Test Bank for - MULTIPLE CHOICE 1. A client has experienced the...

Test Bank for Psychiatric Mental Health Nursing, 10e Karyn Morgan, Mary Townsend (All Chapters) 1 / 4

Townsend PMHN, 10e Chapter 1 - ETB Chapter 1. The Concept of Stress Adaptation

MULTIPLE CHOICE

• A client has experienced the death of a close family member and at the same time

becomes unemployed. The client’s 6-month score on the Recent Life Changes

Questionnaire is 110. The nurse:

• Understands the client is at risk for significant stress-related illness.
• Determines the client is not at risk for significant stress-related illness.
• Needs further assessment of the client’s coping skills to determine susceptibility to

stress-related illness.

• Recognizes the client may view the losses as challenges and perceive them as

opportunities.

ANS: 3

Chapter: Chapter 1, The Concept of Stress Adaptation

Objective: Explain the relationship between stress and diseases of adaptation.

Page: 5

Heading: Stress as an Environmental Event

Integrated Processes: Nursing Process: Evaluation

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Stress

Difficulty: Moderate

Feedback

• This is incorrect. Assessment is the first step of the nursing process. The nurse

should assess the client’s coping skills and available support before determining susceptibility to stress-related physical and psychological illnesses. The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more or a year-score total of 500 or more indicates high stress in a client’s life and susceptibility to stress-related illnesses.

• This is incorrect. Assessment is the first step in the nursing process. The nurse

should assess the client’s coping skills and available support before determining the client’s perception of the current stresses. A 6-month score of 300 or more or a year- score total of 500 or more on the Recent Life Changes Questionnaire indicates high stress in a client’s life and susceptibility to stress-related physical and psychological illnesses.

• This is correct. Assessment is the first step in the nursing process. The nurse should

assess the client’s coping skills and available support before determining susceptibility to stress-related physical and psychological illnesses. A 6-month score 2 / 4

Townsend PMHN, 10e Chapter 1 - ETB of 300 or more or a year-score of 500 or more indicates high stress in a client’s life and risk for significant stress-related physical and psychological illness.

• This is incorrect. Assessment is the first step in the nursing process. The nurse

should assess the client’s coping skills and available support before determining susceptibility to stress-related illness. A 6-month score of 300 or more or a year- score of 500 or more on the Recent Life Changes Questionnaire indicates high stress in a client’s life is susceptible to significant stress-related physical and psychological illness.

CON: Stress

• A physically and emotionally healthy client has just been fired. During a routine

office visit, he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll consider pursuing an art degree.” The nurse determines the client perceives the stressor

of his job loss as:

• Irrelevant
• Harm or loss
• Threatening
• A challenge

ANS: 4

Chapter: Chapter 1, The Concept of Stress Adaptation

Objective: Discuss adaptive coping strategies in the management of stress.

Page: 7

Heading: Stress as a transaction between the individual and the environment

>Individual’s Perception of the Event > Primary Appraisal Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Stress

Difficulty: Easy

Feedback

• This is incorrect. An irrelevant perception is one where the event holds no

significance for the individual.

• This is incorrect. A harm or loss appraisal refers to damage or loss already

experienced by the individual.

• This is incorrect. A threatening appraisal is perceived as anticipated harms or losses.
• This is correct. The client’s statement indicates he perceives the loss of his job as a

challenge and an opportunity for growth, demonstrated by his statement to consider an art degree.

CON: Stress

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Townsend PMHN, 10e Chapter 1 - ETB

• Which client statement alerts the nurse that the client may be maladaptively

responding to stress?

• “Avoiding contact with others helps me cope.”
• “I really enjoy journaling; it’s my private time.”
• “I signed up for a yoga class this week.”
• “I made an appointment to meet with a therapist.”

ANS: 1

Chapter: Chapter 1, The Concept of Stress Adaptation

Objective: Discuss adaptive coping strategies in the management of stress.

Page: 8

Heading: Stress Management

Integrated Processes: Nursing Process: Evaluation

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Stress

Difficulty: Easy

Feedback

• This is correct. Reliance on social isolation as a coping mechanism is a maladaptive

method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems.

• This is incorrect. Journaling is a form of adaptive coping and interpersonal

communication.

• This is incorrect. Group exercise is a form of adaptive coping, relaxation.
• This is incorrect. Seeing a therapist is not considered a maladaptive coping method.

CON: Stress

• A nursing student comes down with a sinus infection toward the end of every

semester. Which stage of stress is the student most likely experiencing when this occurs?

• Alarm reaction
• Resistance
• Exhaustion
• Fight or flight

ANS: 3

Chapter: Chapter 1, The Concept of Stress Adaptation

Objective: Explain the relationship between stress and diseases of adaptation.

Page: 2

Heading: Stress as a Biological Response

Integrated Processes: Nursing Process: Assessment

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