Chapter 37 Stress and Coping-Fundamentals of Nursing

Chapter 37: Stress and Coping
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MULTIPLE CHOICE ra




1.
In a natural disaster relief facility, the nursing attendant observes that an olderadult male has a re
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covery plan, while a 25- ra ra ra ra



yearold male is still overwhelmed by the disaster situation. A nursing attendant is planning care
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for both hospital client s. Which factors will the nursing attendant consider about the diff
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erent coping reactions? ra ra




a. Restorative care factors ra ra




b. Strong financial resource factors ra ra ra




c. Maturational and situational factors ra ra ra




d. Immaturity and intelligence factors ra ra ra




ACCURATE ar



ANSWER:-C
Maturational factors and situational factors can affect people differently depending on their
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life experiences. An older individual would have more life experiences to draw from and to a
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nalyze on why he was successful, whereas a younger individual would have fewer life experi
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ences based on chronological age to analyze for patterns of previous success. Nothing in the s
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cenario implies that either man is in restorative care, has strong financial resources, or is imma
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ture or intelligent. ra ra




DIF:Apply (application) ra



OBJ:Discuss the integration of stress theory with nursing theories. ra ra ra ra ra ra ra ra ar



TOP:Planning MSC: Psychosocial Integrity ra ra




2. A woman who was sexually assaulted a month ago presents to the emergency departme
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nt with ra ar



reports of recurrent nightmares, fear of going to sleep, repeated vivid memories of the se
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xual a ra



ssault, and inability to feel much emotion. Which medical problem will the nursing atte
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ndant expect to see documented in the chart?
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a. General adaptation syndrome (GAS) ra ra ra




b. Posttraumatic stress disorder (PTSD) ra ra ra




c. Acute stress disorder ra ra




d. Alarm reaction ra




ACCURATE ANSWER:-B ra



Posttraumatic stress disorder is characterized by vivid recollections of the traumatic event and
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emotional detachment and often is accompanied by nightmares. General adaptation syndrome
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is the expected reaction to a major stressor. Acute stress disorder is a similar diagnosis that di
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ffers from PTSD in duration of symptoms. Alarm reaction involves physiological events such
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as increased activation of the sympathetic nervous system that would have occurred at the ti
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me of the sexual assault.
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DIF:Apply (application) ra

, OBJ:Summarize characteristics of post-traumatic stress disorder. ra ra ra ra ra



TOP:Communication and Documentation MSC: Psychosocial Integrity ra ra ra ra




3. The nursing attendant teaches stressreduction and relaxation training to a health educ
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ation group of hospital client sra ra ra ra ra ra



after cardiac bypass surgery. Which level of intervention is the nursing attendan
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t using?
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a. Primary
b. Secondary
c. Tertiary
d. Quad
ACCURATE ANSWER:-C ra



Tertiary-
level interventions assist the hospital client in readapting and can include relaxation training an
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d timemanagement training. At the primary level of prevention, you direct nursing activities to id
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entifyi ng individuals and populations who are possibly at risk for stress.
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Nursing interventions at the secondary level include actions directed at symptoms such as prote
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cti ng the hospital client from self-harm. Quad level does not exist.
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DIF:Understand (comprehension) ra



OBJ:Discuss the integration of stress theory with nursing theories ra ra ra ra ra ra ra ra



. TOP:Implementation
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4. A nursing attendant is teaching guided imagery to a prenatal class. Which techniq
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u e did the nursing attendant describe? a. Singing
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b. Massaging back ra




c. Listening to music ra ra




d. Visualizing peaceful settings ra ra




ACCURATE ANSWER:-D ra



Guided imagery is used as a means to create a relaxed state through the person’s imagination. Im
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agi
nation allows the person to create a soothing and peaceful environment. Singing, back massage, a
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nd listening to music are other types of stress management techniques.
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DIF:Understand (comprehension) ra



OBJ:Use clinical judgment to choose stressmanagement techniques that help individuals effectively c
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ope with stress. ra ra



TOP:Teaching/Learning MSC: Psychosocial Integrity ra ra




5. After a natural disaster occurred, an emergency worker referred a family for crisis i
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ntervention s ar




ervices. One family member refused to attend the services, stating, ―No way, I’m n
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ot crazy.‖ W hat is the nursing attendant ’s best response?
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a. ―Many times, disasters can create mental health problems, so you really should p
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articipate with your family.‖ ra ra ra




b. ―Seeking this kind of help does not mean that you have a mental illness; it is a sh ort-
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term problem-solving technique.‖ ra ra




c. ―Don’t worry now. The psychiatrists are well trained to help.‖ ra ar ra ra ra ra ra ra ra




d. ―This will help your family communicate better.‖ ra ra ra ra ra ra

, ACCURATE ANSWER:-B ra



Crisis intervention is a type of brief therapy that is more directive than traditional psychothe
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rapy or counseling. It focuses on problem solving and involves only the problem created by th
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e crisis. The other options do not properly reassure the hospital client and build trust. Giving a
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dvice in the form of ―you really should participate‖ is inappropriate. ―Don’t worry now‖ is fa
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lse reassurance. While crisis intervention may help families communicate better, the goal is t
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o return to precrisis level of functioning; family therapy will focus on helping families commu
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nicate better. ra




DIF:Analyze (analysis) ra



OBJ:Discuss the process of crisis intervention. TO ra ra ra ra ra ra



P:Communication and Documentation ra ra MSC: Psychosocial Integrity ra ra




6. A preadolescent hospital client
ra is experiencing maturational stress. Which area will th ra ra r a ra ra ra ra ra ra ra



e nursing attendant focus on when planning care? a. Identity issues
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b. Self-esteem issues ra



c. Physical appearance ra




d. Major changing life events ra ra ra




ACCURATE ANSWER:-B ra



Preadolescents experience stress related to selfesteem issues, changing family structure as a resul ra ra ra ra ra ra ra ra ra ra ra ra



t of divorce or death of a parent, or hospitali
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zations. Adolescent stressors include identity issues with peer groups and separation from th
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eir families. Children identify stressors related to physical appearance, families, friends, and s
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chool. Adult stressors centralize around major changes in life circumstances.
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DIF:Apply (application) ra



OBJ:Discuss the integration of stress theory with nursing theories. ra ra ra ra ra ra ra ra ar



TOP:Planning MSC: Psychosocial Integrity ra ra




7. A nursing attendant is caring for a hospital client experiencing stress and is in the evaluatio
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n stage of the critical thinking model. Which actions will the nursing attendant take? a.
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Select nursing interventions and promote hospital client ’s adaptation to stress.
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b. Establish short- and long-term goals with the hospital client experiencing stress. ra ra ra ra ra ra ra ra r a ra




c. Identify stress management interventions and achieve expected outcomes. ra ra ra ra ra ra ra




d. Reassess hospital client ’s stress-related symptoms and compare with expected outcomes.
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ACCURATE ANSWER:-D ra



During the evaluation stage, the nursing attendant compares current stressrelated symptoms aga
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inst established measurable outcomes to evaluate the effectiveness of th e intervention.
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Selecting appropriate interventions and establishing goals are part of the planning process.
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DIF:Apply (application) ra



OBJ:Develop a care plan for hospital client s who are ra ra ra ra ra ra ra ra ra ar



experiencing stress. TOP:Implementation MSC: ra ra



Psychosocial Integrity ra




8. An adult male reports new-
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onset, seizurelike activity. An EEG and a neurology consultant’s report rule out a seizure di
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sorder. It is det ra ra ra



ermined the hospital client is using conversion. Which action should the nursing attendant
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take next?
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