Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based
Practice 10th Edition Townsend Test Bank
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
1. A client has experienced the death of a close family member and at the
same time becomes unemployed. The client’s 6-month score on the Recent Life Changes
Questionnaire is 110. The nurse:
A. Understands the client is at risk for significant
stress-related illness.
B. Determines the client is not at risk for
significant stress-related illness.
C. Needs further assessment of the client’s
coping skills to determine susceptibility to
stress-related illness.
D. Recognizes the client may view the losses as
challenges and perceive them as
opportunities.
ANS: C
C
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 5–6
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
________ ______ _____ pg. 1 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, A This is incorrect. Assessment is the first step
of the nursing process. The nurse should
assess the client’s coping skills and available
support before determining susceptibility to
stress-related physical and psychological
illness. 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 and susceptibility to stress-related
illnesses.
B This is incorrect. Assessment is the first step
in the nursing process. The nurse should
assess the client’s coping skills and available
support before determining the client’s
perception of the current stresses. A 6-month
score of 300 or a year-score of 500 or more
on the Recent Life Changes Questionnaire
indicates high stress in a client’s life and
susceptibility to stress-related physical and
psychological illness.
C This is correct. Assessment is the first step in
the nursing process. The nurse should assess
the client’s coping skills and available support
before determining susceptibility to stress-
related physical and psychological illness. A
6-month score of 300 or a year-score of 500
or more indicates high stress in a client’s life
and risk for significant stress-related physical
and psychological illness.
D This is incorrect. Assessment is the first step
in the nursing process. The nurse should
assess the client’s coping skills and available
support before determining susceptibility to
stress-related illness. A 6-month score of 300
or a year-score of 500 or more on the Recent
Life Changes Questionnaire indicates high
stress in a client’s life is susceptible to
significant stress-related physical and
psychological illness.
PTS: 1 CON: Stress
________ ______ _____ pg. 2 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, 2. A physically and emotionally healthy client has just been fired. During a
routine office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe
I’ll consider pursuing an art degree.” The nurse determines the client perceives the
stressor of his job loss as:
A. Irrelevant.
B. Harm/loss.
C. A threat.
D. A challenge.
ANS: D
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management of
stress.
Page: 7
Heading: Individual’s Perception of the Event > Primary Appraisal
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
B This is incorrect. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
C This is incorrect. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
D This is correct. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
PTS: 1 CON: Stress
3. Which client statement alerts the nurse that the client may be responding
maladaptively to stress?
A. “Avoiding contact with others helps me
cope.”
________ ______ _____ pg. 3 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, 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.”
ANS: A
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management of
stress.
Page: 8–9
Heading: Stress Management
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
A This is correct. 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.
B This is incorrect. Journaling is not considered
a maladaptive coping method.
C This is incorrect. Group exercise is not
considered a maladaptive coping method.
D This is incorrect. Seeing a therapist is not
considered a maladaptive coping method.
PTS: 1 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 likely experiencing when this
occurs?
A. Alarm reaction
B. Resistance
C. Exhaustion
D. Fight or flight
ANS: C
________ ______ _____ pg. 4 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 9
Heading: Stress as a Biological Response > Stage of Exhaustion
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. At the alarm reaction stage,
physiological responses of the fight-or-flight
syndrome are initiated.
B This is incorrect. At the stage of resistance,
the individual uses the physiological
responses of the first stage as a defense in the
attempt to adapt to the stressor. Physiological
symptoms may disappear.
C This is correct. 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.
D This is incorrect. The fight-or-flight syndrome
occurs during the alarm reaction stage.
PTS: 1 CON: Stress
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 response by the nurse is best?
A. “Teenagers! They don’t know a thing about
real stress.”
B. “Psychological or physical stress occur only
when there is a loss.”
C. “Poor physical condition can interfere with
psychological well-being.”
D. “A threat to self-esteem can result in
psychological stress.”
ANS: D
________ ______ _____ pg. 5 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Describe the core concept of stress as an environmental
event.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
A This is incorrect. This response is judgmental
and nontherapeutic.
B This is incorrect. Physical and psychological
stress can be precipitated by events other than
loss.
C This is incorrect. Stress can be physical or
psychological in nature. A perceived threat to
self-esteem can be as stressful as a
physiological change.
D This is correct. Determination of an event as
stressful depends on the individual’s cognitive
appraisal of the situation, which is an
individual’s evaluation of the personal
significance of the event or occurrence. Stress
can be physical or psychological in nature. A
perceived threat to self-esteem can be as
stressful as a physiological change.
PTS: 1 CON: Stress
6. A student confides in the school nurse that he is “stressed out” about
deciding whether to go to college or work to provide income the family needs. Which
coping strategy is the nurse’s best recommendation?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANS: B
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management of
________ ______ _____ pg. 6 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
Practice 10th Edition Townsend Test Bank
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
1. A client has experienced the death of a close family member and at the
same time becomes unemployed. The client’s 6-month score on the Recent Life Changes
Questionnaire is 110. The nurse:
A. Understands the client is at risk for significant
stress-related illness.
B. Determines the client is not at risk for
significant stress-related illness.
C. Needs further assessment of the client’s
coping skills to determine susceptibility to
stress-related illness.
D. Recognizes the client may view the losses as
challenges and perceive them as
opportunities.
ANS: C
C
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 5–6
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
________ ______ _____ pg. 1 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, A This is incorrect. Assessment is the first step
of the nursing process. The nurse should
assess the client’s coping skills and available
support before determining susceptibility to
stress-related physical and psychological
illness. 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 and susceptibility to stress-related
illnesses.
B This is incorrect. Assessment is the first step
in the nursing process. The nurse should
assess the client’s coping skills and available
support before determining the client’s
perception of the current stresses. A 6-month
score of 300 or a year-score of 500 or more
on the Recent Life Changes Questionnaire
indicates high stress in a client’s life and
susceptibility to stress-related physical and
psychological illness.
C This is correct. Assessment is the first step in
the nursing process. The nurse should assess
the client’s coping skills and available support
before determining susceptibility to stress-
related physical and psychological illness. A
6-month score of 300 or a year-score of 500
or more indicates high stress in a client’s life
and risk for significant stress-related physical
and psychological illness.
D This is incorrect. Assessment is the first step
in the nursing process. The nurse should
assess the client’s coping skills and available
support before determining susceptibility to
stress-related illness. A 6-month score of 300
or a year-score of 500 or more on the Recent
Life Changes Questionnaire indicates high
stress in a client’s life is susceptible to
significant stress-related physical and
psychological illness.
PTS: 1 CON: Stress
________ ______ _____ pg. 2 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, 2. A physically and emotionally healthy client has just been fired. During a
routine office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe
I’ll consider pursuing an art degree.” The nurse determines the client perceives the
stressor of his job loss as:
A. Irrelevant.
B. Harm/loss.
C. A threat.
D. A challenge.
ANS: D
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management of
stress.
Page: 7
Heading: Individual’s Perception of the Event > Primary Appraisal
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
B This is incorrect. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
C This is incorrect. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
D This is correct. The client’s statement
indicates he perceives the loss of his job as a
challenge and an opportunity for growth.
PTS: 1 CON: Stress
3. Which client statement alerts the nurse that the client may be responding
maladaptively to stress?
A. “Avoiding contact with others helps me
cope.”
________ ______ _____ pg. 3 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, 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.”
ANS: A
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management of
stress.
Page: 8–9
Heading: Stress Management
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
A This is correct. 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.
B This is incorrect. Journaling is not considered
a maladaptive coping method.
C This is incorrect. Group exercise is not
considered a maladaptive coping method.
D This is incorrect. Seeing a therapist is not
considered a maladaptive coping method.
PTS: 1 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 likely experiencing when this
occurs?
A. Alarm reaction
B. Resistance
C. Exhaustion
D. Fight or flight
ANS: C
________ ______ _____ pg. 4 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Explain the relationship between stress and diseases of
adaptation.
Page: 9
Heading: Stress as a Biological Response > Stage of Exhaustion
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress
Difficulty: Easy
Feedback
A This is incorrect. At the alarm reaction stage,
physiological responses of the fight-or-flight
syndrome are initiated.
B This is incorrect. At the stage of resistance,
the individual uses the physiological
responses of the first stage as a defense in the
attempt to adapt to the stressor. Physiological
symptoms may disappear.
C This is correct. 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.
D This is incorrect. The fight-or-flight syndrome
occurs during the alarm reaction stage.
PTS: 1 CON: Stress
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 response by the nurse is best?
A. “Teenagers! They don’t know a thing about
real stress.”
B. “Psychological or physical stress occur only
when there is a loss.”
C. “Poor physical condition can interfere with
psychological well-being.”
D. “A threat to self-esteem can result in
psychological stress.”
ANS: D
________ ______ _____ pg. 5 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
, Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Describe the core concept of stress as an environmental
event.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
A This is incorrect. This response is judgmental
and nontherapeutic.
B This is incorrect. Physical and psychological
stress can be precipitated by events other than
loss.
C This is incorrect. Stress can be physical or
psychological in nature. A perceived threat to
self-esteem can be as stressful as a
physiological change.
D This is correct. Determination of an event as
stressful depends on the individual’s cognitive
appraisal of the situation, which is an
individual’s evaluation of the personal
significance of the event or occurrence. Stress
can be physical or psychological in nature. A
perceived threat to self-esteem can be as
stressful as a physiological change.
PTS: 1 CON: Stress
6. A student confides in the school nurse that he is “stressed out” about
deciding whether to go to college or work to provide income the family needs. Which
coping strategy is the nurse’s best recommendation?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANS: B
Chapter: Chapter 0, The Concept of Stress Adaptation
Chapter learning objective: Discuss adaptive coping strategies in the management of
________ ______ _____ pg. 6 P sychiat ric Mental Healt h Nursing Conce pts of Care in Evidence-Ba sed Practice 10th E dition Townse nd Te st Bank@_____ ___________ ____________ ________
