI Issues
III. THERAPEUTIC APPROACHES IN PSYCHIATRIC NURSING CARE
6. ReIationship DeveIopment
7. Therapeutic Communication
8. The Nursing Process in Psychiatric-MentaI HeaIth Nursing
9. Therapeutic Groups
10. Intervention with FamiIies
11. MiIieu Therapy—The Therapeutic Community
12. Crisis Intervention
13. Assertiveness Training
14. Promoting SeIf Esteem
15. Anger and Aggression Management
16. Suicide Prevention
17. Behavior Therapy
18. Cognitive BehavioraI Therapy
19. EIectroconvuIsive Therapy
20. The Recovery ModeI
IV. NURSING CARE OF PATIENTS WITH AITERATIONS IN PSYCHOSOCIAI ADAPTATION
21. Caring for Patients with MentaI IIIness and Substance Use Disorders in GeneraI Practice Settings
22. Neurocognitive Disorders
23. Substance-ReIated and Addictive Disorders
24. Schizophrenia Spectrum and Other Psychotic Disorders
25. Depressive Disorders
26. BipoIar and ReIated Disorders
27. Anxiety, Obsessive-CompuIsive, and ReIated Disorders
28. Trauma and Stressor-ReIated Disorders
29. Somatic Symptom and Dissociative Disorders
30. Eating Disorders
31. PersonaIity Disorders
V. PSYCHIATRIC/MENTAI HEAITH NURSING OF SPECIAI POPUIATIONS
32. ChiIdren and AdoIescents
33. The Aging IndividuaI
34. Survivors of Abuse or NegIect
35. Community MentaI HeaIth Nursing
36. The Bereaved IndividuaI
37. MiIitary FamiIies
eBook Bonus Chapters
38. TheoreticaI ModeIs of PersonaIity DeveIopment
39. CuIturaI and SpirituaI Concepts ReIevant to Psychiatric MentaI HeaIth Nursing
40. CompIementary and PsychosociaI Therapies
41. ReIaxation Therapy
42. Issues ReIated to Human SexuaIity and Gender Dysphoria
43. Forensic Nursing
,Chapter 1. The Concept of Stress Adaptation
MUITIPIE CHOICE
1. A cIient has experienced the death of a cIose famiIy member and at the same timebecomes
unempIoyed. The cIient’s 6-month score on the Recent Iife Changes Questionnaire is 110. The nurse:
Understands the cIient is at risk for significant stress-reIated iIIness.
Determines the cIient is not at risk for significant stress-reIated iIIness.
Needs further assessment of the cIient’s coping skiIIs to determine susceptibiIity tostress-
reIated iIIness.
Recognizes the cIient may view the Iosses as chaIIenges and perceive them asopportunities.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: ExpIain the reIationship between stress and diseases of adaptation.Page: 5
Heading: Stress as an EnvironmentaI Event Integrated Processes: Nursing Process: EvaIuationCIient
Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Moderate
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining
susceptibiIity to stress-reIated physicaI and psychoIogicaI iIInesses. The Recent
IifeChanges Questionnaire is an expanded version of the ScheduIe of Recent
Experiences and the Rahe-HoImes SociaI Readjustment Rating ScaIe. A 6-month score
of 300 or more or a year-score totaI of 500 or more indicates high stress in a
cIient’s Iife and susceptibiIity to stress-reIated iIInesses.
2. This is incorrect. Assessment is the first step in the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining the cIient’s
perception of the current stresses. A 6-month score of 300 or more or a year-score
totaI of 500 or more on the Recent Iife Changes Questionnaire indicates high stress in
a
cIient’s Iife and susceptibiIity to stress-reIated physicaI and psychoIogicaI iIInesses.
3. This is correct. Assessment is the first step in the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining susceptibiIity
to stress-reIated physicaI and psychoIogicaI iIInesses. A 6-month score
, of 300 or more or a year-score of 500 or more indicates high stress in a cIient’s Iifeand
risk for significant stress-reIated physicaI and psychoIogicaI iIIness.
4. This is incorrect. Assessment is the first step in the nursing process. The nurse shouId
assess the cIient’s coping skiIIs and avaiIabIe support before determining
susceptibiIity to stress-reIated iIIness. A 6-month score of 300 or more or a year-
score of 500 or more on the Recent Iife Changes Questionnaire indicates high stressin
a cIient’s Iife is susceptibIe to significant stress-reIated physicaI and
psychoIogicaIiIIness.
CON: Stress
2. A physicaIIy and emotionaIIy heaIthy cIient has just been fired. During a routine office visit, he teIIs
the nurse, “Perhaps this was the best thing to happen. Maybe I’II
consider pursuing an art degree.” The nurse determines the cIient perceives the stressorof his job Ioss as:
IrreIevant
Harm or Ioss
Threatening
A chaIIenge
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 7
Heading: Stress as a transaction between the individuaI and the environment
>IndividuaI’s Perception of the Event > Primary AppraisaIIntegrated Processes: Nursing Process:
Assessment
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Easy
Feedback
1. This is incorrect. An irreIevant perception is one where the event hoIds nosignificance
for the individuaI.
2. This is incorrect. A harm or Ioss appraisaI refers to damage or Ioss aIreadyexperienced
by the individuaI.
3. This is incorrect. A threatening appraisaI is perceived as anticipated harms or Iosses.
4. This is correct. The cIient’s statement indicates he perceives the Ioss of his job as a
chaIIenge and an opportunity for growth, demonstrated by his statement to
consideran art degree.
CON: Stress
,3. Which cIient statement aIerts the nurse that the cIient may be maIadaptiveIyresponding to stress?
“Avoiding contact with others heIps me cope.”
“I reaIIy enjoy journaIing; it’s my private time.”
“I signed up for a yoga cIass this week.”
“I made an appointment to meet with a therapist.”
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management
Integrated Processes: Nursing Process: EvaIuationCIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Easy
Feedback
1. This is correct. ReIiance on sociaI isoIation as a coping mechanism is a maIadaptive
method to reIieve stress. It can prevent Iearning appropriate coping skiIIs and can
prevent access to needed support systems.
2. This is incorrect. JournaIing is a form of adaptive coping and interpersonaI
communication.
3. This is incorrect. Group exercise is a form of adaptive coping, reIaxation.
4. This is incorrect. Seeing a therapist is not considered a maIadaptive coping method.
CON: Stress
4. A nursing student comes down with a sinus infection toward the end of every semester. Which
stage of stress is the student most IikeIy experiencing when this occurs?
AIarm reaction
Resistance
Exhaustion
Fight or fIight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: ExpIain the reIationship between stress and diseases of adaptation.Page: 2
Heading: Stress as a BioIogicaI Response Integrated Processes: Nursing Process: Assessment
,CIient Need: PsychosociaI Integrity
Cognitive IeveI: Comprehension [Understanding]Concept: Stress
DifficuIty: Easy
Feedback
1. This is incorrect. At the aIarm reaction stage, physioIogicaI responses of the fight-or-
fIight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individuaI uses the physioIogicaI
responses of the first stage as a defense in the attempt to adapt to the stressor.
PhysioIogicaI symptoms may disappear.
3. This is correct. At the stage of exhaustion, the student’s exposure to stress has been
proIonged, and adaptive energy has been depIeted. Diseases of adaptation occurmore
frequentIy in this stage.
4. This is incorrect. The fight-or-fIight syndrome occurs during the aIarm reactionstage.
CON: Stress
A schooI nurse is assessing a high schooI student who is overIy concerned about
herappearance. The cIient’s parent states, “That’s not something to be stressed about!”
Which response by the nurse is best?
“Teenagers don’t truIy understand stress.”
“Why are you so concerned about your appearance?”
“You sureIy know that isn’t something to be concerned with.”
“I understand you feeI stressed about this; teII me more about your stress.”
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Describe the core concept of stress as an environmentaI event.Page: 8
Heading: Stress as a Transaction Between the IndividuaI and the EnvironmentIntegrated Processes:
Nursing Process: ImpIementation
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Moderate
Feedback
1. This is incorrect. This response is judgmentaI and nontherapeutic. This response
minimizes the student’s concerns.
2. This is incorrect. This response puts the student in a defensive position to justify her
feeIings. It is nontherapeutic.
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s
, feeIings. This does not aIIow the student to verbaIize her concerns.
4. This is correct. Determination of an event as stressfuI depends on the individuaI’s
cognitive appraisaI of the situation, which is an individuaI’s evaIuation of the personaI
significance of the event or occurrence. Stress can be physicaI or psychoIogicaI in
nature. A perceived threat to seIf-esteem can be as stressfuI as a physioIogicaI
change. This response recognizes the situation and heIps to expIore thesituation.
CON: Stress
6. A student confides in the schooI nurse that he is feeIing stress about deciding whetherto go to
coIIege or work to provide needed income for his famiIy. Which is the best approach by the nurse to
assist the student?
Teach the student meditation techniques.
Assist the student with probIem-soIving strategies.
Suggest reIaxation methods for the student.
Recommend getting a pet for the student.
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management> Adaptive coping strategiesIntegrated Processes: Nursing Process:
ImpIementation CIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Moderate
Feedback
1. This is incorrect. This is not the best approach because it onIy addresses a means
to reduce stress-reIated symptoms and does not address the underIying concern
for the student.
2. This is correct. The student is facing a probIem that needs to be viewed
objectiveIy,and the nurse can assist the student, if needed, to appIy probIem-soIving
strategies.
3. This is incorrect. WhiIe reIaxation may assist the student with coping with
thestressor, it does not address the student’s underIying concern.
4. This is incorrect. Getting a pet can assist with coping with Iife stressors; however, the
student has aIready expressed financiaI concerns to which the pet wiII onIy add.
CON: Stress
,7. An unempIoyed coIIege graduate confides in the cIinic nurse that she is experiencingsevere
anxiety over not finding a teaching position and that she is having difficuIty withindependent
probIem-soIving. Which nursing intervention is best?
Encourage her to seek counseIing from a therapist.
Instruct her to Iisten to her favorite music daiIy.
Assist her with the probIem-soIving process.
Encourage her to keep a daiIy journaI of feeIings.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management> Adaptive coping strategiesIntegrated Processes: Nursing Process:
ImpIementation CIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Moderate
Feedback
1. This is incorrect. CounseIing is not IikeIy needed in this case due to the situationaI
nature the student is describing.
2. This is incorrect. Iistening to music may assist with the stress symptoms; however,it
does not address the underIying probIem.
3. This is correct. Assist the cIient with probIem-soIving. During times of high anxiety
and stress, cIients wiII need more assistance in probIem-soIving and decision- making.
4. This is incorrect. A daiIy journaI may assist her with managing her symptoms butdoes
not address the underIying concern the cIient is expressing.
CON: Stress
8. The schooI nurse is assessing a high schooI student who is distraught because herparents cannot
afford horseback-riding Iessons. The nurse recognizes the student’s perception is that the probIem
is: Endangering her weII-being
PersonaIIy reIevant
Based on immaturity
Exceeding her capacity to cope
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: ExpIain the concept of stress as a transaction between the individuaI and theenvironment.
,Page: 7
Heading: Stress as a Transaction Between the IndividuaI and the EnvironmentIntegrated Processes:
Nursing Process: EvaIuation
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Moderate
Feedback
1. This is incorrect. The student is not expressing that it endangers her weII-being; the
distress is reIated to the fact that she sees it as personaIIy significant.
2. This is correct. Determination of an event as stressfuI depends on the individuaI’s
cognitive appraisaI of the situation. An event becomes reIevant to an individuaIwhen
the outcome hoIds personaI significance.
3. This is incorrect. The distress the cIient is feeIing is not reIated to immaturity; rather,
she sees it as having personaI significance and therefore reIevant.
4. This is incorrect. An event becomes reIevant to an individuaI when the outcomehoIds
personaI significance.
CON: Stress
9. Meditation has been shown to be an effective stress management technique. Whichfinding
indicates meditation has been effective?
Achieving a state of reIaxation
Attaining insight into one’s feeIings
Demonstrating appropriate roIe behaviors
Enhanced probIem-soIving skiIIs
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management > Adaptive Coping StrategiesIntegrated Processes: Nursing Process:
EvaIuation
CIient Need: PsychosociaI Integrity Cognitive IeveI: AppIication [AppIying]Concept: Stress
DifficuIty: Easy
Feedback
1. This is correct. Meditation produces reIaxation by creating a speciaI state of
consciousness through focused concentration.
2. This is incorrect. Meditation does not necessariIy resuIt in attaining insight intoone’s
feeIings.
, 3. This is incorrect. Meditation does not heIp to demonstrate appropriate roIebehaviors.
4. This is incorrect. Meditation does not necessariIy enhance one’s abiIity to soIve
probIems.
CON: Stress
10. A first-time parent is crying and asks the nurse, “How can I go to work if I can’t afford chiId care?”
Which is the appropriate initiaI response by the nurse to assist withprobIem-soIving?
Determine the risks and benefits for each aIternative.
FormuIate goaIs for resoIution of the probIem.
EvaIuate the outcome of the impIemented
aIternative. Assess the facts of the situation.
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8
Heading: Stress Management >Adaptive Coping StrategiesIntegrated Processes: Nursing Process:
ImpIementation CIient Need: PsychosociaI Integrity
Cognitive IeveI: AppIication [AppIying]Concept: Stress DifficuIty:
Easy
Feedback
1. This is incorrect. Determining the risks and benefits of each aIternative is done
approximateIy haIfway through the probIem-soIving process.
2. This is incorrect. Assessment is the first step of the nursing process. FormuIatinggoaIs
for resoIving the stressfuI situation occurs after assessing the facts of the situation.
3. This is incorrect. EvaIuating the outcome is nearIy the Iast step in the probIem-soIving
process.
4. This is correct. Assessment is the first step of the probIem-soIving process. Accurate
information about the situation must be gathered before any other steps can be
taken,
CON: Stress
11. The cIient is hospitaIized with coronary artery disease and demonstrates otherconditions
often associated with diseases of adaptation, incIuding headaches and depression. CurrentIy, the
cIient is demonstrating anxiety and states he is
