©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
NUR 276 FINAL EXAM STUDY GUIDE
SOLUTIONS
Be able to explain the relationship between the concepts of stress and coping, cellular regulation, and
oxygenation/perfusion - Ans:✔✔-*Respiratory*: Increased ventilatory rate and depth of respirations,
dilation of bronchioles to facilitate increased oxygenation
*Cardiac*: Increased heart rate and cardiac output to promote transport of oxygen and nutrients
throughout the body
*Integumentary*: Increased sweat production (diaphoresis) to offset increased body temperature
secondary to increased metabolism; skin pallor secondary to vasoconstrictive effects of norepinephrine
*GI*: inhibition of the parasympathetic nervous system leads to decreased motility of gastric and
intestinal contents (peristalsis) through the gastrointestinal tract, which may cause constipation and
exccess flatus (intestinal gas); dry mouth due to decreased salivation secondary to inhibition of the
parasympathetic nervous system.
*Urinary*: Increased sodium and water retention due mineralocorticoid release, which leads to
decreased urine output and increased blood volume
*Opthalmic*: Pupillary dilation to allow entrance of more light and enhanced visual perception
Page 1/94
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Neurological: Enhances awareness and alertness in response to severe threats
*Musculoskeletal*: Increased muscular tension in preparation for defense (flight) or rapid mobility
(flight)
*Endocrine*: Increased release of glucocorticoids and increased gluconeogenesis, which leads to an
increased serum glucose (blood sugar)
What lab values are affected by stress and know why (Page 1903) - Ans:✔✔-Stress Response causes
research suggests that peer rejection stimulates an increase in systolic blood pressure and in the
production of saliva a-amylase (sAA), which is an enzyme that is reflective of sympathetic nervous
system activation. Additionally, stressors related to performance-based challenges were associated with
increased cortisol production and increased diastolic blood pressure
1. Release of *catecholamines* and *epinephrine* and *norepinephrine*. This causes an increase in
blood pressure and heart rate.
2. Release of *glucocorticoids* and increased gluconeogenesis
3. Increased serum glucose-increased risk for hyperglycemia and poor glucose control in clients with
diabetes
Page 2/94
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
prolonged exposure to stress may lead to significant enlargement of the adrenal glands and pronounced
shrinkage (atrophy) of the lymphatic structures, including the lymph nodes, thymus, and spleen.
Additionally, within the gastrointestinal tract, ulcers may develop.
the sympathetic nervous system triggers the body's "fight-or-flight" response, which is necessary for
survival. Activation of the sympathetic nervous system causes release of hormones such as epinephrine,
which increases the heart rate and blood pressure to assist in the delivery of oxygen to tissues and
organs. Epinephrine also causes bronchial dilation, which allows for increased oxygen uptake. This
increase in oxygen uptake and delivery is intended to meet the increased metabolic demands associated
with facing a stressor (fight) or escaping the stressor (flight).
Local Adaptation Syndrome (LAS):
1. Alarm reaction: Body prepares for cascade of physiological reactions
2. Resistance: Body attempts to move toward restoration of homeostasis
3. Exhaustion: Energy and resources become depleted, body may rebound or disease/death may occur
Page 3/94
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
epinephrine- increased heart rate
Know how the nurse should interact/intervene with a client experiencing anxiety or stress (Page 1906) -
Ans:✔✔-Initial nursing actions that inspire client confidence and that may help calm anxious clients:
1. Make eye contact, focusing on the person
2. Take a nonthreatening stance
3. Validate the client's feelings: "I know you are very uncomfortable; we will do everything we can to
help you feel better."
4. Determine and address the client's immediate concerns: "What can I do right away to help you?"
5. Remember to address the client by name. Some clients find terms of endearment such as "honey" or
"sweetie" impersonal or demeaning. Using the client's first name may be seen as patronizing if the client
is expected to use the nurse's last name. On the other hang, some clients respond positively to the
informality of first name use. Ask clients how they would prefer to be addressed and never use the first
name of anyone over 18 without permission.
6. Recognize and acknowledge manifestations of stress
7. Identify health coping mechanisms, including ensuring adequate time aware from the workplace and
incorporation of recreational activities into personal life
Page 4/94
FIRST PUBLISH OCTOBER 2024
NUR 276 FINAL EXAM STUDY GUIDE
SOLUTIONS
Be able to explain the relationship between the concepts of stress and coping, cellular regulation, and
oxygenation/perfusion - Ans:✔✔-*Respiratory*: Increased ventilatory rate and depth of respirations,
dilation of bronchioles to facilitate increased oxygenation
*Cardiac*: Increased heart rate and cardiac output to promote transport of oxygen and nutrients
throughout the body
*Integumentary*: Increased sweat production (diaphoresis) to offset increased body temperature
secondary to increased metabolism; skin pallor secondary to vasoconstrictive effects of norepinephrine
*GI*: inhibition of the parasympathetic nervous system leads to decreased motility of gastric and
intestinal contents (peristalsis) through the gastrointestinal tract, which may cause constipation and
exccess flatus (intestinal gas); dry mouth due to decreased salivation secondary to inhibition of the
parasympathetic nervous system.
*Urinary*: Increased sodium and water retention due mineralocorticoid release, which leads to
decreased urine output and increased blood volume
*Opthalmic*: Pupillary dilation to allow entrance of more light and enhanced visual perception
Page 1/94
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Neurological: Enhances awareness and alertness in response to severe threats
*Musculoskeletal*: Increased muscular tension in preparation for defense (flight) or rapid mobility
(flight)
*Endocrine*: Increased release of glucocorticoids and increased gluconeogenesis, which leads to an
increased serum glucose (blood sugar)
What lab values are affected by stress and know why (Page 1903) - Ans:✔✔-Stress Response causes
research suggests that peer rejection stimulates an increase in systolic blood pressure and in the
production of saliva a-amylase (sAA), which is an enzyme that is reflective of sympathetic nervous
system activation. Additionally, stressors related to performance-based challenges were associated with
increased cortisol production and increased diastolic blood pressure
1. Release of *catecholamines* and *epinephrine* and *norepinephrine*. This causes an increase in
blood pressure and heart rate.
2. Release of *glucocorticoids* and increased gluconeogenesis
3. Increased serum glucose-increased risk for hyperglycemia and poor glucose control in clients with
diabetes
Page 2/94
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
prolonged exposure to stress may lead to significant enlargement of the adrenal glands and pronounced
shrinkage (atrophy) of the lymphatic structures, including the lymph nodes, thymus, and spleen.
Additionally, within the gastrointestinal tract, ulcers may develop.
the sympathetic nervous system triggers the body's "fight-or-flight" response, which is necessary for
survival. Activation of the sympathetic nervous system causes release of hormones such as epinephrine,
which increases the heart rate and blood pressure to assist in the delivery of oxygen to tissues and
organs. Epinephrine also causes bronchial dilation, which allows for increased oxygen uptake. This
increase in oxygen uptake and delivery is intended to meet the increased metabolic demands associated
with facing a stressor (fight) or escaping the stressor (flight).
Local Adaptation Syndrome (LAS):
1. Alarm reaction: Body prepares for cascade of physiological reactions
2. Resistance: Body attempts to move toward restoration of homeostasis
3. Exhaustion: Energy and resources become depleted, body may rebound or disease/death may occur
Page 3/94
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
epinephrine- increased heart rate
Know how the nurse should interact/intervene with a client experiencing anxiety or stress (Page 1906) -
Ans:✔✔-Initial nursing actions that inspire client confidence and that may help calm anxious clients:
1. Make eye contact, focusing on the person
2. Take a nonthreatening stance
3. Validate the client's feelings: "I know you are very uncomfortable; we will do everything we can to
help you feel better."
4. Determine and address the client's immediate concerns: "What can I do right away to help you?"
5. Remember to address the client by name. Some clients find terms of endearment such as "honey" or
"sweetie" impersonal or demeaning. Using the client's first name may be seen as patronizing if the client
is expected to use the nurse's last name. On the other hang, some clients respond positively to the
informality of first name use. Ask clients how they would prefer to be addressed and never use the first
name of anyone over 18 without permission.
6. Recognize and acknowledge manifestations of stress
7. Identify health coping mechanisms, including ensuring adequate time aware from the workplace and
incorporation of recreational activities into personal life
Page 4/94
