lOMoAR cPSD| 22896205
TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING
BY MARY TOWNSEND 9TH EDITION, TEST BANK.
pg. 0
, TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITION, TEST
BANK.
Testbank for Psychiatric Mental Health Nursing by Mary Townsend 9th Edition, Test
bank.
Ch 1. Concepts of Stress Adaptation
1.A client has experienced the death of a close family member and at the same time becomes
unemployed. This situation has resulted in a 6-month score of 110 on the Miller and Rahe
Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no
significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without
knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
Correct Answer:
C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent
Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or
more, or a year-score total of 500 or more, indicates high stress in a client's life. However,
positive coping mechanisms and strong social support can limit susceptibility to stress-related
illnesses.
2. A physically and emotionally healthy client has just been fired. During a routine office visit he
states to a nurse: "Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art
degree." How should the nurse characterize the client's appraisal of the job loss stressor? A.
Irrelevant
B. Harm/loss
C. Threatening
D. Challenging Correct Answer: D The client perceives the situation of job loss as a
challenge and an opportunity for growth.
3. Which client statement should alert a nurse that a client may be responding maladaptively to
stress?
A. "I've found that avoiding contact with others helps me cope."
B. "I really enjoy journaling; it's my private time."
C. "I signed up for a yoga class this week."
D. "I made an appointment to meet with a therapist." Correct Answer: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It
can prevent learning appropriate coping skills and can prevent access to needed support systems.
4. A nursing student finds that she comes down with a sinus infection toward the end of every
semester. When this occurs which stage of stress is the student most likely experiencing?
pg. 1
, TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITION, TEST
BANK.
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage Correct Answer: C
At the stage of exhaustion, the student's exposure to stress has been prolonged and adaptive
energy has been depleted. Diseases of adaptation occur more frequently in this stage.
5. A school nurse is assessing a female high school student who is overly concerned about her
appearance. The client's mother states, "That's not something to be stressed about!" Which is the
most appropriate nursing response?
A. "Teenagers! They don't know a thing about real stress."
B. "Stress occurs only when there is a loss."
C. "When you are in poor physical condition, you can't experience psychological well-being." D.
"Stress can be psychological. A threat to self-esteem may result in high stress levels."
Correct Answer:
D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as
stressful as a physiological change.
6. A bright student confides in the school nurse about conflicts related to attending college, or
working to add needed financial support to the family. Which coping strategy is most
appropriate for the nurse to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling Correct Answer: B
The student must assess his situation and determine the best course of action. Problem-solving
training, by providing structure and objectivity, can assist in his decision making.
7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching
position and has difficulty with independent problem solving. During a routine physical
examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing
intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
B. Complete the problem-solving process for the client.
C. Work through the problem-solving process with the client.
D. Encourage the client to keep a journal. Correct Answer: C
During times of high anxiety and stress, clients will need more assistance in problem solving and
decision making.
8. A school nurse is assessing a distraught female high school student who is overly concerned
because her parents can't afford horseback riding lessons. How should the nurse interpret the
student's reaction to her perceived problem?
A. The problem is endangering her well-being.
pg. 2
, TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITION, TEST
BANK.
B. The problem is personally relevant to her.
C. The problem is based on immaturity.
D. The problem is exceeding her capacity to cope. Correct Answer: B
Psychological stressors to self-esteem and self-image are related to how the individual perceives
the situation or event. Self-image is particularly important to adolescents who feel entitled to
have all the advantages that other adolescents experience.
9. Meditation has been shown to be an effective stress management technique. When meditation
is effective, what should a nurse expect to assess?
A. An achieved state of relaxation
B. An achieved insight into one's feelings
C. A demonstration of appropriate role behaviors
D. An enhanced ability to problem solve Correct
Answer: A
Meditation produces relaxation by creating a special state of consciousness through focused
concentration.
10. A distraught, single, first-time mother cries and says to a nurse, "How can I go to work if I
can't afford childcare!" What is the nurse's initial action in assisting the client with the
problemsolving process?
A. Determine the risks and benefits for each alternative
B. Formulate goals for resolution of the problem
C. Evaluate the outcome of the implemented alternative
D. Assess the facts of the situation Correct Answer: D
Before any other steps can be taken, accurate information about the situation must be gathered
and assessed.
11. A nursing instructor is teaching about diseases of adaptation and when they are likely to
occur. When questioned about situations that precipitate these diseases, which student statement
indicates that learning has occurred?
A. "When an individual has limited experience dealing with stress"
B. "When an individual inherits maladaptive genes"
C. "When an individual experiences existing conditions that exacerbate stress"
D. "When an individual's physiological and psychological resources have become depleted"
Correct Answer: D
During the stage of exhaustion of the general adaptation syndrome, the individual loses the
capacity to adapt effectively because physiological and psychological resources have become
depleted. This is the time when diseases of adaptation may occur.
12. When an individual's stress response is sustained over a long period of time, which
physiological effect of the endocrine system should a nurse anticipate?
A. Decreased resistance to disease
B. Increased libido
pg. 3
TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING
BY MARY TOWNSEND 9TH EDITION, TEST BANK.
pg. 0
, TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITION, TEST
BANK.
Testbank for Psychiatric Mental Health Nursing by Mary Townsend 9th Edition, Test
bank.
Ch 1. Concepts of Stress Adaptation
1.A client has experienced the death of a close family member and at the same time becomes
unemployed. This situation has resulted in a 6-month score of 110 on the Miller and Rahe
Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no
significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without
knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
Correct Answer:
C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent
Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or
more, or a year-score total of 500 or more, indicates high stress in a client's life. However,
positive coping mechanisms and strong social support can limit susceptibility to stress-related
illnesses.
2. A physically and emotionally healthy client has just been fired. During a routine office visit he
states to a nurse: "Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art
degree." How should the nurse characterize the client's appraisal of the job loss stressor? A.
Irrelevant
B. Harm/loss
C. Threatening
D. Challenging Correct Answer: D The client perceives the situation of job loss as a
challenge and an opportunity for growth.
3. Which client statement should alert a nurse that a client may be responding maladaptively to
stress?
A. "I've found that avoiding contact with others helps me cope."
B. "I really enjoy journaling; it's my private time."
C. "I signed up for a yoga class this week."
D. "I made an appointment to meet with a therapist." Correct Answer: A
Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It
can prevent learning appropriate coping skills and can prevent access to needed support systems.
4. A nursing student finds that she comes down with a sinus infection toward the end of every
semester. When this occurs which stage of stress is the student most likely experiencing?
pg. 1
, TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITION, TEST
BANK.
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage Correct Answer: C
At the stage of exhaustion, the student's exposure to stress has been prolonged and adaptive
energy has been depleted. Diseases of adaptation occur more frequently in this stage.
5. A school nurse is assessing a female high school student who is overly concerned about her
appearance. The client's mother states, "That's not something to be stressed about!" Which is the
most appropriate nursing response?
A. "Teenagers! They don't know a thing about real stress."
B. "Stress occurs only when there is a loss."
C. "When you are in poor physical condition, you can't experience psychological well-being." D.
"Stress can be psychological. A threat to self-esteem may result in high stress levels."
Correct Answer:
D
Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as
stressful as a physiological change.
6. A bright student confides in the school nurse about conflicts related to attending college, or
working to add needed financial support to the family. Which coping strategy is most
appropriate for the nurse to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling Correct Answer: B
The student must assess his situation and determine the best course of action. Problem-solving
training, by providing structure and objectivity, can assist in his decision making.
7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching
position and has difficulty with independent problem solving. During a routine physical
examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing
intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
B. Complete the problem-solving process for the client.
C. Work through the problem-solving process with the client.
D. Encourage the client to keep a journal. Correct Answer: C
During times of high anxiety and stress, clients will need more assistance in problem solving and
decision making.
8. A school nurse is assessing a distraught female high school student who is overly concerned
because her parents can't afford horseback riding lessons. How should the nurse interpret the
student's reaction to her perceived problem?
A. The problem is endangering her well-being.
pg. 2
, TESTBANK FOR PSYCHIATRIC MENTAL HEALTH NURSING BY MARY TOWNSEND 9TH EDITION, TEST
BANK.
B. The problem is personally relevant to her.
C. The problem is based on immaturity.
D. The problem is exceeding her capacity to cope. Correct Answer: B
Psychological stressors to self-esteem and self-image are related to how the individual perceives
the situation or event. Self-image is particularly important to adolescents who feel entitled to
have all the advantages that other adolescents experience.
9. Meditation has been shown to be an effective stress management technique. When meditation
is effective, what should a nurse expect to assess?
A. An achieved state of relaxation
B. An achieved insight into one's feelings
C. A demonstration of appropriate role behaviors
D. An enhanced ability to problem solve Correct
Answer: A
Meditation produces relaxation by creating a special state of consciousness through focused
concentration.
10. A distraught, single, first-time mother cries and says to a nurse, "How can I go to work if I
can't afford childcare!" What is the nurse's initial action in assisting the client with the
problemsolving process?
A. Determine the risks and benefits for each alternative
B. Formulate goals for resolution of the problem
C. Evaluate the outcome of the implemented alternative
D. Assess the facts of the situation Correct Answer: D
Before any other steps can be taken, accurate information about the situation must be gathered
and assessed.
11. A nursing instructor is teaching about diseases of adaptation and when they are likely to
occur. When questioned about situations that precipitate these diseases, which student statement
indicates that learning has occurred?
A. "When an individual has limited experience dealing with stress"
B. "When an individual inherits maladaptive genes"
C. "When an individual experiences existing conditions that exacerbate stress"
D. "When an individual's physiological and psychological resources have become depleted"
Correct Answer: D
During the stage of exhaustion of the general adaptation syndrome, the individual loses the
capacity to adapt effectively because physiological and psychological resources have become
depleted. This is the time when diseases of adaptation may occur.
12. When an individual's stress response is sustained over a long period of time, which
physiological effect of the endocrine system should a nurse anticipate?
A. Decreased resistance to disease
B. Increased libido
pg. 3
