Unit 8 Stress and Coping Chapter 32

Question 1

Defense Mechanisms

Answer 1

Defense mechanisms are predominantly unconscious, protective coping methods that people may apply in response to a perceived threat.

Question 2

What is the General Adaptation Syndrome (GAS)?

Answer 2

The body’s PHYSICAL response to stress

Hans Selye (1976) named the physical response to stress the general adaptation syndrome (GAS).

Question 3

What is mild anxiety beneficial for?
A. Working
B.Brushing teeth
C. Learning
D. Reading

Answer 3

C. Learning

Mild anxiety can be motivational, foster creativity, and actually increase the ability to think clearly. For example, a person who experiences mild performance anxiety when acting in a play may have a heightened ability to remember lines or cues, which keeps the person at top performance level

Question 4

What are the stages of the General Adaptation Syndrome?
A. Inflammation, Proliferative, Maturation
B. Alarm, Resistance, Exhaustion,
C. Primary Intention, Secondary Intention, Tertiary Intention
D. Glaucoma, Macular Degenration, Cataract

Answer 4

B. Alarm, Resistance, Exhaustion

The GAS consists of three stages: alarm reaction, resistance, and exhaustion. Most stressful events involve only the first two, but some ongoing demands can exceed the body’s resources and lead to the final stage of exhaustion

Question 5

Which stage of the General Adaptation Syndrome is characterized by increased cortisol levels, and an increase in heart rate, and blood pressure?
A. Alarm reaction Stage
B. Resistance stage
C. Exhaustion stage
D. Recovery Stage

Answer 5

A. Alarm reaction Stage

Question 6

What term defines negative stress?
A. Eustress
B. Homeostasis
C.Distress
D. Mild anxiety

Answer 6

C.Distress

He labeled negative stress as distress (stress that is beyond the ability of the affected person to cope with or adapt to effectively), which can cause physical illness or emotional dysfunction.

Question 7

What is scenario illustrates what Eustress beneficial for?
A. The patient is crying
B. The patient is motivated to finish her assignments
C. The patient loss her last 500 dollars and now is broke with no motivation
D. The patient just lost the Super Bowl and does not want to play football ever again.

Answer 7

B. The patient is motivated to finish her assignments

He identified positive stress as eustress (motivational stress), which is associated with effective coping and adaptation. Eustress is thought to be essential for normal growth and development.

Question 8

Which system of the body is in continuous use during the Alarm Stage of the General Adaptivity Syndrome (GAS)?
A. Nervous system
B. Parasympathetic system
C. Sympathetic system
D. Endocrine system

Answer 8

C. Sympathetic system

Question 9

What is a stressor?

Answer 9

A stressor is an event or stimulus that disrupts the person’s sense of equilibrium.

Something or an event that disrupts normalcy in the body, and mind

Selye referred to the demands that produce the adaptive response as stressors and noted that stress is unavoidable.

Stressors disrupt the person’s equilibrium, resulting in illness.

Question 10

You are a nurse working in the college student health center. You receive a call that an athlete has just fallen and has been injured. You know that according to the general adaptation syndrome, the athlete will be exhibiting:
A. an increased appetite.
B. an increased heart rate.
C. a decrease in perspiration.
D. a decrease in respiratory rate.

Answer 10

B. an increased heart rate.

Question 11

Which one of these terms refers to how homeostasis is reestablished?
A. Equilibrium
B. Sinus breathing
C. Allostasis
D. Resistance

Answer 11

C. Allostasis
According to these researchers, allostasis is how homeostasis is reestablished, and the purpose of allostasis is to assist the body in maintaining stability

Question 12

The nurse knows the one theory explaining the variation in response to stress among individuals is identified by which term?
a. Stress appraisal
b. Sense of coherence
c. Allostasis
d. Homeostasis

Answer 12

b. Sense of coherence

concept of sense of coherence (SOC) to help explain this variation in response to stress.

Question 13

When the nurse measures the patient’s blood glucose levels after an acute myocardial infarction (MI), the nurse knows this action is based on which rationale?
a. Damaged muscle tissue releases glucose.
b. Corticosteroids increase glucose.
c. Myocardial infarctions are often seen in diabetics.
d. All patients should have their blood glucose checked.

Answer 13

b. Corticosteroids increase glucose.

Question 14

The nurse is teaching a patient about the difference between mild anxiety and moderate anxiety. Which statement by the patient indicates a need for further education?
a. “Mild anxiety can help me remember things.”
b. “Moderate anxiety will narrow my focus.”
c. “Mild anxiety will help me be creative.”
d. “Moderate anxiety will increase my perception.”

Answer 14

d. “Moderate anxiety will increase my perception.”

Question 15

What is Mild Anxiety

Answer 15

Mild anxiety can be motivational, foster creativity, and increase a person’s ability to think clearly.

Question 16

What is Moderate Anxiety

Answer 16

Moderate anxiety narrows a person’s focus, dulls perception, and may challenge a person to pay attention or use appropriate problem-solving skills.

Question 17

What is Severe Anxiety

Answer 17

Severe anxiety results in the inability to make decisions or solve problems,

Question 18

The nurse is performing a physical assessment of patient who is undergoing a bone marrow biopsy. What finding by the nurse indicates the patient is experiencing stress?
a. Blood pressure of 120/84
b. Temperature of 99.5 F (37.5 C)
c. Heart rate of 110 beats/min
d. Respiratory rate of 10 breaths/min

Answer 18

c. Heart rate of 110 beats/min

The release of hormones increases the heart rate, resulting in increased cardiac output and elevated blood pressure. Smooth muscle in the bronchi relax and dilate the bronchi and smaller airways, and the respiratory rate increases, allowing for an enhanced flow of well-oxygenated blood to muscles and other organs. A reading of 120/84 is a normal blood pressure, and temperature is elevated is indicative of an infection. The respiratory rate increases in stress, not decreases.

Question 19

The nurse knows that when patients are experiencing stress, which physiologic changes can be seen in their signs and symptoms? (Select all that apply.)
a. Increase in heart rate
b. Flaccid muscles
c. Pupil dilation
d. Decrease in blood pressure
e. Increase in respiratory rate

Answer 19

A, C, E

Question 20

What is Projection (Defense Mechanism)

Answer 20

Projection
Attributing one’s own unacceptable feelings or impulses to someone else.

Example:
A man is cheating on his wife and accuses her of having an affair.

Question 21

What is Compensation (Defense Mechanism)?

Answer 21

Compensation
focusing on strengths rather than perceived weaknesses

Covering up a real or perceived weakness by emphasizing a trait one considers more desirable.

Example:
A high-school student struggles with math and concentrates on athletics instead.

Question 22

What is Denial (Defense Mechanism)?

Answer 22

Denial
Ignoring aspects of reality that induce anxiety or contribute to a loss of self-esteem

Refusing to acknowledge the existence of a real situation or the feelings associated with it.

Example:
A man loses his job because of daily drinking but states that he does not have an alcohol problem.

Question 23

What is Regression (Defense Mechanism)?

Answer 23

Regression
Reverting to behavior associated with an earlier stage of development when challenged by thoughts and stressors
THINK GRADESCHOOL

Retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning.

Example:
A 3 year old refuses to use the potty when a sibling is born and asks to drink from a bottle.

Question 24

What is Rationalization (Defense Mechanism)

Answer 24

Rationalization
Explaining personal actions in a way that enhances one’s own self- image
-excuses as to why you did what you did

Attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors.

Example:
An employee calls out sick from work to go to the beach and calls it taking a “mental health day”.

“I cheated on you because I was lonely and you weren’t giving me attention”

Question 25

What is Repression (Defense Mechanism)?

Answer 25

Repression
Blocking unacceptable thoughts and feelings from consciousness

Involuntary blocking unpleasant feelings and experiences from one’s awareness.

Example:
A rape victim can not remember any of the events associated with the traumatic event.

Question 26

What is Intellectualization (Defense Mechanism)?

Answer 26

Intellectualization
Overthinking a challenging situation or impulse to avoid dealing with the emotions it elicits

An attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis.

Example:
A man’s dog dies, and instead of expressing grief, he reasons that he gave the dog a good life for 12 years.

if a person elderly person dies, but instead of showing grief and emotions, you use a logic by saying “ they’ve lived a long life.

Question 27

What is Displacement (Dense Mechanism)?

Answer 27

Displacement
Redirecting negative emotions perceived as unacceptable or threatening to a safer focus

The transfer of feelings from one target to another that is considered less threatening or that is neutral.

Example:
A child is angry at his mother, but kicks the dog instead of expressing his anger at her.

Question 28

What is Sublimation (Defense Mechanism)?

Answer 28

Channeling unacceptable emotions or impulses into acceptable actions or responses

Channeling negative behavior, emotions, and thoughts to a positive outlet

Example:
Feeling upset about how your body looks , but going to the gym to feel better and getting your dream body

Feeling upset but then painting to calm your nerves.

Question 29

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 nurses best response?
1. “Are you thinking of suicide?”
2. “You’ve been doing a good job raising your children. You can do it!”
3. “Is there someone who can help you during the evenings and weekends?»
4. «Tell me what you mean when you say you can’t go on any longer.”

Answer 29

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

Question 30

2. A patient who is having difficulty managing his diabetes melli-tus responds to the news that his hemoglobin Alc, a measure of blood sugar control over the past 90 days, has increased by saying,
”The hemoglobin Alc is wrong. My blood sugar levels have been excellent for the last 6 months.” Which defense mechanism is the patient using?
   A. Denial -
   B. Conversion
   C. Dissociation
   D. Displacement

Answer 30

A. Denial -

Question 31

The high school teacher was criticized for having a disruptive class. When the teacher got home that night, he argued with his wife and kicked the dog.
A. Projection
B. Intellectualization
C. Repression
D. Displacement

Answer 31

D. Displacement

Question 32

The habitual drinker may insist that he really doesn’t care much for the taste of alcohol, but feels that he is obligated to drink with his friends “just to be sociable.
A. Rationalization
B.Regression
C. Displacement
D. Compensation

Answer 32

A. Rationalization

Question 33

Mary has secretly disliked her mother since she was a young child. As these feelings arouse anxiety, Mary usually tells her friends that she loves her mother very much.
A. Reaction Formation
B. Displacement
C. Compensation
D. Regression

Answer 33

A. Reaction Formation

Responding to negative thoughts or feelings by demonstrating opposite emotions and actions

Question 34

It is typical for the person who is most difficult to convince in an argument to say that everyone else is stubborn.
A. Repression
B. Projection
C.Displacement
D. Intelectualizatiom

Answer 34

B. Projection

Question 35

What is Panic

Answer 35

whereas panic (the highest level of anxiety) is associated with a multitude of physiologic changes, as well as subjective feelings of extreme dread or terror

Question 36

When a new baby arrives in the family, the older child will sometimes cry more than usual and be insistent about receiving caresses from the parents.
A. Regression
B. Desperation
C. Depression
D. Aspiration

Answer 36

A.Regression

Question 37

A student forgot that his dreaded final exam in psychology was scheduled for Saturday. This seemed unusual as the date of the exam had been marked on his calendar for several weeks.
A. Repression
B. Regression
C. Displacement
D. Intellectualizationn

Answer 37

A. Repression

Blocking unacceptable thoughts and feelings from consciousness

Question 38

Parents who disguise hostility toward their children by becoming overly protective of them are very likely using the defense mechanism of?
A. Displacement
B. Reaction Formation
C. Stress Appraisal
D. Sense of Coherence

Answer 38

B. Reaction Formation

Responding to negative thoughts or feelings by demonstrating opposite emotions and actions

Question 39

What is Anxiety

Answer 39

Anxiety is a response to stress that causes apprehension or uncertainty. It differs from fear, which has an identifiable source of impending danger

Question 40

What is Anger

Answer 40

Anger is an emotion that involves antagonism toward another person or situation. It is evoked by a feeling of being wronged in some way.

Question 41

What is Depression

Answer 41

Depression sometimes is described as “anger turned inward.” Typically, depression results from an experience of loss—loss of a loved one, relationship, or job; failure of a professional goal; or diminished physical health or appearance.

Question 42

9. Which short-term goal would be most appropriate for a patient with the nursing diagnosis Anxiety with supporting data, including upcoming diagnostic tests, expressions of concern, and pacing around the room?
   a. Patient will discuss specific aspects of concern.
   b. Nurse will administer prescribed antianxiety medication.
   c. Patient will understand diagnostic test procedures.
   d. Nurse will describe test procedures in detail to allay concerns.

Answer 42

a. Patient will discuss specific aspects of concern.

Answer: a
Having the patient discuss specific aspects of concern allows the nurse the opportunity to assess the patient’s level of anxiety and what interventions might be most appropriate to help allay the stated concerns. Goals must be patient centered, measurable, and realistic. None of the other three goals meet these criteria. Two of the goals are nurse focused. The action “understand” is not measurable.

Question 43

1. The nurse has been assigned the same patients for the past 4 days. Two of the patients demand a great deal of attention, and the nurse feels anxious and angry about being given this assignment again. What action would demonstrate the most effective way for the nurse to cope with the patient care assignment?
   a. Share complaints about the assignment with the nurse manager.
   b. Prioritize the patients’ needs and identify a specific time period to care for each patient.
   c. Talk with the patients and explain that they cannot expect so much personal attention.
   d. Trade assignments with another nurse who is unaware of the concerns regarding the patient assignment.

Answer 43

b. Prioritize the patients’ needs and identify a specific time period to care for each patient.

Answer: b
Prioritizing care and setting aside time to spend with specific patients constitute the most effective coping strategy for the nurse to use. Sharing concerns with the nurse manager does not demonstrate strong problem-solving skills; it merely shows a desire to complain. Trading assignments diminishes the continuity of care during which patient trust and nurse–patient relationships are developed. Patients are always the focus of nursing care and should not be given the impression that the nurse does not have time to care or listen to their concerns.

Question 44

What nursing intervention for a pt going through a Crisis ?

Answer 44

Crisis intervention is short-term assistance provided at a time of physical or emotional upheaval with the goal of helping the person in distress to regain equilibrium.

Crisis intervention involves simple, innovative, accessible, practical, and immediate actions that ensure a person’s safety and mental well-being, such as providing counselors for school students after the sudden death of a classmate or encouraging a person to drive as soon as possible after involvement in a fatal accident that took the life of a friend.

Question 45

Nervous Systems Response to Stress

Answer 45

Nervous system response to stress
-Physical signs of stress are those of
sympathetic nervous system stimulation.
- Changes occur within the first minutes of
exposure to a stressor and may be
experienced as the sensations of
palpitations, light-headedness, nausea,
and anxiety.

Question 46

Immune Systems Response to Stress

Answer 46

Immune system response to stress
- Pain, vasodilation, and swelling
- Mobilization of white blood cells and
lymphocytes

Question 47

Endocrine System Response to Stress

Answer 47

Endocrine system response to stress
 Sympathoadrenal response
 Hypothalamic-pituitary-adrenal complex
 Corticosteroids
 Hyperglycemia

Question 48

Psychological responses to stress

Answer 48

Psychological responses to stress
 Resilience and coping
 Anxiety
 Anger
 Depression

Question 49

Objective of Crisis Intervention

Answer 49

-Crisis intervention is short-term assistance provided at a time of physical or emotional upheaval with the goal of helping the person in distress to regain equilibrium.

-Crisis intervention involves immediate action to help reduce the impact of a traumatic event in the affected person’s life.

-When people are overwhelmed by the circumstances confronting them, crisis intervention strategies can help them adapt and restore their ability to function

Question 50

Example of Crisis Intervention

Answer 50

Crisis intervention involves simple, innovative, accessible, practical, and immediate actions that ensure a person’s safety and mental well-being, such as providing counselors for school students after the sudden death of a classmate or encouraging a person to drive as soon as possible after involvement in a fatal accident that took the life of a friend.

OBJECTIVE -helping patients adapt with a traumatic event

Question 51

What is an example of a healthy coping mechism?
A. Smoking
B. Decompressing by going out with your friends and excersing
C. Punching the wall
D. Self isolation

Answer 51

B. Decompressing by going out with your friends and excersing

Question 52

Healthy coping strategies:

Answer 52

Healthy coping strategies:
- exercise,
- balanced nutrition,
-mindfulness therapy

Question 53

Mary has secretly disliked her mother since she was a young child. As these feelings arouse anxiety, Mary usually tells her friends that she loves her mother very much.

Answer 53

Reaction Formation

Question 54

Reaction Formation

Answer 54

Responding to negative thoughts or feelings by demonstrating opposite emotions and actions

Preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors.
Example:
A wife is unhappy in her marriage, but dotes on her husband and declares her love for him on social media.