Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
Chapter 1. The Concept of Stress Adaptation
abirb.com/test
MULTIPLE CHOICE
abirb.com/test
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 abirb.com/test
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
abirb.com/test
stress-related illness.
4. Recognizes the client may view the losses as challenges and perceive them as
opportunities. abirb.com/test
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases ofabirb.com/test
adaptation.
Page: 5
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate abirb.com/test
Feedback
1. This is incorrect. Assessment is the first step of the nursingabirb.com/test
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
abirb.com/test
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 nursingabirb.com/test
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
abirb.com/test
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
abirb.com/test
susceptibility to stress-related physical and psychological illnesses. A 6-month score
abirb.com/test
abirb.com/test
,Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
of 300 or more or a year-score of 500 or more indicates high stress in a client’s life
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 abirb.com/test
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
abirb.com/test
illness.
CON: Stress
abirb.com/test
2. A physically and emotionally healthy client has just been fired.abirb.com/test
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:
abirb.com/test
1. Irrelevant
2. Harm or loss
3. Threatening
4. A challenge abirb.com/test
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the managementabirb.com/test
of stress.
Page: 7
Heading: Stress as a transaction between the individual and the environment
>Individual’s Perception of the Event > Primary Appraisal abirb.com/test
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
abirb.com/test
Concept: Stress
Difficulty: Easy
Feedback abirb.com/test
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 damageabirb.com/test
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 abirb.com/test
his statement to consider
an art degree.
CON: Stress abirb.com/test
abirb.com/test
abirb.com/test
,Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
3. Which client statement alerts the nurse that the client may be maladaptively
responding to stress? abirb.com/test
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.” abirb.com/test
4. “I made an appointment to meet with a therapist.”
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation abirb.com/test
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8
Heading: Stress Management abirb.com/test
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress abirb.com/test
Difficulty: Easy
Feedback abirb.com/test
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.
abirb.com/test
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
abirb.com/testcoping method.
CON: Stress
abirb.com/test
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?
abirb.com/test
1. Alarm reaction
2. Resistance
3. Exhaustion abirb.com/test
4. Fight or flight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation abirb.com/test
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 2
Heading: Stress as a Biological Response abirb.com/test
Integrated Processes: Nursing Process: Assessment
abirb.com/test
abirb.com/test
, Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress
Difficulty: Easy abirb.com/test
Feedback
1. This is incorrect. At the alarm reaction stage, physiologicalabirb.com/test
responses of the fight-or-
flight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individual uses the physiological
responses of the first stage as a defense in the attempt to adapt to the stressor.
Physiological symptoms may disappear. abirb.com/test
3. This is correct. At the stage of exhaustion, the student’s exposure to stress has been
prolonged, and adaptive energy has been depleted. Diseases of adaptation occur
more frequently in this stage. abirb.com/test
4. This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
abirb.com/test
CON: Stress
abirb.com/test
5. A school nurse is assessing a high school student who is overly concerned about her
appearance. The client’s parent states, “That’s not something to be stressed about!”
Which response by the nurse is best?
abirb.com/test
1. “Teenagers don’t truly understand stress.”
2. “Why are you so concerned about your appearance?”
3. “You surely know that isn’t something to be concerned with.”
4. “I understand you feel stressed about this; tell me more about your stress.”
abirb.com/test
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
abirb.com/test
Objective: Describe the core concept of stress as an environmental event.
Page: 8
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress abirb.com/test
Difficulty: Moderate
Feedback
1. This is incorrect. This response is judgmental and nontherapeutic. This response
abirb.com/test
minimizes the student’s concerns.
2. This is incorrect. This response puts the student in a defensive position to justify her
feelings. It is nontherapeutic. abirb.com/test
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s
abirb.com/test
abirb.com/test
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
Chapter 1. The Concept of Stress Adaptation
abirb.com/test
MULTIPLE CHOICE
abirb.com/test
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 abirb.com/test
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
abirb.com/test
stress-related illness.
4. Recognizes the client may view the losses as challenges and perceive them as
opportunities. abirb.com/test
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases ofabirb.com/test
adaptation.
Page: 5
Heading: Stress as an Environmental Event
Integrated Processes: Nursing Process: Evaluation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate abirb.com/test
Feedback
1. This is incorrect. Assessment is the first step of the nursingabirb.com/test
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
abirb.com/test
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 nursingabirb.com/test
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
abirb.com/test
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
abirb.com/test
susceptibility to stress-related physical and psychological illnesses. A 6-month score
abirb.com/test
abirb.com/test
,Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
of 300 or more or a year-score of 500 or more indicates high stress in a client’s life
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 abirb.com/test
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
abirb.com/test
illness.
CON: Stress
abirb.com/test
2. A physically and emotionally healthy client has just been fired.abirb.com/test
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:
abirb.com/test
1. Irrelevant
2. Harm or loss
3. Threatening
4. A challenge abirb.com/test
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the managementabirb.com/test
of stress.
Page: 7
Heading: Stress as a transaction between the individual and the environment
>Individual’s Perception of the Event > Primary Appraisal abirb.com/test
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
abirb.com/test
Concept: Stress
Difficulty: Easy
Feedback abirb.com/test
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 damageabirb.com/test
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 abirb.com/test
his statement to consider
an art degree.
CON: Stress abirb.com/test
abirb.com/test
abirb.com/test
,Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
3. Which client statement alerts the nurse that the client may be maladaptively
responding to stress? abirb.com/test
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.” abirb.com/test
4. “I made an appointment to meet with a therapist.”
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation abirb.com/test
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8
Heading: Stress Management abirb.com/test
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress abirb.com/test
Difficulty: Easy
Feedback abirb.com/test
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.
abirb.com/test
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
abirb.com/testcoping method.
CON: Stress
abirb.com/test
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?
abirb.com/test
1. Alarm reaction
2. Resistance
3. Exhaustion abirb.com/test
4. Fight or flight
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation abirb.com/test
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 2
Heading: Stress as a Biological Response abirb.com/test
Integrated Processes: Nursing Process: Assessment
abirb.com/test
abirb.com/test
, Townsend
PMHN, 10e
Chapter 1 - ETB
abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress
Difficulty: Easy abirb.com/test
Feedback
1. This is incorrect. At the alarm reaction stage, physiologicalabirb.com/test
responses of the fight-or-
flight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individual uses the physiological
responses of the first stage as a defense in the attempt to adapt to the stressor.
Physiological symptoms may disappear. abirb.com/test
3. This is correct. At the stage of exhaustion, the student’s exposure to stress has been
prolonged, and adaptive energy has been depleted. Diseases of adaptation occur
more frequently in this stage. abirb.com/test
4. This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
abirb.com/test
CON: Stress
abirb.com/test
5. A school nurse is assessing a high school student who is overly concerned about her
appearance. The client’s parent states, “That’s not something to be stressed about!”
Which response by the nurse is best?
abirb.com/test
1. “Teenagers don’t truly understand stress.”
2. “Why are you so concerned about your appearance?”
3. “You surely know that isn’t something to be concerned with.”
4. “I understand you feel stressed about this; tell me more about your stress.”
abirb.com/test
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
abirb.com/test
Objective: Describe the core concept of stress as an environmental event.
Page: 8
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation abirb.com/test
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress abirb.com/test
Difficulty: Moderate
Feedback
1. This is incorrect. This response is judgmental and nontherapeutic. This response
abirb.com/test
minimizes the student’s concerns.
2. This is incorrect. This response puts the student in a defensive position to justify her
feelings. It is nontherapeutic. abirb.com/test
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s
abirb.com/test
abirb.com/test
