NURS (FUNDAMENTALS): CH 41 NCLEX STRESS AND ADAPTATION 2023/2024 LATEST WITH RATIONALES GUARANTEED PASS

NURS (FUNDAMENTAL S): CH 41 NCLEX STRESS AND ADAPTATION 2023/2024 LATEST WITH RATIONALES GUARANTEED PASS A nurse is assessing a 49 -year-old male patient who complains of migraines that have become "unbearable." The patient tells the nurse, "I just got laid off from my job last week and I have two kids in college. I don't know ho w I'm going to pay for it all." Which physiologic effects of stress would be expected findings in this patient? Select all that apply. a) Changes in appetite b) Changes in elimination patterns c) Decreased pulse and respirations d) Use of ineffective copi ng mechanisms e) Withdrawal f) Attention -seeking behaviors a, b Physiologic effects of stress include changes in appetite and elimination patterns as well as increased pulse and respirations. Using ineffective coping mechanisms, becoming withdrawn and isolated, and exhibiting attention -seeking behaviors are psychological effects of stress. A nurse caring for patients in a hospital setting uses anticipatory guidance to prepare them for painful procedures. Which instruction would the nurse provide in this ty pe of stress management? a) The nurse teaches patients rhythmic breathing to perform prior to the procedure. b) The nurse tells patients to focus on a pleasant place, mentally place themselves in it, and breathe slowly in and out. c) The nurse teaches pat ients about the pain involved in the procedure and methods to cope with it. d) The nurse teaches patients to create and focus on a mental image during the procedure to become less responsive to the pain. c) The nurse teaches patients about the pain involve d in the procedure and methods to cope with it. Anticipatory guidance focuses on psychologically preparing a person for an unfamiliar or painful event. When patients know what to expect, their anxiety is reduced, which occurs when teaching about the pain involved and related pain relief measures. Rhythmic breathing is a relaxation technique, focusing on a pleasant place and breathing slowly in and out is a meditation technique, and focusing on a mental image to reduce responses to stimuli is a guided image ry technique. A nurse witnesses a street robbery and is assessing a 26 -year-old female patient who is the victim. The patient has minor scrapes and bruises and tells the nurse, "I've never been so scared in my life." What other symptoms would the nurse exp ect to find related to the fight -or-flight response to stress? Select all that apply. a) Increased heart rate b) Decreased muscle strength c) Increased mental alertness d) Increased blood glucose levels e) Decreased cardiac output f) Decreased peristalsis a, c, d The sympathetic nervous system functions under stress to bring about the fight -or-flight response by increasing the heart rate, increasing muscle strength, increasing cardiac output, increasing blood glucose levels, and increasing mental alertnes s. Increased peristalsis is brought on by the parasympathetic nervous system under normal conditions and at rest. A nurse is assessing the developmental levels of patients in a pediatric office. Which individual would a nurse document as experiencing devel opmental stress? a) An infant who learns to turn over b) A school -aged child who learns how to add and subtract c) An adolescent who is a "loner" d) A young adult who has a variety of friends c) An adolescent who is a "loner" The adolescent who is a lone r is not meeting a major task (being a part of a peer group) for that level of growth and development. A nurse is caring for an older male patient in a long -term care facility who has a spinal cord injury affecting his neurologic reflex arc. Based on this patient data, what would be a priority intervention for this patient? a) Monitoring food and drink tem peratures to prevent burns b) Providing adequate pain relief measures to reduce stress c) Monitoring for depression related to social isolation d) Providing meals high in carbohydrates to promote healing a) Monitoring food and drink temperatures to prevent burns A patient with a damaged neurologic reflex arc would have a diminished pain reflex response, which would put the patient at risk for burns as the sensors in the skin would not detect the heat of the food or liquids. All patients should be provided adequate pain relief, but this is not the priority intervention in this patient. Monitoring for depression would be an intervention for this patient but is not related to the damaged neurologic reflex arc . A patient who is immobile should eat a balanced diet based on the ChooseMyPlate dietary guidelines. A nurse is caring for a patient in the shock or alarm reaction phase of the GAS. Which response by the patient would be expected? a) Decreasing pulse b) Increasing sleepiness c) Increasing energy levels d) Decreasing respirations c) Increasing energy levels The body perceives a threat and prepares to respond by increasing the activity of the autonomic nervous and endocrine systems. The initial or shock ph ase is characterized by increased energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness. A nurse interviews a woman who was abused by her partner and is staying at a women's shelter with her three children. She tells the nurse, "I'm so worried that my husband will find me and try to make me go back home." Which data would the nurse most appropriately document? a) "Patient displays moderate anxiety related to her situation." b) "Patient manifests panic related to feelings of imp ending doom." c) "Patient describes severe anxiety related to her situation." d) "Patient expresses fear of her husband." d) "Patient expresses fear of her husband." Fear is a response (feeling of dread) to a known threat. Anxiety, on the other hand, is a vague, uneasy feeling of discomfort or dread from an often unknown source. Panic causes a person to lose control and experience dread and terror, which can lead to exhaustion and death; that is not the case in this situation. A college student visits the school's health center with vague complaints of anxiety and fatigue. The student tells the nurse, "Exams are right around the corner and all I feel like doing is sleeping." The student's vital signs are within normal parameters. What would be an appropriat e question to ask in response to these complaints? a) "Are you worried about failing your exams?" b) "Have you been staying up late studying?"