Ch. 9

Question 1

a client being evaluated in the emergency room is unable to speak logically or follow directions. The client’s family states the client has been under a great deal of stress for about 6 months. The client is most likely experiencing:

Answer 1

Exhaustion

p. 206

Question 2

A health care provider suspects a client has developed PTSD. Select the necessary criterion to validate the diagnosis.

Answer 2

At least 1 month of clinically significant distress affecting a person after witnessing or experiencing a traumatic event that affects other parts of his/her life. p. 216

Question 3

When explaining to a patient admitted for stress induced supraventricular tachycardia, the nurse will incorporate which of the following statements about what happens in the body as a result of excess stress?

Answer 3

The corticotrophin-releasing factor stimulates the release of norepinephrine, which is responsible for fight-flight reaction to stress. P. 209-211

Question 4

The nurse is caring for a client with left-sided heart failure causing chronic activation of the renin-angiotensin-aldosterone system (RAAS). What is the nurse’s priority assessment?

Answer 4

Fluid volume excess p.211

Question 5

T/F. Most physiologic control systems function under positive feedback mechanisms.

Answer 5

False P. 207-208

Question 6

The locus caeruleus (LC) is an area in the brain stem that produces which of the following hormones?

Answer 6

Norepinephrine (NE) p. 210

Question 7

The client experienced a traumatic event in the past that has caused chronic nightmares in which the event is relived. The client may have increased levels of which?

Answer 7

Norepinephrine p. 216

Question 8

The client is receiving chronic glucocorticoid therapy for chronic obstructive pulmonary disease (COPD). Which of the following lab results would the provider expect to see?

Answer 8

increased blood glucose p. 211

Question 9

The term used to describe oscillations with frequency similar to that of the 24-hour light-dark solar day is which of the following?

Answer 9

Circadian P. 214

Question 10

A nurse is caring for an adolescent with PTS. The patient reports having difficulty concentrating and has an increased startle reflex. The nurse’s documentation includes the presence of which?

Answer 10

Hyperarousal p. 219

Question 11

A client who has experience PTSD tells the nurse he now has “flashbacks” during waking hours or nightmare in which the past traumatic event is relived, often in vivid and frightening detail. The nurse recognizes this as:

Answer 11

Intrusion p. 216-217

Question 12

What feedback system provides stability to the stress response?

Answer 12

Negative feedback mechanism. p. 207

Question 13

What will the nurse assess as the end result of activation of the renin angiotensin aldosterone system (RAAS)?

Answer 13

Increased blood pressure p. 211

Question 14

The psychologist is counseling a client who is overwhelmed by losing his job and the recent death of a parent. Which strategy would be effective for stress reduction?

Answer 14

Teaching the client to systematically contract and relax major muscle groups. p. 218

Question 15

The elderly client, with a history of congestive heart failure, is upset following the death of her husband yesterday. The practitioner observes the client for which?

Answer 15

Arrhythmias p. 215

Question 16

The nursing student was initially overwhelmed with the deamnds of school. The student implemented a plan of getting adequate sleep and nutrition to adapt the new demands. These strategies are known as which of the following?

Answer 16

Coping mechanisms

p. 213

Question 17

The psychologist is leading a group session with clients who have recently undergone a variety of stressful events. Which of the following clients will have the best adaptation?

Answer 17

50 y/o female who sees her new life as a widow as a challenge rather than a threat p. 213

Question 18

As a nurse prepares to change a patient’s dressing, the patient states that she is afraid that it will be painful. Noting that the patient’s heart rate and respiratory rate has increased, the nurse adjusts the plan of care to reflect for a patient in which phase of selye’s general adaptation syndrome?

Answer 18

Alarm p. 215

Question 19

the health care provider is teaching a client about the ability of the body to function and maintain homeostasis under conditions of change in the internal and external environment. The most important regulation is controlled by which system?

Answer 19

Physiologic p. 207

Question 20

The nurse is caring for an ex-soldier who has been diagnosed with PTSD. The nurse should prioritize which action?

Answer 20

assessing the client for depression and risk for suicide p. 216