CH 10 SR and Mngmnt Flashcards
The adult child of a client diagnosed with major depressive disorder asks, “Do you think depression and physical illness are connected? Since my father’s death, my mother has had shingles and the flu, but she’s usually not one who gets sick.” Which answer by the nurse best reflects current knowledge?
a. “It is probably a coincidence. Emotions and physical responses travel on different tracts of the nervous system.”
b. “You may be paying more attention to your mother since your father died and noticing more things such as minor illnesses.”
c. “So far, research on emotions or stress and becoming ill more easily is unclear. We do not know for sure if there is a link.”
d. “Negative emotions and prolonged stress interfere with the body’s ability to protect itself and can increase the likelihood of illness.”
d. “Negative emotions and prolonged stress interfere with the body’s ability to protect itself and can increase the likelihood of illness.”
A client diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently the client has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the client be encouraged to visualize?
a. Engaging in activity without using any supplemental oxygen
b. Sleeping comfortably and soundly, without respiratory distress
c. Feeling relaxed and taking regular deep breaths when leaving home
d. Having a younger, healthier body that knows no exercise limitations
c. Feeling relaxed and taking regular deep breaths when leaving home
A nurse leads a psychoeducational group for clients experiencing depression. The nurse plans to implement an exercise regime for each client. What rationale will the nurse use when presenting this plan to the treatment team concerning the benefit of exercise?
a. has been identified as having a diminishing effect on cytokines
b. prevents damage from overstimulation of the sympathetic nervous system.
c. detoxifies the body by removing metabolic wastes and other toxins.
d. improves mood stability for clients with bipolar disorders.
a. has been identified as having a diminishing effect on cytokines
A recent immigrant from Honduras comes to the clinic with a family member who has been a U.S. resident for 10 years. The family member says, “The immigration to America has been very difficult.” Considering cultural background, which expression of stress by this client would the nurse expect?
a. Motor restlessness
b. Somatic complaints
c. Memory deficiencies
d. Sensory perceptual alterations
b. Somatic complaints
Honduras is in Central America. Many people from Central American cultures express distress in somatic terms.
A client nervously says, “Financial problems are stressing my marriage. I’ve heard rumors about cutbacks at work; I am afraid I might get laid off.” The client’s pulse is 112/minute; respirations are 26/minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement?
a. Advise the client, “Go to sleep 30 to 60 minutes earlier each night to increase rest.”
b. Direct the client in slow and deep breathing using abdominal muscles.
c. Suggest the client consider that a new job might be better than the present one.
d. Tell the client, “Relax by spending more time playing with your pet.”
b. Direct the client in slow and deep breathing using abdominal muscles.
The client is responding to stress with increased arousal of the sympathetic nervous system, as evident by elevated vital signs. These will have a negative effect on his health and increase his perception of being anxious and stressed. Stimulating the parasympathetic nervous system will counter the sympathetic nervous system’s arousal, normalizing these vital sign changes and reducing the physiological demands stress is placing on his body. Other options do not address his physiological response pattern as directly or immediately
According to the Recent Life Changes Questionnaire, which situation would most necessitate a complete assessment of a person’s stress status and coping abilities?
a. A person who has been assigned more responsibility at work
b. A parent whose job required relocation to a different city
c. A person returning to college after an employer ceased operations
d. A man who recently separated from his wife because of marital problems
c. A person returning to college after an employer ceased operations
A client newly diagnosed as HIV-positive seeks the nurse’s advice on how to reduce the risk of infections. The client says, “I went to church years ago and I was in my best health then. Maybe I should start going to church again.” Which response will the nurse offer?
a. “Religion does not usually affect health, but you were younger and stronger then.”
b. “Contact with supportive people at a church might help, but religion itself is not
especially helpful.”
c. “Studies show that spiritual practices can enhance immune system function and
coping abilities.”
d. “Going to church would expose you to many potential infections. Let’s think about
some other options.”
c. “Studies show that spiritual practices can enhance immune system function and
coping abilities.”
When a nurse asks a newly admitted client to describe social supports, the client says, “My parents died last year, and I have no family. I am newly divorced, and my former in-laws blame me. I don’t have many friends because most people my age just want to go out drinking.” Which action will the nurse apply?
a. Advise the client that being so particular about potential friends reduces social contact.
b. Suggest using the Internet as a way to find supportive others with similar values.
c. Encourage the client to begin dating again, perhaps with members of the church.
d. Discuss how divorce support groups could increase coping and social support.
d. Discuss how divorce support groups could increase coping and social support.
A client experiencing significant stress associated with a disturbing new medical diagnosis asks the nurse, “Do you think saying a prayer would help?” Select the nurse’s best answer.
a. “It could be that prayer is your only hope.”
b. “You may find prayer gives comfort and lowers your stress.”
c. “I can help you feel calmer by teaching you meditation exercises.”
d. “We do not have evidence that prayer helps, but it wouldn’t hurt.”
b. “You may find prayer gives comfort and lowers your stress.”
A client is brought to the Emergency Department (ED) after a motorcycle accident. The client is alert, responsive, and diagnosed with a broken leg. The client’s vital signs are pulse (P) 72 and respiration (R) 16. After being informed surgery is required for the broken leg, which vital sign readings would be expected?
a. P64,R14
b. P68,R12
c. P72,R16
d. P80,R20
d. P80,R20
A client tells the nurse, “I know that I should reduce the stress in my life, but I have no idea
where to start.” What would be the best initial nursing response?
a. “Physical exercise works to elevate mood and reduce anxiety.”
b. “Reading about stress and how to manage it might be a good place to start.”
c. “Why not start by learning to meditate? That technique will cover everything.”
d. “Let’s talk about what is going on in your life and then look at possible options.”
d. “Let’s talk about what is going on in your life and then look at possible options.”
A client tells the nurse, “My primary care provider thinks my problems with stress relate to the negative way I think about things and suggested I learn new ways of thinking.” Which response by the nurse would support the recommendation?
a. Encourage the client to imagine being in calm circumstances.
b. Provide the client with a blank journal and guidance about journaling.
c. Teach the client to recognize, reconsider, and reframe irrational thoughts.
d. Teach the client to use instruments that give feedback about bodily functions.
c. Teach the client to recognize, reconsider, and reframe irrational thoughts.
A client who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the client returns to the clinic 2 weeks later, which finding most clearly shows the client is coping more effectively with stress?
a. The client’s systolic blood pressure has changed from the 140s to the 120s mm Hg.
b. The client reports, “I feel better, and that things are not bothering me as much.”
c. The client reports, “I spend more time napping or sitting quietly at home.”
d. The client’s weight decreased by 3 pounds.
a. The client’s systolic blood pressure has changed from the 140s to the 120s mm Hg.
A client tells the nurse, “I will never be happy until I’m as successful as my older sister.” The nurse asks the client to reassess this statement and reframe it. Which reframed statement by the client is most likely to promote coping?
a. “People should treat me as well as they treat my sister.”
b. “I can find contentment in succeeding at my own job level.”
c. “I won’t be happy until I make as much money as my sister.”
d. “Being as smart or clever as my sister isn’t really important.”
b. “I can find contentment in succeeding at my own job level.”
A client says, “One result of my chronic stress is that I feel so tired. I usually sleep from 11:00 PM to 6:30 AM. I started setting my alarm to give me an extra 30 minutes of sleep each morning, but I don’t feel any better and I’m rushed for work.” Which nursing response would best address the client’s concerns?
a. “You may need to speak to your doctor about taking a sedative to help you sleep.”
b. “Perhaps going to bed a half-hour earlier would work better than sleeping later.”
c. “A glass of wine in the evening might take the edge off and help you to rest.”
d. “Exercising just before retiring for the night may help you to sleep better.”
b. “Perhaps going to bed a half-hour earlier would work better than sleeping later.”
