NURS 344 FINAL EXAM 2026 QUESTIONS AND SOLUTIONS
SCORED A+
✔✔Equilibrium - ✔✔A state of physical and psychological balance sought by the body
to maintain functioning
✔✔Resilience - ✔✔Successful adaptation to difficult and challenging life experiences.
"Bending rather than breaking"
✔✔Dissociation - ✔✔Disconnection and lack of continuity between thoughts, memories,
surroundings, actions, and identity
✔✔Depersonalization - ✔✔Dissociative symptoms of persistent or recurrent
experiences of feeling detached from and as if one were an outside observer of one's
own mental processes or body (e.g., feel like they are in a dram, sense of unreality, time
moving very slowly)
✔✔Derealization - ✔✔dissociative symptoms of persistent or recurrent experiences of
unreality of surroundings (world is experienced as dreamlike, unreal, distant, or
distorted)
✔✔Scope of stess - ✔✔-All individuals experience stress on a daily basis. The
individual perception of stress will be
-No stress (neutral): individual does not perceive stress, coping adequate, and at
equilibrium
-Challenging: stress is perceived as manageable with existing personal coping
mechanisms and resources
-Threatening: stress exceeds existing coping abilities and resources
-Effective (adaptive): response though constructive coping mechanisms
-Ineffective (maladaptive) responses through destructive coping mechanisms
✔✔Scope of coping - ✔✔-Viewed from individual, family, and community
-Adaptive coping
-Maladaptive coping
✔✔Adaptive/effective coping - ✔✔-Constructive coping mechanisms- person relies on
thinking in an effort to resolve the problem
✔✔Maladaptive/ineffective coping - ✔✔-Destructive coping mechanisms-- person
addresses feelings and does not resolve the problem
✔✔Risk factors for ineffective coping or ineffective stress management/ individuals and
groups at greatest risk for negative effects of stress - ✔✔-Children: brain is developing
-Adolescents
-Older adults: increase in physical problems
,-Those with life-threatening acute or chronic disease
-Caregivers (family members and healthcare workers)
-Impaired cognition
-Illiteracy
-Foreign culture
-Poverty, limited resources, or financial difficulties
-Isolation
-Changes in health or chronic health conditions: pain, disability
-Environmental trauma: war, famine, natural disaster, epidemics
✔✔Physiology of the alarm response - ✔✔-Stressor(s)- real or otherwise perceived from
internal and/or external environments
-Alarm stage responses include activation of the hypothalamus and cortex in the brain
which signals endorphin release and signals the adrenals to release adrenalin
(activation of the SNS). Heart rate, BP, respirations, pupils, and blood system affected--
produce corticosteroids
-Alarm stage cannot be maintained, or death will result. If adaptation does not occur,
exhaustion stage will develop in which resources are depleted and stress becomes
chronic
-Chronic stress leads to immune system dysfunction and chronic disease states in
physical, psychological, and social realms (biopsychososcial). Systems affected include
CNS, cardiovascular, immune, musculoskeletal, GI, integumentary, sexuality, and
reproductive
✔✔Effective coping includes - ✔✔-Primary
appraisal
-Secondary appraisal
-Engagement
-Engagement
✔✔Primary appraisal - ✔✔Initial assessment by the individual determines meaning and
impact of the stressor(s). Includes evaluation of self or other harm by stressor, self-
esteem and self-perception of the individual and personal values
✔✔Secondary appraisal - ✔✔Individual evaluates the resources available to overcome,
eliminate, or reduce the stressor(s)
✔✔Engagement - ✔✔Follows appraisal action and evaluation of action to determine if
problem is solved- may lead to normal or the need for a new equilibrium
✔✔Factors that influence ability for primary and secondary appraisal - ✔✔Many factors
influence ability for primary and secondary appraisal, such as type and number of
stressors involved, perception, social support, level of education, past life experiences,
cognition, current coping style, values, expectations, spiritual beliefs, self-efficacy,
world-views, current health, and culture
, ✔✔Consequences of ineffective coping or a maladaptive response - ✔✔-Leads to
exhaustion and chronic state of stress
-Variable between persons and stressors
-Leads to biopsychosocial dysfunction
✔✔Lifespan considerations for infants and children when dealing with stress and coping
- ✔✔-Stressors can be internal or external. What adults may not view as a stressor a
child may due to developmental level. Children are often unable to verbalize stressors
well or their thoughts and feelings regarding it. Stress may manifest in a variety of ways:
during play, withdrawal, crying, silence, acting out, and anger. Cognition is not
developed so ability to cope is compromised
✔✔Interventions/management to help infants and children with stress and coping - ✔✔-
Help child verbalize thoughts and feelings
-Adequate nutrition, sleep, and exercise
-Listen
-Help them with a coping plan
-Be present
✔✔Lifespan considerations for adolescence when dealing with stress and coping - ✔✔-
Teens (as well as adults) in the USA identify high levels of stress with school being #1.
This in turn will overflow into the family life. Few can identify the mind/body connection
in regards to stress, nor can they identify appropriate coping mechanisms. Cognition is
not at adult level.
✔✔Interventions/management for adolescence dealing with stress - ✔✔-Educate on
importance of diet, exercise, sleep, and physical activity
-Help them find and explore their strengths
✔✔Lifespan considerations for those that are pregnant and dealing with stress - ✔✔-
Pregnancy is always a positive or negative stressor. Additional stressors can occur
associated with the pregnancy such as abuse, financial worries, living arrangement
concerns, job concerns, and role changes
✔✔Interventions/management for pregnant women who are dealing with stress - ✔✔-
Always assess how the pregnancy is viewed by the patient and all persons pertinent to
the patient
✔✔lifespan considerations for adults with stress - ✔✔-Many life events can cause stress
in adulthood, job, finances, housing, family issues, raising children, "sandwich
generation"
✔✔Lifespan considerations for older adults with stress - ✔✔-Often a time of many
changes such as possible health status decline, sensory impairments, mobility
SCORED A+
✔✔Equilibrium - ✔✔A state of physical and psychological balance sought by the body
to maintain functioning
✔✔Resilience - ✔✔Successful adaptation to difficult and challenging life experiences.
"Bending rather than breaking"
✔✔Dissociation - ✔✔Disconnection and lack of continuity between thoughts, memories,
surroundings, actions, and identity
✔✔Depersonalization - ✔✔Dissociative symptoms of persistent or recurrent
experiences of feeling detached from and as if one were an outside observer of one's
own mental processes or body (e.g., feel like they are in a dram, sense of unreality, time
moving very slowly)
✔✔Derealization - ✔✔dissociative symptoms of persistent or recurrent experiences of
unreality of surroundings (world is experienced as dreamlike, unreal, distant, or
distorted)
✔✔Scope of stess - ✔✔-All individuals experience stress on a daily basis. The
individual perception of stress will be
-No stress (neutral): individual does not perceive stress, coping adequate, and at
equilibrium
-Challenging: stress is perceived as manageable with existing personal coping
mechanisms and resources
-Threatening: stress exceeds existing coping abilities and resources
-Effective (adaptive): response though constructive coping mechanisms
-Ineffective (maladaptive) responses through destructive coping mechanisms
✔✔Scope of coping - ✔✔-Viewed from individual, family, and community
-Adaptive coping
-Maladaptive coping
✔✔Adaptive/effective coping - ✔✔-Constructive coping mechanisms- person relies on
thinking in an effort to resolve the problem
✔✔Maladaptive/ineffective coping - ✔✔-Destructive coping mechanisms-- person
addresses feelings and does not resolve the problem
✔✔Risk factors for ineffective coping or ineffective stress management/ individuals and
groups at greatest risk for negative effects of stress - ✔✔-Children: brain is developing
-Adolescents
-Older adults: increase in physical problems
,-Those with life-threatening acute or chronic disease
-Caregivers (family members and healthcare workers)
-Impaired cognition
-Illiteracy
-Foreign culture
-Poverty, limited resources, or financial difficulties
-Isolation
-Changes in health or chronic health conditions: pain, disability
-Environmental trauma: war, famine, natural disaster, epidemics
✔✔Physiology of the alarm response - ✔✔-Stressor(s)- real or otherwise perceived from
internal and/or external environments
-Alarm stage responses include activation of the hypothalamus and cortex in the brain
which signals endorphin release and signals the adrenals to release adrenalin
(activation of the SNS). Heart rate, BP, respirations, pupils, and blood system affected--
produce corticosteroids
-Alarm stage cannot be maintained, or death will result. If adaptation does not occur,
exhaustion stage will develop in which resources are depleted and stress becomes
chronic
-Chronic stress leads to immune system dysfunction and chronic disease states in
physical, psychological, and social realms (biopsychososcial). Systems affected include
CNS, cardiovascular, immune, musculoskeletal, GI, integumentary, sexuality, and
reproductive
✔✔Effective coping includes - ✔✔-Primary
appraisal
-Secondary appraisal
-Engagement
-Engagement
✔✔Primary appraisal - ✔✔Initial assessment by the individual determines meaning and
impact of the stressor(s). Includes evaluation of self or other harm by stressor, self-
esteem and self-perception of the individual and personal values
✔✔Secondary appraisal - ✔✔Individual evaluates the resources available to overcome,
eliminate, or reduce the stressor(s)
✔✔Engagement - ✔✔Follows appraisal action and evaluation of action to determine if
problem is solved- may lead to normal or the need for a new equilibrium
✔✔Factors that influence ability for primary and secondary appraisal - ✔✔Many factors
influence ability for primary and secondary appraisal, such as type and number of
stressors involved, perception, social support, level of education, past life experiences,
cognition, current coping style, values, expectations, spiritual beliefs, self-efficacy,
world-views, current health, and culture
, ✔✔Consequences of ineffective coping or a maladaptive response - ✔✔-Leads to
exhaustion and chronic state of stress
-Variable between persons and stressors
-Leads to biopsychosocial dysfunction
✔✔Lifespan considerations for infants and children when dealing with stress and coping
- ✔✔-Stressors can be internal or external. What adults may not view as a stressor a
child may due to developmental level. Children are often unable to verbalize stressors
well or their thoughts and feelings regarding it. Stress may manifest in a variety of ways:
during play, withdrawal, crying, silence, acting out, and anger. Cognition is not
developed so ability to cope is compromised
✔✔Interventions/management to help infants and children with stress and coping - ✔✔-
Help child verbalize thoughts and feelings
-Adequate nutrition, sleep, and exercise
-Listen
-Help them with a coping plan
-Be present
✔✔Lifespan considerations for adolescence when dealing with stress and coping - ✔✔-
Teens (as well as adults) in the USA identify high levels of stress with school being #1.
This in turn will overflow into the family life. Few can identify the mind/body connection
in regards to stress, nor can they identify appropriate coping mechanisms. Cognition is
not at adult level.
✔✔Interventions/management for adolescence dealing with stress - ✔✔-Educate on
importance of diet, exercise, sleep, and physical activity
-Help them find and explore their strengths
✔✔Lifespan considerations for those that are pregnant and dealing with stress - ✔✔-
Pregnancy is always a positive or negative stressor. Additional stressors can occur
associated with the pregnancy such as abuse, financial worries, living arrangement
concerns, job concerns, and role changes
✔✔Interventions/management for pregnant women who are dealing with stress - ✔✔-
Always assess how the pregnancy is viewed by the patient and all persons pertinent to
the patient
✔✔lifespan considerations for adults with stress - ✔✔-Many life events can cause stress
in adulthood, job, finances, housing, family issues, raising children, "sandwich
generation"
✔✔Lifespan considerations for older adults with stress - ✔✔-Often a time of many
changes such as possible health status decline, sensory impairments, mobility
