TERM 3- MY NOTES MENTAL HEALTH NURSING CARE CH.6 " STRESS AND COPING"

Question 1

Homeostasis

Answer 1

,

Question 2

Homeostasis is the state of dynamic balance of the human body’s internal environment, which is always adjusting in response to internal and external changes.
A)true
B)false

Answer 2

A

Question 3

A stressor is anything that puts the individual out of homeostasis. The brain has evolved to seek homeostasis, so it initiates the stress response, which is the reaction of the body in an attempt to restore homeostasis
A)true
B)false

Answer 3

A

Question 4

The Stress Response

Answer 4

,

Question 5

Theorist Hans Selye (1976) described stress as the physiological response to changes experienced by a biological organism. He found that the stress response is a general body reaction. Whether a person is being chased by a hungry alligator or has to walk up on a stage to accept an important award, the physiological reaction will be the same. This physiological reaction to a stressor is called the fight or flight response
A)true
B)false

Answer 5

A

Question 6

Epinephrine stimulates the sympathetic nervous system to prepare the body to fight the source of danger or to run away. This stress response is only adaptive when the stressor is a physical threat.
A)true
B)false

Answer 6

A

Question 7

In such an emergency, it would help people survive if they could see better in low light (dilated pupils), could run faster (blood diverted away from GI traer to skeletal muscle), and had more energy to run longer (increased glucose availability)
A)true
B)false

Answer 7

A

Question 8

Chronic exposure to sympathetic nervous system stimulation is not healthy. Although increased blood glucose is great in an emergency, prolonged hyperglycemia causes early fatigue and increased risk of type 2 diabetes.
A)true
B)false

Answer 8

A

Question 9

A chronically elevated blood pressure can increase risks of stroke, heart attack, and kidney disease. Inhibition of the immune system increases the risk of infection in the short term and inhibits tumor immunity in the long term
A)true
B)false

Answer 9

A

Question 10

INDIVIDUAL VARIATION

Answer 10

,

Question 11

It is the person’s perception of an event that makes it stressful. One person receiving an immunization who has had several before with no problems may not be concerned about it (and experience no stress response). Another person, whose father died from anaphylactic shock after an immunization, may be terrified (and will experience a severe stress response)
A)true
B)false

Answer 11

A

Question 12

A variety of faccors influence how a person perceives and reacts to a stressor. The predisposing faccors include age, maturity, culture, life experiences, and personality traits.
A)true
B)false

Answer 12

A

Question 13

EFFECT OF CULTURE ON STRESS RESPONSE

Answer 13

,

Question 14

For example, a fracture of a right-handed client’s right hand requiring a cast may be especially stressful if the client is from the Middle East where the left hand is considered unclean. This client would not be able to touch people politely, gesture, or even pass food or other items to another person with her left hand, so she would be under more stress and would feel more disabled than a European American client with the same injury who only sees it as an inconvenience to function with her nondominant hand.
A)true
B)false

Answer 14

A

Question 15

CULTURAL PULSE POINTS

Answer 15

,

Question 16

Cultural Effects on Signs and Symptoms of Stress

Western European and North American cultures generally expect that emotional stress will be expressed emotionally and physical stress will be expressed physically. In contrast, the majority of African, Asian, and Central American cultures expect people to express emotional distress in physical terms.

For example, a client from Mexico, Nigeria, or Vietnam may have abdominal pain or a headache when they are worried or under psychological stress. To be culturally sensitive, nurses must recognize that a client’s physical discomfort may have emotional causes and must include this possibility in nursing assessments

Answer 16

True

Question 17

Adaptation to Stress

Answer 17

,

Question 18

Adaptation is behavior that maintains the integrity of the individual. It is a healthy response to stress or life events.
A)true
B)false

Answer 18

A

Question 19

Maladaptation is unhealthy behavior that disrupts the integrity of the individual
A)true
B)false

Answer 19

A

Question 20

POSITIVE (ADAPTIVE} STRESS RESPONSES

Answer 20

,

Question 21

• Problem solving. Identify the problem, plan a response, and actively work on it.
• Using social support. Request and accept help from caring others.
• Reframing. Redefine the situation to see positive as well as negative sides and how to use the situation to your advantage.

Answer 21

True

Question 22

NEGATIVE (MALADAPTIVE} STRESS RESPONSES

Answer 22

,

Question 23

• Avoidance. Choosing not to deal with the situation. Negative feelings may become chronic.
• Self-blame. Blaming self takes the focus off working toward resolution of the problem. Feelings are about the self and not the problem.
• Wishful thinking. Thinking that “everything will be fine” to the exclusion of doing anything to make this happen. This is a form of denial.

Answer 23

True

Question 24

Factors Affecting the Ability to Adapt to a Stressor

Answer 24

,

Question 25

Age
The capacity to adapt is decreased in the very young and the old

Genetics
A family history of psychological or physical conditions, intelligence, or physical strength or weakness may affect ability to cope with stressors.

Health status
Severe or chronic illness can decrease a client’s reserves of energy and healing capacity when confronted with a new stressor. Good nutrition and adequate sleep can improve the ability to adapt.

Past experiences
The individual’s prior experience in a similar situation may help (by learning strategies for success) or hinder (by causing the anticipation of a bad result) the ability to adapt this time.

Resources
The availability of financial, personal (such as maturity), social, and coping skills improve the individual’s ability to adapt.

Answer 25

True

Question 26

Levels of Assertiveness

Answer 26

,

Question 27

Passive
The passive person meets the needs of others, without asking for own needs to be met.

Example:
“OK, you can have my ice cream cone.l didn’t want it anyway.”

Answer 27

True

Question 28

Assertive
The assertive person asks for own needs to be met, with respectful concern for the needs of others

Example:
Sure, I’ll drive you to work today. Will you drive me on Tuesday when my sister needs to use my car?”

Answer 28

True

Question 29

Aggressive
The aggressive person demands for own needs to be met, without regard for the needs of others.

Example:
“I want to play now. I don’t care if you think it’s your turn.”

Answer 29

True

Question 30

KEYTERMS

Answer 30

,

Question 31

cognitive reframing-restructuring irrational or self-defeating beliefs
A)true
B)false

Answer 31

A

Question 32

coping mechanisms-mental process by which knowledge is acquired and processed, including reasoning, judgement, memory, awareness and perception
A)true
B)false

Answer 32

A

Question 33

KEY Points

Answer 33

,

Question 34

• Stress has become an epidemic in our society.
• The stress response functions to alert the individual to a threat and to return the body to homeostasis. When it lasts after the stressor is resolved or is activated too frequently, some diseases are more likely to occur.
• People can respond to stress adaptively or maladaptively.
• The stress response begins with the fight or flight response.
• The stress response is nonspecific, meaning that the body responds the same no matter what the stressor is.
• The degree of stress caused by an event depends on how the individual perceives it. Two people experiencing the same event can feel different amounts of stress related to it.
• Culture affects how people perceive and react to stressful events.
• There are many approaches to stress management.
• Nurses experience many job-related stressors and must engage in self-care.

Answer 34

True

Question 35

NCLEX-PN® Exam Preparation

Answer 35

,

Question 36

A nurse is caring for a client who was admitted to the hospital with pneumonia. The client is constantly clenching his fists, refusing to eat, and having difficulty sleeping. He may be experiencing stress from more than his current illness. If all of the following events had recently occurred for this client, which would be the most likely source of his
obvious stress?
1. Promotion at work
2. Recognition for 25 years of service at his firm
3. Divorce
4. Ticket for minor traffic violation

Answer 36

3

Question 37

According to Hans Selye’s theory of a general body reaction to any stressor, which of the following symptoms might be experienced by a client concerned about his X-ray results?

1. Hypoglycemia
2. Increased heart rate
3. Increased urine output
4. Constricted pupils

Answer 37

2

Question 38

Which of the following physical conditions can be caused by continuous stimulation of the sympathetic nervous system?

1. Hypoglycemia
2. Glaucoma
3. Cardiovascular disease
4. Chronic obstructive pulmonary disease

Answer 38

3

Question 39

As a nurse, you would be more concerned about the stress response of a client being admitted into the hospital if you knew that:

1. His wife died in the same hospital recently.
2. This was his first hospitalization.
3. This was his first serious illness.
4. He is concerned about missing his son’s first soccer game.

Answer 39

1

Question 40

Which of the following clients is likely to be more susceptible to the negative aspects of stress?

1. A teenager living at home with a single parent
2. A poor, elderly widow suffering from chronic back pain due to osteoporosis
3. A young married woman with her first pregnancy
4. A successful businessman with a broken hip

Answer 40

2

Question 41

Which of the following clients is handling stress in an adaptive way?

1. The client assesses a situation to see why he is responding in such a stressed way.
2. The client avoids dealing with the stressor, assuming it will disappear soon.

Answer 41

2

Question 42

A newly admitted client has an accidental gunshot wound to her thigh. She states that she is concerned that she might lose her job if she has to be in the hospital for a long

time. Choose the best response by the nurse.
1. “It’s too soon to worry about that right now.”
2. “You have a great physician. I’m sure you won’t be in here a long time.”
3. “I can see this is really a concern to you. Let’s talk about this.”
4. “Do you have a history of attendance problems at work?”

Answer 42

3

Question 43

The nursing diagnosis of Ineffective Coping is appropriate for a client who:

1. Discusses her stress openly and frequently with family and friends.
2. Chooses not to discuss the source of her stress.
3. Writes about her feelings daily in a private journal.
4. Requests to see the hospital chaplain for prayer

Answer 43

2

Question 44

Select the best stress management technique that you might suggest to a client confined to bed:

1. Drink herb tea.
2. Practice progressive muscle relaxation.
3. Practice being aggressive with those who have been a source of stress in the past.
4. Get a cat or dog

Answer 44

2

Question 45

The client has expressed extreme stress about his current health situation of chronic renal disease. He is recently widowed and his wife had done all the driving due to his
poor vision.
He has now been told that he must begin renal dialysis. The nurse and the client agree that a nursing diagnosis of”ineffective Coping related to a situational crisis” is
appropriate. Select the appropriate early nursing interventions from the following choices.
1. Ask the client to list all perceived sources of his stress.
2. Reassure the client that everything will work out.
3. Review community resources for alternate transportation sources to dialysis.
4. Educate him on the methods of dialysis available.
5. Ask him if he is sure that dialysis is necessary at this point.
6. Advocate with his physician for a stress-relieving medication for him.

Answer 45

1 3 4

Question 46

STRESS AND COPING

Answer 46

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