,
,Chapter 1. The Concept of Stress Adaptation
n n n n n n
MULTIPLE CHOICE n
1. A client has experienced the death of a close family member and at the same timebecomes unemploy
n n n n n n n n n n n n n n n n
ed. The client’s 6-
n n n
month score on the Recent Life Changes Questionnaire is 110. The nurse: Understands the client is at r
n n n n n n n n n n n n n n n n n
isk for significant stress-related illness.
n n n n
Determines the client is not at risk for significant stress-related illness.
n n n n n n n n n n
Needs further assessment of the client’s coping skills to determine susceptibility tostress-
n n n n n n n n n n n
related illness. n
Recognizes the client may view the losses as challenges and perceive them asopportunities.
n n n n n n n n n n n n
ANS: 3 n
Chapter: Chapter 1, The Concept of Stress Adaptation
n n n n n n n
Objective: Explain the relationship between stress and diseases of adaptation.Page: 5
n n n n n n n n n n
Heading: Stress as an Environmental Event Integrated Processes: Nursing Process: EvaluationClient Need:
n n n n n n n n n n n
nPsychosocial Integrity n
Cognitive Level: Application [Applying]Concept: Stress Difficulty
n n n n n
: Moderate
n
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse should ass
n n n n n n n n n n n n n n n
ess the client’s coping skills and available support before determining susceptibility to str
n n n n n n n n n n n n
ess-
related physical and psychological illnesses. The Recent LifeChanges Questionnaire is a
n n n n n n n n n n
n expanded version of the Schedule of Recent Experiences and the Rahe-
n n n n n n n n n n n
Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more or a year-
n n n n n n n n n n n n n n
score total of 500 or more indicates high stress in a
n n n n n n n n n n
client’s life and susceptibility to stress-related illnesses.
n n n n n n
2. This is incorrect. Assessment is the first step in the nursing process. The nurse should asse
n n n n n n n n n n n n n n n
ss the client’s coping skills and available support before determining the client’s percepti
n n n n n n n n n n n n
on of the current stresses. A 6-month score of 300 or more or a year-
n n n n n n n n n n n n n n
score total of 500 or more on the Recent Life Changes Questionnaire indicates high stress
n n n n n n n n n n n n n n n
in a client’s life and susceptibility to stress-related physical and psychological illnesses.
n n n n n n n n n n n
3. This is correct. Assessment is the first step in the nursing process. The nurse should assess
n n n n n n n n n n n n n n n
nthe client’s coping skills and available support before determining susceptibility
n n n n n n n n n
to stress-related physical and psychological illnesses. A 6-month score
n n n n n n n n
, of 300 or more or a year-score of 500 or more indicates high stress in a client’s lifeand
n n n n n n n n n n n n n n n n n
risk for significant stress-related physical and psychological illness.
n n n n n n n
4. This is incorrect. Assessment is the first step in the nursing process. The nurse should ass
n n n n n n n n n n n n n n n
ess the client’s coping skills and available support before determining susceptibility to str
n n n n n n n n n n n n
ess-related illness. A 6-month score of 300 or more or a year- n n n n n n n n n n n
score of 500 or more on the Recent Life Changes Questionnaire indicates high stressin a
n n n n n n n n n n n n n n n n
client’s life is susceptible to significant stress-related physical and psychologicalillness.
n n n n n n n n n
CON: Stress n
2. A physically and emotionally healthy client has just been fired. During a routine office visit, he tells th
n n n n n n n n n n n n n n n n n
e nurse, “Perhaps this was the best thing to happen. Maybe I’ll
n n n n n n n n n n n
consider pursuing an art degree.” The nurse determines the client perceives the stressorof his job loss as:
n n n n n n n n n n n n n n n n
Irrelevant H n
arm or loss Tn n n
hreatening A n
nchallenge
ANS: 4 n
Chapter: Chapter 1, The Concept of Stress Adaptation
n n n n n n n
Objective: Discuss adaptive coping strategies in the management of stress.Page: 7Heading: Stre
n n n n n n n n n n n
ss as a transaction between the individual and the environment
n n n n n n n n n
>Individual’s Perception of the Event > Primary AppraisalIntegrated Processes: Nursing Process: Assessm
n n n n n n n n n n n
ent
Client Need: Psychosocial Integrity Cognitive Level: Application [Applying]Concept: Stress D
n n n n n n n n n
ifficulty: Easy n
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds nosignificance
n n n n n n n n n n n n
for the individual. n n
2. This is incorrect. A harm or loss appraisal refers to damage or loss alreadyexperienced
n n n n n n n n n n n n n
by the individual.
n n
3. This is incorrect. A threatening appraisal is perceived as anticipated harms or losses.
n n n n n n n n n n n n
4. This is correct. The client’s statement indicates he perceives the loss of his job as a challe
n n n n n n n n n n n n n n n n
nge and an opportunity for growth, demonstrated by his statement to consideran
n n n n n n n n n n n
art degree. n
CON: Stress n
3. Which client statement alerts the nurse that the client may be maladaptivelyresponding to stress?
n n n n n n n n n n n n n
“Avoiding contact with others helps me cope.” “I n n n n n n n n
really enjoy journaling; it’s my private time.” “I si
n n n n n n n n
gned up for a yoga class this week.”
n n n n n n n
“I made an appointment to meet with a therapist.”
n n n n n n n n
ANS: 1 n
Chapter: Chapter 1, The Concept of Stress Adaptation
n n n n n n n
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8Heading: Stre
n n n n n n n n n n n
ss Management
n
Integrated Processes: Nursing Process: EvaluationClient Need: Psychosocial Integrity Cognitiv
n n n n n n n n
e Level: Application [Applying]Concept: Stress
n n n n
Difficulty: Easy n
,Chapter 1. The Concept of Stress Adaptation
n n n n n n
MULTIPLE CHOICE n
1. A client has experienced the death of a close family member and at the same timebecomes unemploy
n n n n n n n n n n n n n n n n
ed. The client’s 6-
n n n
month score on the Recent Life Changes Questionnaire is 110. The nurse: Understands the client is at r
n n n n n n n n n n n n n n n n n
isk for significant stress-related illness.
n n n n
Determines the client is not at risk for significant stress-related illness.
n n n n n n n n n n
Needs further assessment of the client’s coping skills to determine susceptibility tostress-
n n n n n n n n n n n
related illness. n
Recognizes the client may view the losses as challenges and perceive them asopportunities.
n n n n n n n n n n n n
ANS: 3 n
Chapter: Chapter 1, The Concept of Stress Adaptation
n n n n n n n
Objective: Explain the relationship between stress and diseases of adaptation.Page: 5
n n n n n n n n n n
Heading: Stress as an Environmental Event Integrated Processes: Nursing Process: EvaluationClient Need:
n n n n n n n n n n n
nPsychosocial Integrity n
Cognitive Level: Application [Applying]Concept: Stress Difficulty
n n n n n
: Moderate
n
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse should ass
n n n n n n n n n n n n n n n
ess the client’s coping skills and available support before determining susceptibility to str
n n n n n n n n n n n n
ess-
related physical and psychological illnesses. The Recent LifeChanges Questionnaire is a
n n n n n n n n n n
n expanded version of the Schedule of Recent Experiences and the Rahe-
n n n n n n n n n n n
Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more or a year-
n n n n n n n n n n n n n n
score total of 500 or more indicates high stress in a
n n n n n n n n n n
client’s life and susceptibility to stress-related illnesses.
n n n n n n
2. This is incorrect. Assessment is the first step in the nursing process. The nurse should asse
n n n n n n n n n n n n n n n
ss the client’s coping skills and available support before determining the client’s percepti
n n n n n n n n n n n n
on of the current stresses. A 6-month score of 300 or more or a year-
n n n n n n n n n n n n n n
score total of 500 or more on the Recent Life Changes Questionnaire indicates high stress
n n n n n n n n n n n n n n n
in a client’s life and susceptibility to stress-related physical and psychological illnesses.
n n n n n n n n n n n
3. This is correct. Assessment is the first step in the nursing process. The nurse should assess
n n n n n n n n n n n n n n n
nthe client’s coping skills and available support before determining susceptibility
n n n n n n n n n
to stress-related physical and psychological illnesses. A 6-month score
n n n n n n n n
, of 300 or more or a year-score of 500 or more indicates high stress in a client’s lifeand
n n n n n n n n n n n n n n n n n
risk for significant stress-related physical and psychological illness.
n n n n n n n
4. This is incorrect. Assessment is the first step in the nursing process. The nurse should ass
n n n n n n n n n n n n n n n
ess the client’s coping skills and available support before determining susceptibility to str
n n n n n n n n n n n n
ess-related illness. A 6-month score of 300 or more or a year- n n n n n n n n n n n
score of 500 or more on the Recent Life Changes Questionnaire indicates high stressin a
n n n n n n n n n n n n n n n n
client’s life is susceptible to significant stress-related physical and psychologicalillness.
n n n n n n n n n
CON: Stress n
2. A physically and emotionally healthy client has just been fired. During a routine office visit, he tells th
n n n n n n n n n n n n n n n n n
e nurse, “Perhaps this was the best thing to happen. Maybe I’ll
n n n n n n n n n n n
consider pursuing an art degree.” The nurse determines the client perceives the stressorof his job loss as:
n n n n n n n n n n n n n n n n
Irrelevant H n
arm or loss Tn n n
hreatening A n
nchallenge
ANS: 4 n
Chapter: Chapter 1, The Concept of Stress Adaptation
n n n n n n n
Objective: Discuss adaptive coping strategies in the management of stress.Page: 7Heading: Stre
n n n n n n n n n n n
ss as a transaction between the individual and the environment
n n n n n n n n n
>Individual’s Perception of the Event > Primary AppraisalIntegrated Processes: Nursing Process: Assessm
n n n n n n n n n n n
ent
Client Need: Psychosocial Integrity Cognitive Level: Application [Applying]Concept: Stress D
n n n n n n n n n
ifficulty: Easy n
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds nosignificance
n n n n n n n n n n n n
for the individual. n n
2. This is incorrect. A harm or loss appraisal refers to damage or loss alreadyexperienced
n n n n n n n n n n n n n
by the individual.
n n
3. This is incorrect. A threatening appraisal is perceived as anticipated harms or losses.
n n n n n n n n n n n n
4. This is correct. The client’s statement indicates he perceives the loss of his job as a challe
n n n n n n n n n n n n n n n n
nge and an opportunity for growth, demonstrated by his statement to consideran
n n n n n n n n n n n
art degree. n
CON: Stress n
3. Which client statement alerts the nurse that the client may be maladaptivelyresponding to stress?
n n n n n n n n n n n n n
“Avoiding contact with others helps me cope.” “I n n n n n n n n
really enjoy journaling; it’s my private time.” “I si
n n n n n n n n
gned up for a yoga class this week.”
n n n n n n n
“I made an appointment to meet with a therapist.”
n n n n n n n n
ANS: 1 n
Chapter: Chapter 1, The Concept of Stress Adaptation
n n n n n n n
Objective: Discuss adaptive coping strategies in the management of stress.Page: 8Heading: Stre
n n n n n n n n n n n
ss Management
n
Integrated Processes: Nursing Process: EvaluationClient Need: Psychosocial Integrity Cognitiv
n n n n n n n n
e Level: Application [Applying]Concept: Stress
n n n n
Difficulty: Easy n
