Chapter_09-_Stress_and_Adaptation My Nursing Test Banks

 

1.

According to Walter B. Cannon, homeostasis is a stable internal environment achieved through a system of:

A)

interdependent system-wide adaptive responses.

B)

variable internal and external conditioning factors.

C)

coordinated physiologic processes that oppose change.

D)

compatibility between cells and the internal environment.

2.

Allostasis is characterized by:

A)

organ-specific physiologic responses.

B)

interactive physiologic changes in numerous systems.

C)

systems that detect psychologic function.

D)

future expectations as a catalyst for change.

3.

According to Hans Selye, the first stage of the general adaptation syndrome (GAS) is:

A)

alarm.

B)

exhaustion.

C)

resistance.

D)

anticipation.

4.

Although stress exposure initiates integrated responses by multiple systems, the functional changes are first manifested by which system?

A)

Pulmonary

B)

Gastrointestinal

C)

Cardiovascular

D)

Neuroendocrine

5.

Which manifestation of stress reflects the nonspecific fight-or-flight response?

A)

Decreased pupillary light response

B)

Increased gastrointestinal motility

C)

Decreased short-term memory

D)

Increased cardiopulmonary rates

6.

Stress-induced cortisol hormone secretion is associated with:

A)

increased growth hormone level.

B)

regulation of the stress response.

C)

increased thyroid-stimulating hormone.

D)

depressed adrenal gland function.

7.

Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:

A)

a sense of purpose in life.

B)

circadian rhythm disruption.

C)

age-related renal dysfunction.

D)

excessive weight gain or loss.

8.

Acute stress is characterized by:

A)

a time-limited fight or flight response.

B)

recurrent exposure to a stressor.

C)

negative feedback overactivity.

D)

system impairment and fatigue.

9.

The patient recently returned from a year of military battle duty and has posttraumatic stress disorder (PTSD). This disorder includes an intrusion state that is experienced as:

A)

excessive anxiety and safety concerns.

B)

repeated relived memories as nightmares.

C)

loss of concentration and increased vigilance.

D)

emotional numbing and feelings of depression.

10.

A patient is extremely anxious about his impending surgery. Which of the following measures should the nurse implement to create an atmosphere for effective use of relaxation techniques?

A)

A quiet, dim environment

B)

A soothing, warm foot soak

C)

Gentle muscle stroking

D)

Repetitive questioning

11.

A patient is experiencing significant stress while awaiting the results of her recent lymph node biopsy. Among the hormonal contributors to this response is a release of aldosterone, resulting in which of the following physiologic effects?

A)

Decreased release of insulin

B)

Increased cardiac contractility

C)

Potentiation of epinephrine

D)

Increased sodium absorption

12.

A patient is experiencing stress as a nurse prepares to insert a peripheral intravenous catheter into his forearm. The patients locus ceruleus (LC) is consequently producing which of the following hormones?

A)

Norepinephrine (NE)

B)

Corticotropin-releasing factor (CRF)

C)

Antidiuretic hormone (ADH)

D)

Adrenocorticotropic hormone (ACTH)

13.

A college student has just learned that her latest Pap smear revealed atypical cells, a fact that has resulted in stress and an accompanying release of angiotensin II. How would the effects of this hormone be objectively demonstrated?

A)

Increased respiratory rate

B)

Increased blood pressure

C)

Decreased oxygen saturation

D)

Decreased blood sugar

14.

A nursing students current clinical placement has been a source of stress due to high patient acuity combined with interpersonal conflict with some of the unit staff. At the same time, the student has been fighting a cold for more than 2 weeks and has been unable to regain a normal feeling of health. How might these two phenomena be related?

A)

Epinephrine and norepinephrine inhibit the release and action of lymphocytes.

B)

Stress and illness lack a statistical correlation, though they are often thought to coexist.

C)

The effects of stress on the cerebellum initiate a decrease in immunity.

D)

Endocrine-immune interactions may suppress the students immune response.

15.

Which of the following factors are known to contribute to an individuals ability to adapt to stress? Select all that apply.

A)

Ethnicity

B)

Age

C)

Socioeconomic status

D)

Gender

E)

Health status

16.

A student is participating in an extended fast as part of a charitable fundraising effort. Which of the following is an example of the physiologic reserve that will facilitate the students adaptation to the stress of this sudden change in diet?

A)

The student has experience in demonstrating perseverance from previous participation in competitive sports.

B)

The students adipose tissue contains large and accessible stores of energy.

C)

The student is young, male, and has no pre-existing medical conditions.

D)

The student is utilizing guided imagery to achieve a sense of mind over matter.

17.

A 70-year-old patient admitted to a hospital for a prostatectomy is surprised to learn that his physician has prescribed insulin on a sliding scale, despite the fact that the patient successfully manages his type 2 diabetes using diet and oral antihyperglycemics when at home. Which of the following facts may underlie the physicians action?

A)

The stress of illness stimulates the hypothalamus to release corticotropin-releasing factor (CRF).

B)

Stress-induced release of vasopressin increases serum blood glucose.

C)

Stress and illness can increase glycogenolysis and insulin resistance.

D)

Increased levels of epinephrine and norepinephrine cause alterations in glucose metabolism.

18.

A female patient experienced a random assault several months earlier, and her recent vigilance around her own safety is described as obsessive by her friends and family. Which of the following aspects of posttraumatic stress disorder (PTSD) characterizes the patients behavior?

A)

Avoidance

B)

Intrusion

C)

Hyperarousal

D)

Flashbacks

19.

An occupational therapist is preparing to begin a relaxation program on the oncology unit of a hospital. Which of the following variables is most likely to determine the success or failure of the program?

A)

Rapport between the therapist and patients

B)

The therapists own ability to relax

C)

A quiet and therapeutic environment

D)

Appropriate use of pharmacologic techniques

20.

A patients primary care provider has recommended biofeedback in an effort to address her chronic stress and reduce the potential for complications. What will be the goal of this intervention?

A)

Using exercise to control the patients endocrine function

B)

Helping the patient to accommodate continued nervous stimulation

C)

Relieving tension by using tactile stimulation

D)

Teaching the patient to consciously control her own body functioning

Answer Key

1.

C

2.

B

3.

A

4.

D

5.

D

6.

B

7.

A

8.

A

9.

B

10.

A

11.

D

12.

A

13.

B

14.

D

15.

B, D, E

16.

B

17.

C

18.

C

19.

C

20.

D

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