Stress and Stress Management Nursing Quiz for your nursing review.Stress management and stress. It is widely acknowledged that a tiny amount of stress can boost your productivity. Whatever you’re doing gains a sense of urgency from it, which helps to motivate you.
When a patient at the clinic is informed that testing indicates the presence of gonorrhea, the patient sighs and says, “That, I can handle.” What does the nurse understand about the patient in this situation?
a. The patient is in denial about the possible complications of gonorrhea.
b. The patient does not perceive the gonorrhea infection as a threatening stressor.
c. The patient does not have other current stressors that require adaptation or coping mechanisms.
d. The patient knows how to cope with gonorrhea from dealing with previous gonorrhea infections.
Answer Key:
b. When individuals do not become stressed with a situation or an event, it is because they do not perceive the event as a demand being made on them or as a threat to their well-being. Perceptions of stressors have significant variability and, for whatever reasons, this patient does not perceive this diagnosis as stressful.
The student nurse is depressed. He is trying to study for an important exam but cannot focus. Yesterday he received news that his mother was diagnosed with metastatic breast cancer. What effect could the stress on the student’s mind and spirit most likely have on the student’s body?
a. The student’s stress will cause the failure of the exam.
b. The student’s stress will contribute to physical illness.
c. The student’s worry will affect his driving to see his mother.
d. The student’s emotional stress will cause bad feelings about the exam.
Answer Key:
b. The student's stress related to difficulty studying for the important exam, and the emotional and spiritual stress from the mother's diagnosis will affect the student's body by weakening the immune system and making the student more likely to catch a cold or other illness. Failure of the exam and driving skill are not effects of stress on the student's body. To prevent illness, the student will want to plan a healthy diet and sleep pattern before the exam.
Identify four key personal characteristics that promote adaptation to stressors.
a. b. c. d.
Answer Key:
Resilience, hardiness, attitude, and optimism. Other factors that could have been selected are age, health status, personality characteristics, prior experience with stress, nutritional status, sleep status, and genetic background. These are all factors that are internal to the individual and may affect the response to stress.
Using the words and phrases listed below, fill in the boxes below with the numbers of the words or phrases that illustrate the physiologic responses to stress.
Word and Phrase List
- Interpretation of event
- ↑ ADH (antidiuretic hormone)
- Cortisol
- ↑ Blood volume
- ↑ HR and stroke volume
- ↑ Water retention
- Wakefulness and alertness
- ↑ Sympathetic response
- β-Endorphin
- Self-preservation behaviors
- ↑ Cardiac output
- Corticotropin-releasing hormone
- Aldosterone
- ACTH (adrenocorticotropic hormone)
- Blunted pain perception
- ↑ Gluconeogenesis
- ↑ Epinephrine and norepinephrine
- ↓ Digestion
- ↑ Proopiomelanocortin (POMC)
- ↑ Systolic blood pressure
- ↓ Inflammatory response
- Glycogenolysis
- ↑ Blood to vital organs and large muscles
- ↑ Blood glucose
- ↑ Na and H2O reabsorption
Answer Key:
| Objective Manifestations | Subjective Findings |
|---|---|
| a. | a. |
| b. | b. |
| c. | c. |
| d. | d. |
| e. | |
| f. | |
| g. | |
| h. |
Answer Key:
| Objective Manifestations | Subjective Findings |
|---|---|
| a. Increased heart rate | a. Anxiety, fear |
| b. Increased blood pressure | b. Decreased perception of pain |
| c. Cool, clammy skin | c. Verbalization of stress |
| d. Decreased bowel sounds | d. Wakefulness, restlessness |
| e. Hyperglycemia | |
| f. Decreased lymphocytes | |
| g. Decreased neutrophils | |
| h. Decreased urinary output |
While caring for a female patient with Alzheimer’s disease and her caregiver husband, the nurse finds that the patient’s husband is experiencing increased asthma problems. What is a possible explanation for this finding?
a. Progressive worsening of asthma occurs in people as they age.
b. Chronic and intense stress can cause exacerbation of immune-based diseases.
c. The husband is probably smoking more to help him cope with needing to care continually for his wife.
d. The husband inadequately copes with his wife’s condition by unconsciously forgetting to take his medications.
Answer Key:
b. One of the many physiologic changes that occur as a result of prolonged, increased stress is immunosuppression, which may exacerbate or increase the risk of progression of immune-based diseases, including asthma. The other options are not valid explanations for the worsening asthma.
Identify the behaviors listed below as either positive coping (P) or negative coping (N) strategies.
a. Smoking cigarettes
b. Ignoring a situation
c. Joining a support group
d. Starting an exercise program
e. Increasing time spent with friends
Answer Key:
a. N; b. N; c. P; d. P; e. P
A patient has recently had a myocardial infarction. What emotion-focused coping strategies should the nurse encourage him to use to adapt to the physical and emotional stress of his illness (select all that apply)?
a. Use meditation.
b. Plan dietary changes.
c. Start an exercise program.
d. Do favorite escape activities (e.g., playing cards).
e. Share feelings with a spouse or other family members.
Answer Key:
a, d, e. The other answers are problem-focused coping mechanisms.
Patient-Centered Care: While teaching relaxation therapy to a patient with fibromyalgia, what does the nurse recognize as being most important to incorporate?
a. Exercise
b. Relaxation breathing
c. Soft background music
d. Progressive muscle relaxation
Answer Key:
b. Because it is almost impossible to maintain muscle tension while breathing slowly and deeply, relaxation breathing is a component of all relaxation therapies. With fibromyalgia, exercise would not relax this patient. Progressive muscle relaxation first requires relaxed breathing, and although soft music can decrease stress, it should be used with other therapies.
Priority Decision: After receiving the assigned patients for the day, the nurse determines that stress-relieving interventions are a priority for which patient?
a. The man with peptic ulcer disease
b. The newly admitted woman with cholecystitis
c. The man with a bacterial exacerbation of chronic bronchitis
d. The woman who is 1 day postoperative for knee replacement
Answer Key:
a. Peptic ulcer disease is one of several disorders with a known stress component. Although many patients have stress related to a health problem, stress-relieving interventions are always indicated for patients with diseases in which stress contributes to the problem.
A 32-yr-old man is admitted to the hospital with an acute exacerbation of Crohn’s disease. Coping strategies that may be suggested by the nurse during his hospitalization include (select all that apply)
a. Humor
b. Exercise
c. Journaling
d. A cleansing diet
e. Relaxation therapy
Answer Key:
a, c, e. Humor, journaling, and relaxation activities are realistic strategies that can be used during hospitalization by a patient with an acute episode of a chronic disease. Exercise or a cleansing diet would not be appropriate for an exacerbation of Crohn's disease.
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