NURS 344 COMPREHENSIVE EXAM 2026 QUESTIONS AND
SOLUTIONS SCORED A+
✔✔Stress management and reduction techniques - ✔✔-Breathing exercises
-Progressive muscle relaxation
-Meditation (this includes prayer and mindfulness exercises)
-Guided imagery
-Physical exercise
-Journaling
-Humor
-Cognitive reframing
-Biofeedback
-Support groups
✔✔Counseling for stress - ✔✔-Talk therapy
-Counseling regarding not only stress, but identifying and changing health patterns that
increase stress and/or limit coping
-Referral if necessary and may include individual, family, or group counseling
✔✔Family enhancement for stress - ✔✔-Assisting families when change is imminent or
expected such as during pregnancy, relocations, long-term care placement, etc.
-Done through education, presence, and use of therapeutic techniques
✔✔Social support enhancement and network building for stress - ✔✔-Identifying areas
of need and starting programs-educational, emotional and physical support
-Identifying community resources and referring appropriately
-Done on an individual basis in both acute and community settings
-Wellness programs with emphasis on sleep, diet, exercise, and education
✔✔Secondary prevention and screening for stress - ✔✔-Tools for stress and coping
screenings include: Recent Life Changes Questionnaire, ways of coping checklist,
COPE scale, Perceived Stress scales, Sleep scales
✔✔Collaborative Interventions for stress - ✔✔-Counseling and/or psychotherapy
✔✔Counseling and/or psychotherapy for stress - ✔✔-To understand counseling and
psychotherapy interventions conducted by various healthcare personal including
nursing, a bsic understand of psychological theories is important, especially the
following:
-Psychoanalytic
-Erik Erikson's Ego Theory
-Interpersonal theories
-Behavior theories
-Cognitive theories
,-Cognitive behavior therapy (CBT)
✔✔Psychoanalytic theory - ✔✔-Unresolved issues from childhood impact perception
and reaction in adults-- basis for psychodynamic therapy which works best for those
who have clear areas of difficulty, are intelligent, and motivated to change
✔✔Erik Erikson's Ego Theory - ✔✔-Stages of development assist in identifying
appropriate nursing interventions
✔✔Interpersonal theories - ✔✔-Namely Peplau's theory of interpersonal relationships in
nursing--nurses are active participants in assisting patients to make positive changes in
their healthcare status, the nurse does with the patient, not to the patient--nurses can
assist patients in lowering their anxiety thereby improving their thinking and functioning
✔✔Behavior theories - ✔✔-Focus is on behaviors limiting the individual or impairing
society--behavior therapy is based on changing behaviors without insight into
understanding the cause-- works well for many conditions. Examples include: modeling,
conditioning, aversion therapy, systematic desensitization, biofeedback
✔✔Modeling - ✔✔Nurses everywhere at all times should try to model optimum physical,
mental, and emotional behavior. This is a professional responsibility.
✔✔Conditioning - ✔✔-Positive reinforcement for desired behavior (tokens, praise,
attention, etc.)
✔✔Aversion therapy - ✔✔-Negative reinforcement for an undesirable behavior
(punishment, avoidance training, noxious stimuli paired with an undesirable behavior)
✔✔Systematic desensitization - ✔✔-Treats fears by incremental exposure to the fear
stimuli as the patient works through the exposure using learning and practiced
techniques
✔✔Biofeedback - ✔✔Connecting mind and body
✔✔Cognitive theories - ✔✔Focus is on the thoughts. Thoughts occur before feelings
and actions, but thoughts may not be based on reality. The goal is to identify and
change thoughts that are impairing functioning or impacting negatively on society.
✔✔Cognitive behavior therapy (CBT) - ✔✔Links cognitive theory and behavior theory.
Feelings and behaviors are determined by the way people think about the world and
their place in it. Automatic thinking which is common can lead to cognitive distortions
(irrational thoughts leadings to false assumptions and misinterpretations). Goal is for the
person to identify the cognitive distortion arising from the thought and replace the
thought. Nurses use this extensively in patient care and in all areas of nursing practice.
, It is also useful for many people, including nurses, to develop self-awareness into
thought processes that may be interfering with relationships and/or optimum functioning
***This is strongly supported by EBP for many disorders and carries and efficacy the
same as, or higher than medications for certain disorders
✔✔Humanistic theories - ✔✔-Maslow's hierarchy of needs
-When lower level of needs are met, higher needs are able to emerge--self actualization
is a goal for all persons- nurses attempt to attain for themselves and assist patients in
attaining.
✔✔Motivational Interviewing (MI) - ✔✔-A method of counseling that focuses on
facilitating and engaging intrinsic (within the person) motivation in the patient in order to
change behavior. MI is a goal-oriented, client-centered counseling style for eliciting
behavior change by helping clients to explore and resolve ambivalence
✔✔Milieu therapy - ✔✔-The recognition that all persons (patients, staff, visitors), all
aspects of the setting (both broad and specific), and emotional climate (from all sources
animate and inanimate) are vital to healing. Milieu can negatively affect or positively
affect all persons in the environment, thereby impacting physical and/or emotional
healing. Nursing staff, because they are often the unchanging part of the environment
have a huge impact on milieu in any given setting. Nurses often provide appropriate
milieu most notably in providing a clean, safe environment
✔✔Pharmacologic therapy - ✔✔-Focus is on neurological, chemical, biological, and
genetic issues in the interconnection of the body and brain. The nurse monitors and
intervenes when necessary: the patient's health status, administers medications,
monitors for side effects, educates on medications or procedures
✔✔Pharmacogenetics - ✔✔The study of how genetic variations lead to altered drug
responses in different individuals or ethnic groups. For patients with treatment failure of
many of the psychotropics, there are FDA approved genotyping tests available to
determine individual metabolism of certain drugs. Genetic testing can be expensive, but
many of the psychotropic medications are expensive also and create unnecessary
expense for the patient, insurances, and/or society if the medications are not effective
✔✔Anxiolytics (antianxiety) & hypnotics - ✔✔-Benzodiazepines
-Sleeping medications
-Buspirone
✔✔Benzodiazepines - ✔✔(most end in -lam or -pam) - GABA enhances- useful for short
term, have addiction potential
✔✔Sleeping medications - ✔✔GABA enhances (zolpidem, zaleplon, eszopiclone)-
melatonin receptor agonists (remelteon), and low dose antidepressant doxepin
SOLUTIONS SCORED A+
✔✔Stress management and reduction techniques - ✔✔-Breathing exercises
-Progressive muscle relaxation
-Meditation (this includes prayer and mindfulness exercises)
-Guided imagery
-Physical exercise
-Journaling
-Humor
-Cognitive reframing
-Biofeedback
-Support groups
✔✔Counseling for stress - ✔✔-Talk therapy
-Counseling regarding not only stress, but identifying and changing health patterns that
increase stress and/or limit coping
-Referral if necessary and may include individual, family, or group counseling
✔✔Family enhancement for stress - ✔✔-Assisting families when change is imminent or
expected such as during pregnancy, relocations, long-term care placement, etc.
-Done through education, presence, and use of therapeutic techniques
✔✔Social support enhancement and network building for stress - ✔✔-Identifying areas
of need and starting programs-educational, emotional and physical support
-Identifying community resources and referring appropriately
-Done on an individual basis in both acute and community settings
-Wellness programs with emphasis on sleep, diet, exercise, and education
✔✔Secondary prevention and screening for stress - ✔✔-Tools for stress and coping
screenings include: Recent Life Changes Questionnaire, ways of coping checklist,
COPE scale, Perceived Stress scales, Sleep scales
✔✔Collaborative Interventions for stress - ✔✔-Counseling and/or psychotherapy
✔✔Counseling and/or psychotherapy for stress - ✔✔-To understand counseling and
psychotherapy interventions conducted by various healthcare personal including
nursing, a bsic understand of psychological theories is important, especially the
following:
-Psychoanalytic
-Erik Erikson's Ego Theory
-Interpersonal theories
-Behavior theories
-Cognitive theories
,-Cognitive behavior therapy (CBT)
✔✔Psychoanalytic theory - ✔✔-Unresolved issues from childhood impact perception
and reaction in adults-- basis for psychodynamic therapy which works best for those
who have clear areas of difficulty, are intelligent, and motivated to change
✔✔Erik Erikson's Ego Theory - ✔✔-Stages of development assist in identifying
appropriate nursing interventions
✔✔Interpersonal theories - ✔✔-Namely Peplau's theory of interpersonal relationships in
nursing--nurses are active participants in assisting patients to make positive changes in
their healthcare status, the nurse does with the patient, not to the patient--nurses can
assist patients in lowering their anxiety thereby improving their thinking and functioning
✔✔Behavior theories - ✔✔-Focus is on behaviors limiting the individual or impairing
society--behavior therapy is based on changing behaviors without insight into
understanding the cause-- works well for many conditions. Examples include: modeling,
conditioning, aversion therapy, systematic desensitization, biofeedback
✔✔Modeling - ✔✔Nurses everywhere at all times should try to model optimum physical,
mental, and emotional behavior. This is a professional responsibility.
✔✔Conditioning - ✔✔-Positive reinforcement for desired behavior (tokens, praise,
attention, etc.)
✔✔Aversion therapy - ✔✔-Negative reinforcement for an undesirable behavior
(punishment, avoidance training, noxious stimuli paired with an undesirable behavior)
✔✔Systematic desensitization - ✔✔-Treats fears by incremental exposure to the fear
stimuli as the patient works through the exposure using learning and practiced
techniques
✔✔Biofeedback - ✔✔Connecting mind and body
✔✔Cognitive theories - ✔✔Focus is on the thoughts. Thoughts occur before feelings
and actions, but thoughts may not be based on reality. The goal is to identify and
change thoughts that are impairing functioning or impacting negatively on society.
✔✔Cognitive behavior therapy (CBT) - ✔✔Links cognitive theory and behavior theory.
Feelings and behaviors are determined by the way people think about the world and
their place in it. Automatic thinking which is common can lead to cognitive distortions
(irrational thoughts leadings to false assumptions and misinterpretations). Goal is for the
person to identify the cognitive distortion arising from the thought and replace the
thought. Nurses use this extensively in patient care and in all areas of nursing practice.
, It is also useful for many people, including nurses, to develop self-awareness into
thought processes that may be interfering with relationships and/or optimum functioning
***This is strongly supported by EBP for many disorders and carries and efficacy the
same as, or higher than medications for certain disorders
✔✔Humanistic theories - ✔✔-Maslow's hierarchy of needs
-When lower level of needs are met, higher needs are able to emerge--self actualization
is a goal for all persons- nurses attempt to attain for themselves and assist patients in
attaining.
✔✔Motivational Interviewing (MI) - ✔✔-A method of counseling that focuses on
facilitating and engaging intrinsic (within the person) motivation in the patient in order to
change behavior. MI is a goal-oriented, client-centered counseling style for eliciting
behavior change by helping clients to explore and resolve ambivalence
✔✔Milieu therapy - ✔✔-The recognition that all persons (patients, staff, visitors), all
aspects of the setting (both broad and specific), and emotional climate (from all sources
animate and inanimate) are vital to healing. Milieu can negatively affect or positively
affect all persons in the environment, thereby impacting physical and/or emotional
healing. Nursing staff, because they are often the unchanging part of the environment
have a huge impact on milieu in any given setting. Nurses often provide appropriate
milieu most notably in providing a clean, safe environment
✔✔Pharmacologic therapy - ✔✔-Focus is on neurological, chemical, biological, and
genetic issues in the interconnection of the body and brain. The nurse monitors and
intervenes when necessary: the patient's health status, administers medications,
monitors for side effects, educates on medications or procedures
✔✔Pharmacogenetics - ✔✔The study of how genetic variations lead to altered drug
responses in different individuals or ethnic groups. For patients with treatment failure of
many of the psychotropics, there are FDA approved genotyping tests available to
determine individual metabolism of certain drugs. Genetic testing can be expensive, but
many of the psychotropic medications are expensive also and create unnecessary
expense for the patient, insurances, and/or society if the medications are not effective
✔✔Anxiolytics (antianxiety) & hypnotics - ✔✔-Benzodiazepines
-Sleeping medications
-Buspirone
✔✔Benzodiazepines - ✔✔(most end in -lam or -pam) - GABA enhances- useful for short
term, have addiction potential
✔✔Sleeping medications - ✔✔GABA enhances (zolpidem, zaleplon, eszopiclone)-
melatonin receptor agonists (remelteon), and low dose antidepressant doxepin
