Townsend
PMHN, 10e
Chapter 1 - ETB
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
1. A client has experienced the death of a close family member and at the same time becomes
unemployed. The client’s 6-month score on the Recent Life Changes Questionnaire is 110. The
nurse:
1. Understands the client is at risk for significant stress-related illness.
2. Determines the client is not at risk for significant stress-related illness.
3. Needs further assessment of the client’s coping skills to determine susceptibility to stress-
related illness.
4. Recognizes the client may view the losses as challenges and perceive them as opportunities.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 5
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse
should assess the client’s coping skills and available support before determining
susceptibility to stress-related physical and psychological illnesses. The Recent Life
Changes Questionnaire is an expanded version of the Schedule of Recent
Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month
score of 300 or more or a year-score total of 500 or more indicates high stress in a
client’s life and susceptibility to stress-related illnesses.
2. This is incorrect. Assessment is the first step in the nursing process. The nurse
should assess the client’s coping skills and available support before determining the
client’s perception of the current stresses. A 6-month score of 300 or more or a year-
score total of 500 or more on the Recent Life Changes Questionnaire indicates high
stress in a client’s life and susceptibility to stress-related physical and psychological
illnesses.
3. This is correct. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining
susceptibility to stress-related physical and psychological illnesses. A 6-month score
of 300 or more or a year-score of 500 or more indicates high stress in a client’s life
,Townsend
PMHN, 10e
Chapter 1 - ETB
and risk for significant stress-related physical and psychological illness.
4. This is incorrect. Assessment is the first step in the nursing process. The nurse
should assess the client’s coping skills and available support before determining
susceptibility to stress-related illness. A 6-month score of 300 or more or a year-
score of 500 or more on the Recent Life Changes Questionnaire indicates high stress
in a client’s life is susceptible to significant stress-related physical and psychological
illness.
CON: Stress
2. A physically and emotionally healthy client has just been fired. During a routine office visit,
he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll consider pursuing an art
degree.” The nurse determines the client perceives the stressor of his job loss as:
1. Irrelevant
2. Harm or loss
3. Threatening
4. A challenge
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 7
Heading: Stress as a transaction between the individual and the environment >Individual’s
Perception of the Event > Primary Appraisal
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds no
significance for the individual.
2. This is incorrect. A harm or loss appraisal refers to damage or loss already
experienced by the individual.
3. This is incorrect. A threatening appraisal is perceived as anticipated harms or losses.
4. This is correct. The client’s statement indicates he perceives the loss of his job as a
challenge and an opportunity for growth, demonstrated by his statement to consider
an art degree.
CON: Stress
, Townsend
PMHN, 10e
Chapter 1 - ETB
3. Which client statement alerts the nurse that the client may be maladaptively responding to
stress?
1. “Avoiding contact with others helps me cope.”
2. “I really enjoy journaling; it’s my private time.”
3. “I signed up for a yoga class this week.”
4. “I made an appointment to meet with a therapist.”
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8
Heading: Stress Management
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1. This is correct. Reliance on social isolation as a coping mechanism is a maladaptive
method to relieve stress. It can prevent learning appropriate coping skills and can
prevent access to needed support systems.
2. This is incorrect. Journaling is a form of adaptive coping and interpersonal
communication.
3. This is incorrect. Group exercise is a form of adaptive coping, relaxation.
4. This is incorrect. Seeing a therapist is not considered a maladaptive coping method.
CON: Stress
4. A nursing student comes down with a sinus infection toward the end of every semester. Which
stage of stress is the student most likely experiencing when this occurs?
1. Alarm reaction
2. Resistance
3. Exhaustion
4. Fight or flight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 2
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
PMHN, 10e
Chapter 1 - ETB
Chapter 1. The Concept of Stress Adaptation
MULTIPLE CHOICE
1. A client has experienced the death of a close family member and at the same time becomes
unemployed. The client’s 6-month score on the Recent Life Changes Questionnaire is 110. The
nurse:
1. Understands the client is at risk for significant stress-related illness.
2. Determines the client is not at risk for significant stress-related illness.
3. Needs further assessment of the client’s coping skills to determine susceptibility to stress-
related illness.
4. Recognizes the client may view the losses as challenges and perceive them as opportunities.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 5
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
Feedback
1. This is incorrect. Assessment is the first step of the nursing process. The nurse
should assess the client’s coping skills and available support before determining
susceptibility to stress-related physical and psychological illnesses. The Recent Life
Changes Questionnaire is an expanded version of the Schedule of Recent
Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month
score of 300 or more or a year-score total of 500 or more indicates high stress in a
client’s life and susceptibility to stress-related illnesses.
2. This is incorrect. Assessment is the first step in the nursing process. The nurse
should assess the client’s coping skills and available support before determining the
client’s perception of the current stresses. A 6-month score of 300 or more or a year-
score total of 500 or more on the Recent Life Changes Questionnaire indicates high
stress in a client’s life and susceptibility to stress-related physical and psychological
illnesses.
3. This is correct. Assessment is the first step in the nursing process. The nurse should
assess the client’s coping skills and available support before determining
susceptibility to stress-related physical and psychological illnesses. A 6-month score
of 300 or more or a year-score of 500 or more indicates high stress in a client’s life
,Townsend
PMHN, 10e
Chapter 1 - ETB
and risk for significant stress-related physical and psychological illness.
4. This is incorrect. Assessment is the first step in the nursing process. The nurse
should assess the client’s coping skills and available support before determining
susceptibility to stress-related illness. A 6-month score of 300 or more or a year-
score of 500 or more on the Recent Life Changes Questionnaire indicates high stress
in a client’s life is susceptible to significant stress-related physical and psychological
illness.
CON: Stress
2. A physically and emotionally healthy client has just been fired. During a routine office visit,
he tells the nurse, “Perhaps this was the best thing to happen. Maybe I’ll consider pursuing an art
degree.” The nurse determines the client perceives the stressor of his job loss as:
1. Irrelevant
2. Harm or loss
3. Threatening
4. A challenge
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 7
Heading: Stress as a transaction between the individual and the environment >Individual’s
Perception of the Event > Primary Appraisal
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds no
significance for the individual.
2. This is incorrect. A harm or loss appraisal refers to damage or loss already
experienced by the individual.
3. This is incorrect. A threatening appraisal is perceived as anticipated harms or losses.
4. This is correct. The client’s statement indicates he perceives the loss of his job as a
challenge and an opportunity for growth, demonstrated by his statement to consider
an art degree.
CON: Stress
, Townsend
PMHN, 10e
Chapter 1 - ETB
3. Which client statement alerts the nurse that the client may be maladaptively responding to
stress?
1. “Avoiding contact with others helps me cope.”
2. “I really enjoy journaling; it’s my private time.”
3. “I signed up for a yoga class this week.”
4. “I made an appointment to meet with a therapist.”
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8
Heading: Stress Management
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Easy
Feedback
1. This is correct. Reliance on social isolation as a coping mechanism is a maladaptive
method to relieve stress. It can prevent learning appropriate coping skills and can
prevent access to needed support systems.
2. This is incorrect. Journaling is a form of adaptive coping and interpersonal
communication.
3. This is incorrect. Group exercise is a form of adaptive coping, relaxation.
4. This is incorrect. Seeing a therapist is not considered a maladaptive coping method.
CON: Stress
4. A nursing student comes down with a sinus infection toward the end of every semester. Which
stage of stress is the student most likely experiencing when this occurs?
1. Alarm reaction
2. Resistance
3. Exhaustion
4. Fight or flight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 2
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
