NURS 535 Exam #1 Questions with
Guaranteed Pass Solutions 2025-2026
Updated.
Describe the physiologic response and clinical manifestations of pain and its relation to the
sympathetic-adrenal-medullary system stress response. - Answer If an individual is exposed
to pain and they perceive this pain as stressful; the adrenal medulla secretes adrenaline
(hormone). Adrenaline leads to the arousal of the sympathetic nervous system and reduced
activity in the parasympathetic nervous system. Once the painful threat is over, the
parasympathetic branch takes control and brings the body back to homeostasis.
Potential changes in the body r/t adrenaline: ↑HR, Pulse, and BP; ↓ digestion; and ↑ sweating
(diaphoresis)
Biological Syndrome of Stress
What are the 3 structural changes? - Answer 1. Adrenal Gland Cortex enlargement
2. Atrophy of thymus gland and other lymphoid structures
3. Development of bleeding ulcers in stomach and duodenal lining
Homeostasis - Answer Physiologic regulation around an unchanging set point
Stable or Remaining the same
Allostasis - Answer Long-term or chronic exaggerated responses to stress
Proposes physiologic systems are dynamic & capable of changing set-points after exposure to
stress
Ability to successfully adjust to challenges
Allostatic Overload - Answer Chronic over-activation of adaptive regulatory physiologic
systems that increases susceptibility to disease
Exaggerated pathophysiologic responses to stress
,What is stress? - Answer Transactional or interactional concept - it is not necessarily the
event but how we perceive and react to the event that produces stress.
The state of affairs arising when a person relates to situations in a certain way.
A person experiences stress when a demand (real or imagined) exceeds a person's coping
abilities.
Allostatic load - Answer The individualized cumulative effects of stressors that exist in
people's lives and influence their physiologic responses.
Under conditions of allostatic overload, the parasympathetic system may (increase, decrease)
its restraint of the sympathetic system resulting in (increased, decreased) inflammatory
responses. - Answer decrease, increased
What are the 3 key mediators and biomarkers of allostatic overload? - Answer 1.
glucocorticoid cortisol
2. catecholamines (released from the sympathetic nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) - Answer the sum of all nonspecific reactions of the
body to prolonged systemic stress, comprising of 3 successive stages → Alarm Stage; The Stage
of Resistance; and The Stage of Exhaustion
Alarm Stage - Answer First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation - Answer Second stage of the GAS, during which the
body adapts to and uses resources to cope with a stressor.
Mobilization contributes to "Fight or Flight"
When does the Stage of Resistance or Adaptation begin? - Answer Begins when the actions
of Cortisol, norepinephrine and epinephrine all start to go to work doing their respective jobs.
The Stage of Exhaustion (Allostatic Overload) - Answer Third stage of the general adaptation
syndrome.
, Stress continues; adaptation unsuccessful.
Continuous stress causes the progressive breakdown of compensating mechanisms (acquired
adaptations) and homeostasis. Exhaustion marks the onset of certain diseases.
The body's ability to resist stress becomes depleted; illness, disease, and even death may occur.
Causing impairment of the immune response, heart failure, and kidney failure, leading to death.
Hypothalamic-Pituitary-Adrenal (HPA) axis - Answer Stress (+) → Hypothalamus (+) [Release
CRH] → Anterior Pituitary Gland [Releases ACTH] → Adrenal Gland [Releases Cortisol] → Via
Negative Feedback Cortisol goes to hypothalamus and Anterior Pituitary Gland to halt the
release of hormones
The release of cortisol causes a number of changes that help the body deal with stress.
When cortisol levels in the blood get high, this is sensed by receptors in areas of the brain (like
the hippocampus & hypothalamus) which leads to the shutting off of the stress response via
negative feedback mechanism.
Compare and Contrast the sympathetic-adrenal-medullary system activation to the
hypothalamic-pituitary-adrenal (HPA) axis response that is activated during the stage of
resistance (adaptation). - Answer When a stress response is triggered, it sends signals to two
other structures: the pituitary gland and the adrenal medulla. These short term responses are
produced by the "fight or flight" response via the sympathetic-adrenal-medullary system. Long
term stress is regulated by the hypothalamic pituitary-adrenal (HPA) system.
Sympathetic-adrenal-medullary system in the periphery releases catecholamines
(norepinephrine and epinephrine) - IS FAST ACTING
Hypothalamic-pituitary-adrenal (HPA) axis culminates cortisol - IS SLOWER ACTING
The activation of these two stress systems redirects adaptive energy to the CNS and peripheral
body sites to cope with stress.
Describe the physiology of pain, including the role of endorphins. - Answer Pain perception is
mediated via the limbic system & cerebral cortex. Pain modulation can occur through
endogenous opioid peptides, such as endorphins & enkephalins. Descending inhibitory
pathways from the PAG, raphe nucleus, & RVM release norepinephrine & serotonin on
Guaranteed Pass Solutions 2025-2026
Updated.
Describe the physiologic response and clinical manifestations of pain and its relation to the
sympathetic-adrenal-medullary system stress response. - Answer If an individual is exposed
to pain and they perceive this pain as stressful; the adrenal medulla secretes adrenaline
(hormone). Adrenaline leads to the arousal of the sympathetic nervous system and reduced
activity in the parasympathetic nervous system. Once the painful threat is over, the
parasympathetic branch takes control and brings the body back to homeostasis.
Potential changes in the body r/t adrenaline: ↑HR, Pulse, and BP; ↓ digestion; and ↑ sweating
(diaphoresis)
Biological Syndrome of Stress
What are the 3 structural changes? - Answer 1. Adrenal Gland Cortex enlargement
2. Atrophy of thymus gland and other lymphoid structures
3. Development of bleeding ulcers in stomach and duodenal lining
Homeostasis - Answer Physiologic regulation around an unchanging set point
Stable or Remaining the same
Allostasis - Answer Long-term or chronic exaggerated responses to stress
Proposes physiologic systems are dynamic & capable of changing set-points after exposure to
stress
Ability to successfully adjust to challenges
Allostatic Overload - Answer Chronic over-activation of adaptive regulatory physiologic
systems that increases susceptibility to disease
Exaggerated pathophysiologic responses to stress
,What is stress? - Answer Transactional or interactional concept - it is not necessarily the
event but how we perceive and react to the event that produces stress.
The state of affairs arising when a person relates to situations in a certain way.
A person experiences stress when a demand (real or imagined) exceeds a person's coping
abilities.
Allostatic load - Answer The individualized cumulative effects of stressors that exist in
people's lives and influence their physiologic responses.
Under conditions of allostatic overload, the parasympathetic system may (increase, decrease)
its restraint of the sympathetic system resulting in (increased, decreased) inflammatory
responses. - Answer decrease, increased
What are the 3 key mediators and biomarkers of allostatic overload? - Answer 1.
glucocorticoid cortisol
2. catecholamines (released from the sympathetic nervous system activation)
3. proinflammatory cytokines
General Adaptation Syndrome (GAS) - Answer the sum of all nonspecific reactions of the
body to prolonged systemic stress, comprising of 3 successive stages → Alarm Stage; The Stage
of Resistance; and The Stage of Exhaustion
Alarm Stage - Answer First Stage of GAS.
CNS aroused and body's defenses are mobilized
The Stage of Resistance or Adaptation - Answer Second stage of the GAS, during which the
body adapts to and uses resources to cope with a stressor.
Mobilization contributes to "Fight or Flight"
When does the Stage of Resistance or Adaptation begin? - Answer Begins when the actions
of Cortisol, norepinephrine and epinephrine all start to go to work doing their respective jobs.
The Stage of Exhaustion (Allostatic Overload) - Answer Third stage of the general adaptation
syndrome.
, Stress continues; adaptation unsuccessful.
Continuous stress causes the progressive breakdown of compensating mechanisms (acquired
adaptations) and homeostasis. Exhaustion marks the onset of certain diseases.
The body's ability to resist stress becomes depleted; illness, disease, and even death may occur.
Causing impairment of the immune response, heart failure, and kidney failure, leading to death.
Hypothalamic-Pituitary-Adrenal (HPA) axis - Answer Stress (+) → Hypothalamus (+) [Release
CRH] → Anterior Pituitary Gland [Releases ACTH] → Adrenal Gland [Releases Cortisol] → Via
Negative Feedback Cortisol goes to hypothalamus and Anterior Pituitary Gland to halt the
release of hormones
The release of cortisol causes a number of changes that help the body deal with stress.
When cortisol levels in the blood get high, this is sensed by receptors in areas of the brain (like
the hippocampus & hypothalamus) which leads to the shutting off of the stress response via
negative feedback mechanism.
Compare and Contrast the sympathetic-adrenal-medullary system activation to the
hypothalamic-pituitary-adrenal (HPA) axis response that is activated during the stage of
resistance (adaptation). - Answer When a stress response is triggered, it sends signals to two
other structures: the pituitary gland and the adrenal medulla. These short term responses are
produced by the "fight or flight" response via the sympathetic-adrenal-medullary system. Long
term stress is regulated by the hypothalamic pituitary-adrenal (HPA) system.
Sympathetic-adrenal-medullary system in the periphery releases catecholamines
(norepinephrine and epinephrine) - IS FAST ACTING
Hypothalamic-pituitary-adrenal (HPA) axis culminates cortisol - IS SLOWER ACTING
The activation of these two stress systems redirects adaptive energy to the CNS and peripheral
body sites to cope with stress.
Describe the physiology of pain, including the role of endorphins. - Answer Pain perception is
mediated via the limbic system & cerebral cortex. Pain modulation can occur through
endogenous opioid peptides, such as endorphins & enkephalins. Descending inhibitory
pathways from the PAG, raphe nucleus, & RVM release norepinephrine & serotonin on
