Chapter 08: Stress and Disease My Nursing Test Banks

Huether and McCance: Understanding Pathophysiology, 5th Edition

Chapter 08: Stress and Disease

Test Bank

MULTIPLE CHOICE

1. After teaching about stress, which information indicates a correct understanding of stress?

a.

It worsens but does not cause disease.

b.

It can be viewed as transactional.

c.

It is a psychologic, rather than biologic, event.

d.

It is a passive event.

ANS: B

Stress has come to be defined by most as a transactional concept.

There is a relationship between stress and disease.

Stress is both a psychologic and a biologic event.

Stress is an active, rather than a passive, event.

REF: p. 208

2. Selye reported several structural changes in rats exposed to repeated stressors. These included:

a.

Hypertrophy of the thymus gland

b.

Ulceration in the gastrointestinal system

c.

Atrophy of the cortex in the adrenal gland

d.

Fight or flight response

ANS: B

Selye found the development of bleeding ulcers in response to stress.

Selye found atrophy, not hypertrophy, of the thymus gland.

Selye found enlargement of the cortex, rather than atrophy.

The flight or fight response was part of the general adaptation syndrome, not a structural change.

REF: p. 204

3. A female student is driving to school when another driver nearly hits her. Her heart begins beating harder and faster as she becomes aroused and scared. Which of the following stages of the general adaptation syndrome is she experiencing?

a.

Alarm stage

b.

Stage of resistance

c.

Adaptation

d.

Exhaustion

ANS: A

The alarm stage is manifested by arousal of the bodys defenses.

The stage of resistance is the second step.

Adaptation is a part of resistance.

Exhaustion marks the breakdown of compensatory mechanisms.

REF: p. 204

4. Exhaustion occurs if stress continues and _____ is not successful.

a.

Fight or flight

b.

Alarm

c.

Adaptation

d.

Arousal

ANS: C

Exhaustion occurs if adaptation is not successful.

Exhaustion occurs if adaptation is not successful, not fight or flight.

Alarm is part of the adaptation process, but it is adaptation that prevents exhaustion.

Arousal is the recognition of stress.

REF: p. 205

5. A male student arrives at school to find that he has an exam for which he is unprepared. Which of the following would be expected?

a.

Decreased lipolysis

b.

Bronchoconstriction

c.

Decreased cortisol release

d.

Increased glucagon release

ANS: D

The student would experience increased glucagon release to supply glucose.

Increased lipolysis would occur, not decreased.

Bronchodilation would occur, not constriction.

The student would experience increased cortisol release.

REF: p. 206 | p. 211

6. A 10-year-old female is arriving at a national spelling bee contest. Her heart starts beating faster and harder, and she begins to sweat. Which of the following is she experiencing?

a.

Anticipatory response

b.

Homeostasis

c.

Reactive response

d.

Exhaustion stage

ANS: A

Anticipation of experiencing these events produces a physiologic stress response.

Homeostasis is a steady state.

Reactive response occurs following a stressful event; the student is anticipating a stressful event.

Exhaustion stage is the final stage of the stressful response.

REF: p. 207

7. Which of the following hormones activates adrenergic receptors?

a.

Oxytocin

b.

Prolactin

c.

Epinephrine

d.

Somatotropin

ANS: C

Epinephrine activates adrenergic receptors.

Oxytocin activates receptors in the uterus.

Prolactin does not activate adrenergic receptors.

Somatotropin activates protein and carbohydrate metabolism.

REF: p. 209

8. A 35-year-old male is diagnosed with a hormone-secreting tumor of the adrenal medulla. He experiences elevated blood pressure, pupil dilation, goose bumps, and increased anxiety. Which of the following hormones is the predominant one released by the tumor?

a.

Antidiuretic hormone

b.

Acetylcholine

c.

Norepinephrine

d.

Cortisol

ANS: C

Norepinephrine regulates blood pressure and promotes arousal, increased vigilance, increased anxiety, and other protective emotional responses.

Antidiuretic hormone regulates urine output.

Acetylcholine will not result in an increase in blood pressure.

Cortisol regulates glucocorticoids.

REF: p. 209

9. Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:

a.

Epinephrine and aldosterone

b.

Norepinephrine and cortisol

c.

Epinephrine and norepinephrine

d.

Cortisol and aldosterone

ANS: C

The catecholamines are epinephrine and norepinephrine.

The catecholamines are epinephrine and norepinephrine, not aldosterone.

The catecholamines are epinephrine and norepinephrine, not cortisol.

The catecholamines are epinephrine and norepinephrine, not cortisol and aldosterone.

REF: p. 209

10. A nurse recalls stress-induced stimulation of the adrenal cortex causes it to secrete:

a.

Estrogen

b.

Cortisol

c.

Parathyroid hormone

d.

Adrenocorticotropin hormone (ACTH)

ANS: B

The adrenal cortex secretes cortisol.

The adrenal cortex secretes cortisol, not estrogen.

The adrenal cortex secretes cortisol, not parathyroid hormone.

The adrenal cortex secretes cortisol, not ACTH.

REF: p. 210

11. Stress-induced catecholamine release from the adrenal medulla may result in:

a.

Decreased blood flow to the brain

b.

Elevated blood pressure

c.

Increased glycogen synthesis in the liver

d.

Decreased muscle contraction resulting from energy depletion

ANS: B

Catecholamine release results in elevated blood pressure.

Catecholamine release results in increased blood flow to the brain.

Catecholamine release results in increased glucose production, not glycogen synthesis.

Catecholamine release results in increased muscle contraction.

REF: p. 209

12. A 50-year-old female is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which of the following would be expected?

a.

Decreased blood pressure

b.

Increased lipogenesis of face and trunk

c.

Increased lipogenesis of extremities

d.

Decreased gastric secretion

ANS: B

Increased release of cortisol leads to increased lipogenesis of face and trunk.

Increased release of cortisol leads to increased blood pressure.

Increased release of cortisol leads to lipolysis, not lipogenesis, of the extremities.

Increased release of cortisol leads to increased gastric secretion.

REF: p. 206 | p. 211

13. A 30-year-old male develops poison ivy after mowing the lawn near the woods. His primary care provider prescribes a synthetic cortisol. How will the cortisol relieve his symptoms?

a.

Suppressing Th1 cell activity

b.

Increasing cytokine secretion

c.

Suppressing natural killer cell activity

d.

Increasing Th2 activity

ANS: A

Cortisol suppresses Th1 responses.

Cortisol does not increase cytokine secretion.

Cortisol does not suppress natural killer cell activity.

Cortisol suppresses Th2 activity.

REF: p. 213

14. When assessing the effects of elevated -endorphins in a patient, which of the following should the nurse monitor?

a.

Peripheral vasoconstriction

b.

Hyperglycemia

c.

Pain inhibition

d.

Decreased immune cell activity

ANS: C

Elevated -endorphins activate endorphin (opiate) receptors on peripheral sensory nerves leading to pain relief or analgesia.

Elevated -endorphins activate endorphin (opiate) receptors on peripheral sensory nerves leading to pain relief or analgesia, not vasoconstriction.

Elevated -endorphins activate endorphin (opiate) receptors on peripheral sensory nerves leading to pain relief or analgesia, not hyperglycemia.

Elevated -endorphins activate endorphin (opiate) receptors on peripheral sensory nerves leading to pain relief or analgesia, not decreased immune cell activity.

REF: p. 214

15. A 10-year-old male was physically abused for the previous 4 years. He reports feeling stressed all the time and frequently gets ill. Which of the following hormones is most likely suppressed in this child?

a.

Endorphins

b.

Growth hormone

c.

Prolactin

d.

Cortisol

ANS: B

Increased levels of growth hormone are associated with psychological stimuli associated with stress and, thus, increase the chance of becoming ill.

Increased levels of growth hormone are associated with psychological stimuli associated with stress; endorphins do not affect this.

Increased levels of growth hormone are associated with psychological stimuli associated with stress; prolactin does not affect this.

Increased levels of growth hormone are associated with psychological stimuli associated with stress; cortisol does not affect this.

REF: p. 219

16. After teaching about coping, which information indicates a correct understanding? Coping is best defined as the process of:

a.

Adjusting to disease

b.

Preventing psychological distress

c.

Mediating anger

d.

Managing stressful challenges

ANS: D

Coping is the process of managing stressful challenges that tax the individuals resources.

Coping is the process of managing stressful challenges that tax the individuals resources; it is not adjusting to disease.

Coping is the process of managing stressful challenges that tax the individuals resources; it is not preventing psychological distress.

Coping is the process of managing stressful challenges that tax the individuals resources; it is not mediating anger.

REF: p. 217

MULTIPLE RESPONSE

1. When teaching about the stress-age syndrome, what information should the nurse include? (Select all that apply.)

a.

Decreased cortisol secretion

b.

Increased thyroxine

c.

Immunodepression

d.

Increased catecholamine secretion

e.

Hypercoagulation of the blood

f.

Free radical damage

ANS: B, C, D, E, F

The stress-age syndrome includes alterations in the excitability of structures of the limbic system and hypothalamus; rise of the blood concentration of catecholamines, ADH, ACTH, and cortisol; decrease in testosterone, thyroxine, and others; alterations of opioid peptides; immunodepression and pattern of chronic inflammation; alterations in lipoproteins; hypercoagulation of the blood; and free radical damage of cells.

REF: p. 218

2. When dealing with repression in patients, which of the following assessment findings are associated with repression? (Select all that apply.)

a.

Decreased monocyte counts

b.

Increased eosinophil counts

c.

Decreased serum glucose

d.

Increased pulse rates

e.

Increased medication reactions

ANS: A, B, E

Repression was associated with lower monocyte counts, higher eosinophil counts, higher serum glucose, and more self-reported medication reactions in medical outpatients. It is not associated with increased pulse rates and glucose increases, rather than decreases.

REF: p. 217

Mosby items and derived items 2012 Mosby, Inc., an imprint of Elsevier Inc.

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