stress and coping

Question 1

stress management

Answer 1

time management
anger management
nutrition
support groups

Question 2

time management

Answer 2

• Prioritizing tasks that must be done and identifying those that do not have to be performed
• Setting goals that are reasonable or feasible
• Honing skills associated with concentration
• Reducing distractions so goals can be accomplished or tasks can be done
• Avoiding procrastination and recognizing that “putting things off” causes stress that may become debilitating
• Setting boundaries (e.g., learning when to say “no” to added responsibilities)
• Maintaining self-discipline (e.g., to perform interventions to reduce stress)

Question 3

anger management

Answer 3

avoiding destructive bxs

• Expressing feelings calmly and in a nonconfrontational way
• Exercising
  Identifying solutions to problems
• Taking a “time-out” to think before acting or to implement coping skills
• Forgiving, which relieves the heart and diffuses anger
• Lightening the situation with humor (if appropriate)
• “Owning” and taking responsibility for negative feelings
• Doing deep-breathing exercises when frustration begins

Question 4

nutrition

Answer 4

stress is linked to unhealthy food choices, which affect mood and affect a person’s response to inflammation. Stress affects the immune system, making it more difficult to fight infection. Altered nutrition also delays wound healing.

Question 5

support groups

Answer 5

Support groups can help patients who share common life stressors (e.g., grief) or common disease processes (e.g., alcoholism). It can be comforting for patients to know they are not alone in their battles or challenges.

Question 6

Complementary and Integrative Therapies

Answer 6

relaxation therapy,
exercise
sleep
meditation
guided imagery
energy therapy
mindfulness
yoga
biofeedback 
traditional Chinese medicine

Question 7

crisis intervention

Answer 7

Crisis intervention is short-term and immediate assistance provided to a person at a time of physical or emotional upheaval (e.g., death of a loved one, suicidal feelings) with the goal of helping the person who is in extreme distress regain balance. Crisis intervention is immediate action to help reduce the negative impact of a traumatic event in the life of the affected person
Crisis intervention involves simple, creative, accessible, practical actions that ensure a person’s safety and restore mental well-being.

Question 8

Which interventions would the nurse choose to help a patient manage anger in a healthy way?

Answer 8

Jogging

Physical exercise is an effective anger management intervention.

Using humor

Diffusing the situation with humor is an effective anger management intervention.

Problem-solving

Identifying potential solutions is an effective anger management intervention.

Question 9

Which explanation demonstrates how relaxation therapy differs from energy therapy?

Answer 9

Relaxation therapy teaches patients to recognize and respond to stress in any setting.

Relaxation therapy teaches patients to recognize and respond to potential stressors by initiating relaxation techniques, whereas energy therapy requires physical touch from a practitioner.

Question 10

interventions w pts w support group

Answer 10

has an intact, reliable support system, interventions can be targeted at stress recognition. The support system can often recognize signs of escalating stress in the patient and remind the patient about investing in self-care. The support system can also provide a healthy distraction by engaging in healthy activities with the patient that foster positive mental health.

Question 11

without support group

Answer 11

interventions are geared toward referrals to community resources such as support groups and organizations that assist with providing basic needs like food and shelter. Often the nurse will coordinate with a case manager or social worker to provide these referrals.

Question 12

pt who are caregivers

Answer 12

Actively practice self-compassion (Lloyd et al., 2019).
Be willing to accept help from others.
Join a support group for caregivers.
Commit to your own nutrition and exercise plans, which can increase mental health.
Make use of available community resources, such as respite care or adult day care.
Coordinate with a case manager who can provide information about possible financial assistance.
Set aside time during the day just for you, even if it is only 30 to 60 minutes.
Recognize signs and symptoms of stress (e.g., fatigue, feelings of powerlessness, unplanned weight loss or gain, losing interest in normally pleasurable activities).

Question 13

With which team member would the nurse collaborate when a patient reports having financial difficulties affording food?

Answer 13

Case manager

The case manager’s role is to provide social services assistance to the patient. This individual can help with finding shelter, groceries, and other means of financial support that can benefit the patient.

Question 14

Which stress management interventions would the nurse recommend to a patient with overwhelming work responsibilities?

Answer 14

• Increasing concentration skills
  A patient experiencing stress related to overwhelming work responsibilities would benefit from time management, specifically increasing concentration skills.
• Setting achievable goals
  A patient experiencing stress related to overwhelming work responsibilities would benefit from time management, specifically setting achievable goals.

-Avoiding procrastination
A patient experiencing stress related to overwhelming work responsibilities would benefit from time management, specifically avoiding procrastination.

-Nutrition counseling
Nutrition counseling can benefit any patient who is experiencing stress.

Question 15

Match the stressor with the appropriate stress management strategy.

Answer 15

Prioritizing tasks
---Overwhelming stress 
Exercising  
---Anger 
Support groups  
---Divorce

Question 16

A patient has stayed in bed for almost a week in an attempt to relieve stress-related anxiety. Which principle explains why this is not the most effective stress management technique?

Answer 16

Stress management must focus on balance, relaxation, and nutrition.

To maximize the effectiveness of stress management strategies, the patient must observe balance, relaxation, and nutrition. An imbalance contributes to further physiologic and physical signs of stress. Staying in bed all week does not represent balance.

Question 17

For which patient would the nurse recommend including nutrition counseling as the primary method to decrease stress?

Answer 17

A patient with a postoperative wound that is slow to heal

Unhealthy food choices can affect a patient’s response to inflammation, including delayed wound healing. Nutrition counseling to encourage people to eat a balanced diet can facilitate stress reduction and improve physical well-being.

Question 18

Which method of support would the nurse recommend for a patient who needs care but has no living relatives or close friends?

Answer 18

Community agencies

Community agencies can provide numerous types of support, ranging from social support to support groups. This is an appropriate referral to make for a patient who does not have anyone else close by that can serve as a caretaker.

Question 19

Which recommendation would the nurse give to a caretaker who is feeling overwhelmed and tired?

Answer 19

Seek community services such as respite care for your loved one.

Respite care can alleviate some of the burden on a caretaker; therefore, this is an appropriate referral to address the caretaker’s feelings of being overwhelmed and tired.

Question 20

Which symptom, when reported by a caretaker, would the nurse identify as a sign of stress?

Answer 20

Unintentionally lost 5 pounds last month

Fatigue, feelings of powerlessness, unplanned weight loss or gain, and/or losing interest in normally pleasurable activities are signs of caretaker stress.

Question 21

developing hypothesis

Answer 21

Based on assessment findings, the nurse may determine that a patient is at risk for developing problems related to stress or coping, in the midst of an actual problem related to stress or coping, or would benefit from health teaching to avoid stress or coping problems.
An actual problem is one that currently exists. The problem may be reported by the patient, or the nurse may analyze cues that alert that a problem exists. This problem can be addressed by the nurse, health care team, patient, and patient support system.

Question 22

prioritizing hyposthese

Answer 22

Priority hypotheses are established after collection and analysis of assessment data. Assessments are objective (visualized) or subjective (reported by the patient) in nature. Specific assessment techniques and findings related to stress and coping can be found earlier in this module.

Question 23

Which action would the nurse take when caring for a patient with stress?

Answer 23

Provide referrals to mental health professionals.

This role is served by the nurse.

Question 24

Which priority hypotheses demonstrate that the patient is experiencing an actual problem related to stress or coping?

Answer 24

Anxiety

A priority hypothesis of Anxiety demonstrates that the patient is in the midst of experiencing a problem related to stress or coping.

Stress Overload

A priority hypothesis of Stress Overload demonstrates that the patient is in the midst of experiencing a problem related to stress or coping.

Question 25

Which goal related to stress and coping is written correctly?

Answer 25

Patient will discuss strategies to cope with family violence with a social worker within 24 hours.

This goal is appropriately stated as it has a definable action and time frame within which to accomplish the action.

Question 26

A single mother of a globally handicapped child says, “I haven’t had a full night’s sleep or 10 minutes to myself since the baby came home from the hospital 3 months ago. She is so sick and her care is such a challenge. There are some days I just want to scream.” Which priority hypothesis is most appropriate for this patient?

Answer 26

Caregiver Stress

An appropriate priority hypothesis for a mother experiencing stress related to the care of a globally handicapped child is Caregiver Stress related to exhaustion from providing 24-hour care.

Question 27

Which goal is appropriate for a caregiver who is fatigued as a result of caring for a spouse with Alzheimer disease?

Answer 27

The caregiver will arrange for biweekly respite care.

This goal is both patient centered and measurable and is an appropriate goal.

Question 28

Which goal is appropriate and measurable for a recently widowed patient whose priority hypothesis is Ready to Learn regarding community resources?

Answer 28

The patient will attend a weekly bereavement support group.

This is a measurable goal that is appropriate for a patient whose priority hypothesis is Ready to Learn regarding community resources.

Question 29

Match the team member with whom the nurse would collaborate to the patient situation.

Answer 29

A patient whose stress is manifested as weight gain –Dietitian

A patient who has severe anxiety related to paying medical bills
—Social worker

A patient questioning his/her role in life
—Spiritual care provider

A patient requiring care from multiple health professionals
—Case manager

Question 30

A 55-year-old patient comes to the clinic with weight loss, depression, and malaise. Which collaborative partner would be beneficial in assisting in the plan of care?

Answer 30

Mental health care provider

The nurse should address the most immediate needs of the patient first; therefore, the nurse would collaborate first and most importantly with a mental health care provider to address the patient’s depression.

Question 31

Which member of the health care team would the nurse collaborate with to identify appropriate services for a 20-year-old female victim of domestic violence?

Answer 31

Social worker

The nurse should collaborate with a social worker first to identify resources, such as support groups or safe homes, for the patient.

Question 32

Which priority hypothesis demonstrates that the patient could possibly develop problems related to stress or coping?

Answer 32

Risk for Difficulty with Coping

A priority hypothesis of Risk for Difficulty with Coping demonstrates that the patient could possibly develop problems since he or she is “at risk” for a concern related to stress or coping.

Question 33

Which priority hypothesis demonstrates that the patient could benefit from health teaching?

Answer 33

Ready to Learn

A priority hypothesis of Ready to Learn demonstrates that the patient could benefit from health teaching.

Question 34

1. The nurse is interviewing a patient in the community clinic and gathers the following information about her: she is intermittently homeless, a single parent with two children who have developmental delays. She has had asthma since she was a teenager. She does not laugh or smile, does not volunteer any information, and at times appears close to tears. She has no support system and does not work. She is experiencing an allostatic load. As a result, which of the following would be present during complete patient assessment? (Select all that apply.)

Answer 34

3. Chronic illness
4. Insomnia
5. Depression

Question 35

2. A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1c, a measure of blood sugar control over the past 90 days, has increased by saying, “The hemoglobin A1c is wrong. My blood sugar levels have been excellent for the last 6 months.” Which defense mechanism is the patient using?

Answer 35

1. denial`

Question 36

3. When assessing a young woman who was a victim of a home invasion 3 months earlier, the nurse learns that the woman has vivid images of the event whenever she hears loud yelling or a sudden noise. The nurse recognizes this as ____________.

Answer 36

PTSD

Question 37

4. While assessing an older woman who is recently widowed, the nurse suspects that this woman is experiencing a developmental crisis. Which questions provide information about the impact of this crisis? (Select all that apply.)

Answer 37

1. With whom do you talk on a routine basis?
2. What do you do when you feel lonely?
3. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking?

Question 38

5. The nurse plans care for a 16-year-old male, taking into consideration that stressors experienced most commonly by adolescents include which of the following? (Select all that apply.)

Answer 38

2. Physical appearance and body image
3. Accepting one’s personal identity
4. Separation from family

Question 39

6. A 10-year-old girl was playing on a slide at a playground during a summer camp. She fell and broke her arm. The camp notified the parents and took the child to the emergency department according to the camp protocol for injuries. The parents arrive at the emergency department and are stressed and frantic. The 10-year-old is happy in the treatment room, eating a Popsicle and picking out the color of her cast. List in order of priority what the nurse should say to the parents.

Answer 39

2. “Your daughter is happy in the treatment room, eating a Popsicle and picking out the color of her cast.”
3. “I want to be sure you are ok. Let’s talk about what your concerns are about your daughter before we go see her.”
4. “I’ll have the doctor come out and talk to you as soon as possible.”
5. “Can I contact someone to help you?”

Question 40

7. When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, what is the first assessment the nurse conducts?

Answer 40

3. A thorough physical assessment

Question 41

8. A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and doesn’t see how he can go on much longer. Which statement would be the nurse’s best response?

Answer 41

4. “Tell me what you mean when you say you can’t go on any longer.”

Question 42

9. The nurse is evaluating how well a patient newly diagnosed with multiple sclerosis and psychomotor impairment is coping. Which statements indicate that the patient is beginning to cope with the diagnosis? (Select all that apply.)

Answer 42

3. “I’m going to let the occupational therapist assess my home to improve efficiency.”
4. “I’m going to attend a support group to learn more about multiple sclerosis.”

Question 43

10. A crisis intervention nurse is working with a mother whose child with Down syndrome has been hospitalized with pneumonia and who has lost her child’s disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in her classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? (Select all that apply.)

Answer 43

1. Referral to social service process reestablishing the child’s disability payment
2. Coordinating hospital-based and home-based schooling with the child’s teacher
3. Teaching the mother signs and symptoms of a respiratory tract infection