Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based
Practice 11th Edition
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
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
ChangesQuestionnaire 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
,MIBS UNIVERSITY
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 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.
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 stress-
related 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
, MIBS UNIVERSITY
1. 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
2. Which client statement alerts the nurse that the client may be responding
maladaptively to stress?
A. “Avoiding contact with others helps me
cope.”
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