Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based Practice 10th Edition Townsend Test Bank

1. 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: A. Understands the client is at risk for significant stress-related illness. B. Determines the client is not at risk for significant stress-related illness. C. Needs further assessment of the client’s coping skills to determine susceptibility to stress-related illness. D. Recognizes the client may view the losses as challenges and perceive them as opportunities. ANS: C C Chapter learning objective: Explain the relationship between stress and diseases of adaptation. Page: 5–6 Heading: Stress as an Environmental Event Integrated Processes: Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Moderate Feedback A 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 illness. The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the RaheHolmes 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. 10th edition healthcare Feedback A 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 illness. The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the RaheHolmes 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. B 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 a year-score 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 illness. C 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 stressrelated physical and psychological illness. A 6-month score of 300 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. D 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 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. PTS: 1 CON: Stress 2. 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: A. Irrelevant. B. Harm/loss. C. A threat. D. A challenge. ANS: D Chapter: Chapter 0, The Concept of Stress Adaptation Chapter learning objective: Discuss adaptive coping strategies in the management of stress. Page: 7 Heading: 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 A This is incorrect. The client’s statement indicates he perceives the loss of his job as a challenge and an opportunity for growth. B This is incorrect. The client’s statement indicates he perceives the loss of his job as a challenge and an opportunity for growth. C This is incorrect. The client’s statement indicates he perceives the loss of his job as a challenge and an opportunity for growth. D This is correct. The client’s statement indicates he perceives the loss of his job as a challenge and an opportunity for growth. PTS: 1 CON: Stress 3. Which client statement alerts the nurse that the client may be responding maladaptively to stress? A. “Avoiding contact with others helps me cope.” B. “I really enjoy journaling; it’s my private time.” C. “I signed up for a yoga class this week.” D. “I made an appointment to meet with a therapist.” A. “Avoiding contact with others helps me cope.” B. “I really enjoy journaling; it’s my private time.” C. “I signed up for a yoga class this week.” D. “I made an appointment to meet with a therapist.” ANS: A Chapter: Chapter 0, The Concept of Stress Adaptation Chapter learning objective: Discuss adaptive coping strategies in the management of stress. Page: 8–9 Heading: Stress Management Integrated Processes: Nursing Process: Evaluation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Easy Feedback A 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. B This is incorrect. Journaling is not considered a maladaptive coping method. C This is incorrect. Group exercise is not considered a maladaptive coping method. D This is incorrect. Seeing a therapist is not considered a maladaptive coping method. PTS: 1 CON: Stress 4. 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? A. Alarm reaction B. Resistance C. Exhaustion D. Fight or flight ANS: C Chapter: Chapter 0, The Concept of Stress Adaptation Chapter learning objective: Explain the relationship between stress and diseases of adaptation. Page: 9 Heading: Stress as a Biological Response Stage of Exhaustion Integrated Processes: Nursing Process: Assessment Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Stress Difficulty: Easy Feedback A This is incorrect. At the alarm reaction stage, physiological responses of the fight-or-flight syndrome are initiated. B This is incorrect. At the stage of resistance, the individual uses the physiological responses of the first stage as a defense in the attempt to adapt to the stressor. Physiological symptoms may disappear. C This is correct. At the stage of exhaustion, the student’s exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. D This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction stage. PTS: 1 CON: Stress 5. A school nurse is assessing a female high-school student who is overly concerned about her appearance. The client’s mother states, “That’s not something to be stressed about!” Which response by the nurse is best? A. “Teenagers! They don’t know a thing about real stress.” B. “Psychological or physical stress occur only when there is a loss.” C. “Poor physical condition can interfere with psychological well-being.” D. “A threat to self-esteem can result in psychological stress.” ANS: D Chapter: Chapter 0, The Concept of Stress Adaptation Chapter learning objective: Describe the core concept of stress as an environmental event. Page: 7 Heading: Stress as a Transaction Between the Individual and the Environment Integrated Processes: Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Stress Difficulty: Moderate Feedback A This is incorrect. This response is judgmental and nontherapeutic. B This is incorrect. Physical and psychological stress can be precipitated by events other than loss. C This is incorrect. Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. D This is correct. Determination of an event as stressful depends on the individual’s cognitive appraisal of the situation, which is an individual’s evaluation of the personal significance of the event or occurrence. Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. PTS: 1 CON: Stress