Chapter 06: Stress Management
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. An adult patient arrived in the emergency department (ED) with minor facial
lacerations after a motor vehicle accident and has an initial blood pressure (BP) of
182/94. Which action by the nurse is most appropriate?
a. Start an IV line to administer antihypertensive medications.
b. Discuss the need for hospital admission to control blood pressure.
c. Treat the abrasions and discuss the risks associated with hypertension.
d. Recheck the blood pressure after the patient is stabilized and has received
treatment.
ANS: D
When a patient experiences an acute stressor, the blood pressure increases. The
nurse should plan to recheck the BP after the patient has stabilized and received
treatment. This will provide a more accurate indication of the patients usual blood
pressure. Elevated blood pressure that occurs in response to acute stress does not
increase the risk for health problems such as stroke, indicate a need for
hospitalization, or indicate a need for IV antihypertensive medications.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
2. A female patient who initially came to the clinic with incontinence was recently
diagnosed with endometrial cancer. She is usually well organized and calm but the
nurse who is giving her preoperative instructions observes that she is irritable, has
difficulty concentrating, and yells at her husband. Which action should the nurse
take?
a. Ask the health care provider for a psychiatric referral.
b. Focus teaching on preventing postoperative complications.
c. Try to calm patient and reinforce and repeat teaching about the surgery.
d. Encourage the patient to have bladder repair at the same time as the
hysterectomy.
ANS: C
Since behavioral responses to stress include temporary changes such as
irritability, changes in memory, and poor concentration, patient teaching will need
to be repeated. It is also important to try to calm the patient by listening to her
concerns and fears. Psychiatric referral will not necessarily be needed for her, but
that can better be evaluated after surgery. Focusing on postoperative care does not
address the need for preoperative instruction such as the procedure, NPO
instructions before surgery, date and time of surgery, medications to be taken
, and/or discontinued before surgery, etc. The issue of incontinence is not
immediately relevant in the discussion of preoperative teaching for her
hysterectomy. .
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
3. An adult patient who is hospitalized following a motorcycle accident when a car ran a
red light tells the nurse, I didnt sleep last night because I worried about missing work
at my new job and losing my insurance coverage. Which nursing diagnosis is
appropriate to include in the plan of care?
a. Anxiety
b. Defensive coping
c. Ineffective denial
d. Risk prone health behavior
ANS: A
The information about the patient indicates that anxiety is an appropriate nursing
diagnosis. The patient data do not support defensive coping, ineffective denial, or
risk prone health behavior as problems for this patient.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Diagnosis MSC: NCLEX: Psychosocial Integrity
4. A patient is extremely anxious about having a biopsy on a femoral lymph node in the
groin area. Which relaxation technique would be best for the nurse to use at this
time?
a. Meditation
b. Yoga stretching
c. Guided imagery
d. Relaxation breathing
ANS: D
Relaxation breathing is an easy relaxation technique to teach and use. The patient
should remain still during the biopsy and not move or stretch any of his
extremities. Meditation and guided imagery require more time to practice and
learn.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
5. A patient who suffers from frequent migraines tells the nurse, My life feels chaotic
and out of my control. I will not be able to manage if anything else happens. Which
response should the nurse make initially?
a. Regular exercise may get your mind off the pain.
b. Guided imagery can be helpful in regaining control.
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. An adult patient arrived in the emergency department (ED) with minor facial
lacerations after a motor vehicle accident and has an initial blood pressure (BP) of
182/94. Which action by the nurse is most appropriate?
a. Start an IV line to administer antihypertensive medications.
b. Discuss the need for hospital admission to control blood pressure.
c. Treat the abrasions and discuss the risks associated with hypertension.
d. Recheck the blood pressure after the patient is stabilized and has received
treatment.
ANS: D
When a patient experiences an acute stressor, the blood pressure increases. The
nurse should plan to recheck the BP after the patient has stabilized and received
treatment. This will provide a more accurate indication of the patients usual blood
pressure. Elevated blood pressure that occurs in response to acute stress does not
increase the risk for health problems such as stroke, indicate a need for
hospitalization, or indicate a need for IV antihypertensive medications.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
2. A female patient who initially came to the clinic with incontinence was recently
diagnosed with endometrial cancer. She is usually well organized and calm but the
nurse who is giving her preoperative instructions observes that she is irritable, has
difficulty concentrating, and yells at her husband. Which action should the nurse
take?
a. Ask the health care provider for a psychiatric referral.
b. Focus teaching on preventing postoperative complications.
c. Try to calm patient and reinforce and repeat teaching about the surgery.
d. Encourage the patient to have bladder repair at the same time as the
hysterectomy.
ANS: C
Since behavioral responses to stress include temporary changes such as
irritability, changes in memory, and poor concentration, patient teaching will need
to be repeated. It is also important to try to calm the patient by listening to her
concerns and fears. Psychiatric referral will not necessarily be needed for her, but
that can better be evaluated after surgery. Focusing on postoperative care does not
address the need for preoperative instruction such as the procedure, NPO
instructions before surgery, date and time of surgery, medications to be taken
, and/or discontinued before surgery, etc. The issue of incontinence is not
immediately relevant in the discussion of preoperative teaching for her
hysterectomy. .
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
3. An adult patient who is hospitalized following a motorcycle accident when a car ran a
red light tells the nurse, I didnt sleep last night because I worried about missing work
at my new job and losing my insurance coverage. Which nursing diagnosis is
appropriate to include in the plan of care?
a. Anxiety
b. Defensive coping
c. Ineffective denial
d. Risk prone health behavior
ANS: A
The information about the patient indicates that anxiety is an appropriate nursing
diagnosis. The patient data do not support defensive coping, ineffective denial, or
risk prone health behavior as problems for this patient.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Diagnosis MSC: NCLEX: Psychosocial Integrity
4. A patient is extremely anxious about having a biopsy on a femoral lymph node in the
groin area. Which relaxation technique would be best for the nurse to use at this
time?
a. Meditation
b. Yoga stretching
c. Guided imagery
d. Relaxation breathing
ANS: D
Relaxation breathing is an easy relaxation technique to teach and use. The patient
should remain still during the biopsy and not move or stretch any of his
extremities. Meditation and guided imagery require more time to practice and
learn.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
5. A patient who suffers from frequent migraines tells the nurse, My life feels chaotic
and out of my control. I will not be able to manage if anything else happens. Which
response should the nurse make initially?
a. Regular exercise may get your mind off the pain.
b. Guided imagery can be helpful in regaining control.
