Townsend (9th Edition, 2017)
TEST BANK q w
,Chapter 01. The Concept of Stress Adaptation
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Multiple Choice qw
1. A client has experienced the death of a close family member and at the same time becomes unem
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ployed. This situation has resulted in a 6-
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month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this cli
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ent data? qw
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
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B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant t
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hreat of stress-related illness.
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C. Susceptibility to stress- qw qw
related physical or psychological illness cannot be estimated without knowledge of coping resources an
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d available supports.
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D. The client may view these losses as challenges and perceive them as opportunities.
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ANS: C qw
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences an
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d the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-
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score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms
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and strong social support can limit susceptibility to stress-related illnesses.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
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Psychosocial Integrity qw
2. A physically and emotionally healthy client has just been fired. During a routine office visit he stat
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es to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree.
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How should the qw qw
NURSINGTB.COM
nurse characterize the clients appraisal of job loss stressor?
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wthe
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D qw
The client perceives the situation of job loss as a challenge and an opportunity for growth.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
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Psychosocial Integrity qw
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
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A. Ive found that avoiding contact with others helps me cope.
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B. I really enjoy journaling; its my private time.
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C. I signed up for a yoga class this week.
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D. I made an appointment to meet with a therapist.
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ANS: A qw
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can p
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,revent learning appropriate coping skills and can prevent access to needed support systems.
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, KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
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Psychosocial Integrity qw
4. A nursing student finds that she comes down with a sinus infection toward the end of every semester
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. When this occurs, which stage of stress is the student most likely experiencing?
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A. Alarm reaction stage qw qw
B. Stage of resistance qw qw
C. Stage of exhaustion qw qw
D. Fight-or-flight stage qw
ANS: C qw
At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy ha
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s been depleted. Diseases of adaptation occur more frequently in this stage.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
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Psychosocial Integrity qw
5. A school nurse is assessing a female high school student who is overly concerned about her appearan
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ce. The clients mother states, Thats not something to be stressed about! Which is the most approp
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riate nursing response?
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A. Teenagers! They dont know a thing about real stress.
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B. Stress occurs only when there is a loss.
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C. When you are in poor physical condition, yNoU
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ncMe psychological well-being.
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D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
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ANS: D qw
Stress can be physical or psychological in nature. A perceived threat to self-
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esteem can be as stressful as a physiological change.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Nee
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d:
Psychosocial Integrity qw
6. A bright student confides in the school nurse about conflicts related to attending college or working
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to add needed financial support to the family. Which coping strategy is most appropriate for the nurse
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to recommend to the student at this time?
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A. Meditation
B. Problem-solving training qw
C. Relaxation
D. Journaling
ANS: B qw
The student must assess his or her situation and determine the best course of action. Problem-
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solving training, by providing structure and objectivity, can assist in decision making.
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KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Nee
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d:
Psychosocial Integrity qw