,Morgan
PMHN, 11e
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 of significant stress-related illness.
2. Determines the client is not at risk of significant stress-related illness.
3. Needs further assessment of the client’s coping skills to determine susceptibility to stress-re-
lated 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 and Coping
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 sus-
ceptibility to stress-related physical and psychological illnesses. The Recent Life
Changes Questionnaire is an expanded version of the Rahe-Holmes Social Readjust-
ment 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 illness.
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
illness.
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 suscepti-
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
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,Morgan
PMHN, 11e
Chapter 1 - ETB
bility to stress-related physical and psychological illness. A 6-month score of 300 or
more or a year score of 500 or more indicates high stress in a client’s life and risk of
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 sus-
ceptibility to stress-related illness. 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 significant stress-related physical and psycho-
logical illness.
CON: Stress and Coping
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 and Coping
Difficulty: Easy
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds no signifi-
cance for the individual.
2. This is incorrect. A harm or loss appraisal refers to damage or loss already experi-
enced 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.
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
CON: Stress and Coping
CON: Stress
3.Which of the following is a stage in the general adaptation syndrome?
1. Journaling thoughts and feelings
2. Adapting to and overcoming a stressor
3. Primary appraisal
4. Spending time with a pet
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 3
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Journaling thoughts and feelings is a positive adaptive coping
mechanism but is not a stage in the general adaptation syndrome.
2. This is correct. Adapting to and overcoming a stressor is the stage of resistance in
the general adaptation syndrome defined by Selye.
3. This is incorrect. Primary appraisal is a concept of stress defined by Lazarus and
Folkman in 1984.
4. This is incorrect. Spending time with a pet is a positive adaptive coping mechanism
but is not a stage in the general adaptation syndrome.
CON: Stress and Coping
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
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from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 3
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. At the alarm reaction stage, physiological responses of the fight-or-
flight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individual uses the physiological re-
sponses of the first stage as a defense in an attempt to adapt to the stressor. Physio-
logical symptoms may disappear.
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.
4. This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
CON: Stress and Coping
5. A school nurse is assessing a high school student who is overly concerned about her appear-
ance. The client’s parent states, “That’s not something to be stressed about!” Which response by
the nurse is best?
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.”
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Describe the core concept of stress as an environmental event.
Page: 6-7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
Difficulty: Moderate
Feedback
1. This is incorrect. This response is judgmental and nontherapeutic. This response
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.
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s feel-
ings. This does not allow the student to verbalize her concerns.
4. This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation, which is an individual’s evaluation of the per-
sonal significance of the event or occurrence. Stress can be physical or psychological
in nature. A perceived threat to self-esteem can be as stressful as a physiological
change. This response recognizes the situation and helps to explore the situation.
CON: Stress and Coping
6. A student confides in the school nurse that he is feeling stress about deciding whether to go to
college or work to provide needed income for his family. Which is the best approach by the
nurse to assist the student?
1. Teach the student meditation techniques.
2. Assist the student with problem-solving strategies.
3. Suggest relaxation methods for the student.
4. Recommend getting a pet for the student.
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. This is not the best approach because it only addresses a means to
reduce stress-related symptoms and does not address the underlying concern for the
student.
2. This is correct. The student is facing a problem that needs to be viewed objectively,
and the nurse can assist the student, if needed, to apply problem-solving strategies.
Copyright © 2024 by F.A. Davis Company
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
3. This is incorrect. While relaxation may assist the student with coping with the stres-
sor, it does not address the student’s underlying concern.
4. This is incorrect. Getting a pet can assist with coping with life stressors; however,
the student has already expressed financial concerns, to which the pet will only add.
CON: Stress and Coping
7. An unemployed college graduate confides in the clinic nurse that she is experiencing severe
anxiety over not finding a teaching position and that she is having difficulty with independent
problem-solving. Which nursing intervention is best?
1. Encourage her to seek counseling from a therapist.
2. Instruct her to listen to her favorite music daily.
3. Assist her with the problem-solving process.
4. Encourage her to keep a daily journal of feelings.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 9
Heading: Stress Management > Adaptive Coping Strategies > Problem-Solving
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. Counseling is not likely needed in this case due to the situational
nature the student is describing.
2. This is incorrect. Listening to music may assist with the stress symptoms; however,
it does not address the underlying problem.
3. This is correct. Assist the client with problem-solving. During times of high anxiety
and stress, clients will need more assistance in problem-solving and decision-mak-
ing.
4. This is incorrect. A daily journal may assist her with managing her symptoms but
does not address the underlying concern the client is expressing.
CON: Stress and Coping
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
8. The school nurse is assessing a high school student who is distraught because her parents can-
not afford horseback riding lessons. The nurse recognizes the student’s perception is that the
problem is:
1. Endangering her well-being
2. Personally relevant
3. Based on immaturity
4. Challenging to her
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the concept of stress as a transaction between the individual and the environ-
ment.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. The student is not expressing that it endangers her well-being; the
distress is related to the fact that she sees it as personally significant.
2. This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation. An event becomes relevant to an individual
when the outcome holds personal significance.
3. This is incorrect. The distress the client is feeling is not related to immaturity; rather,
she sees it as having personal significance and therefore relevant.
4. This is incorrect. The emotions associated with challenging events tend to be posi-
tive, such as eagerness and excitement, rather than being distraught.
CON: Stress and Coping
9. Meditation has been shown to be an effective stress management technique. Which finding
indicates meditation has been effective?
1. Achieving a state of relaxation
2. Attaining insight into one’s feelings
3. Demonstrating appropriate role behaviors
4. Enhanced problem-solving skills
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies > Meditation
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is correct. Meditation produces relaxation by creating a special state of con-
sciousness through focused concentration.
2. This is incorrect. Meditation does not necessarily result in attaining insight into
one’s feelings.
3. This is incorrect. Meditation does not help to demonstrate appropriate role behav-
iors.
4. This is incorrect. Meditation does not necessarily enhance one’s ability to solve
problems.
CON: Stress and Coping
10.Which client is at the highest risk of having a high score on the Recent Life Changes Ques-
tionnaire (RLCQ)?
1. An older married man
2. An unmarried young adult woman
3. An older unmarried woman
4. A married young man
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective Stress as an environmental event.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Married and older people rate lower levels of stress than unmarried
and younger people.
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
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, Morgan
PMHN, 11e
Chapter 1 - ETB
2. This is correct. People who are unmarried, young, and female rate higher levels of
stress than those who are married, older, and male.
3. This is incorrect. Women rate higher levels of stress, but older adults rate lower lev-
els of stress than younger people.
4. This is incorrect. People who are married and male rate lower levels of stress even
though younger people rate higher levels of stress than older people.
CON: Stress and Coping
11. The client is hospitalized with coronary artery disease and demonstrates other conditions of-
ten associated with diseases of adaptation, including headaches and depression. Currently, the
client is demonstrating anxiety and states he is
“really worried” about his spouse. Which is the most appropriate nursing response to the situa-
tion?
1. Inform the client that he has to learn to cope with stressors.
2. Teach the client how to meditate when he is feeling anxious.
3. Encourage the client to talk through his concerns about his spouse.
4. Ask the client if he has a pet he would like to see while in the hospital.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 9
Heading: Stress Management > Interpersonal Communication
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychological Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Informing the client that he needs to learn something new at this
time will likely increase his stress and is not helpful to the immediate situation.
2. This is incorrect. Teaching the client meditation is not appropriate at this time, when
he is expressing anxiety and concerns about his spouse.
3. This is correct. Interpersonal communication can assist the nurse to understand the
client’s concerns and allows the client to reduce the escalation of stress at this time.
4. This is incorrect. While this may be helpful in some situations, it is not something
that can address the client’s immediate needs.
CON: Stress and Coping
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
PMHN, 11e
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 of significant stress-related illness.
2. Determines the client is not at risk of significant stress-related illness.
3. Needs further assessment of the client’s coping skills to determine susceptibility to stress-re-
lated 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 and Coping
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 sus-
ceptibility to stress-related physical and psychological illnesses. The Recent Life
Changes Questionnaire is an expanded version of the Rahe-Holmes Social Readjust-
ment 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 illness.
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
illness.
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 suscepti-
Copyright © 2024 by F.A. Davis Company
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
bility to stress-related physical and psychological illness. A 6-month score of 300 or
more or a year score of 500 or more indicates high stress in a client’s life and risk of
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 sus-
ceptibility to stress-related illness. 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 significant stress-related physical and psycho-
logical illness.
CON: Stress and Coping
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 and Coping
Difficulty: Easy
Feedback
1. This is incorrect. An irrelevant perception is one where the event holds no signifi-
cance for the individual.
2. This is incorrect. A harm or loss appraisal refers to damage or loss already experi-
enced 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.
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
CON: Stress and Coping
CON: Stress
3.Which of the following is a stage in the general adaptation syndrome?
1. Journaling thoughts and feelings
2. Adapting to and overcoming a stressor
3. Primary appraisal
4. Spending time with a pet
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 3
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Journaling thoughts and feelings is a positive adaptive coping
mechanism but is not a stage in the general adaptation syndrome.
2. This is correct. Adapting to and overcoming a stressor is the stage of resistance in
the general adaptation syndrome defined by Selye.
3. This is incorrect. Primary appraisal is a concept of stress defined by Lazarus and
Folkman in 1984.
4. This is incorrect. Spending time with a pet is a positive adaptive coping mechanism
but is not a stage in the general adaptation syndrome.
CON: Stress and Coping
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
Copyright © 2024 by F.A. Davis Company
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the relationship between stress and diseases of adaptation.
Page: 3
Heading: Stress as a Biological Response
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. At the alarm reaction stage, physiological responses of the fight-or-
flight syndrome are initiated.
2. This is incorrect. At the stage of resistance, the individual uses the physiological re-
sponses of the first stage as a defense in an attempt to adapt to the stressor. Physio-
logical symptoms may disappear.
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.
4. This is incorrect. The fight-or-flight syndrome occurs during the alarm reaction
stage.
CON: Stress and Coping
5. A school nurse is assessing a high school student who is overly concerned about her appear-
ance. The client’s parent states, “That’s not something to be stressed about!” Which response by
the nurse is best?
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.”
ANS: 4
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Describe the core concept of stress as an environmental event.
Page: 6-7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Copyright © 2024 by F.A. Davis Company
All rights reserved. This material is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or trans-
mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
Difficulty: Moderate
Feedback
1. This is incorrect. This response is judgmental and nontherapeutic. This response
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.
3. This is incorrect. This is a nontherapeutic response that minimizes the student’s feel-
ings. This does not allow the student to verbalize her concerns.
4. This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation, which is an individual’s evaluation of the per-
sonal significance of the event or occurrence. Stress can be physical or psychological
in nature. A perceived threat to self-esteem can be as stressful as a physiological
change. This response recognizes the situation and helps to explore the situation.
CON: Stress and Coping
6. A student confides in the school nurse that he is feeling stress about deciding whether to go to
college or work to provide needed income for his family. Which is the best approach by the
nurse to assist the student?
1. Teach the student meditation techniques.
2. Assist the student with problem-solving strategies.
3. Suggest relaxation methods for the student.
4. Recommend getting a pet for the student.
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. This is not the best approach because it only addresses a means to
reduce stress-related symptoms and does not address the underlying concern for the
student.
2. This is correct. The student is facing a problem that needs to be viewed objectively,
and the nurse can assist the student, if needed, to apply problem-solving strategies.
Copyright © 2024 by F.A. Davis Company
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
3. This is incorrect. While relaxation may assist the student with coping with the stres-
sor, it does not address the student’s underlying concern.
4. This is incorrect. Getting a pet can assist with coping with life stressors; however,
the student has already expressed financial concerns, to which the pet will only add.
CON: Stress and Coping
7. An unemployed college graduate confides in the clinic nurse that she is experiencing severe
anxiety over not finding a teaching position and that she is having difficulty with independent
problem-solving. Which nursing intervention is best?
1. Encourage her to seek counseling from a therapist.
2. Instruct her to listen to her favorite music daily.
3. Assist her with the problem-solving process.
4. Encourage her to keep a daily journal of feelings.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 9
Heading: Stress Management > Adaptive Coping Strategies > Problem-Solving
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. Counseling is not likely needed in this case due to the situational
nature the student is describing.
2. This is incorrect. Listening to music may assist with the stress symptoms; however,
it does not address the underlying problem.
3. This is correct. Assist the client with problem-solving. During times of high anxiety
and stress, clients will need more assistance in problem-solving and decision-mak-
ing.
4. This is incorrect. A daily journal may assist her with managing her symptoms but
does not address the underlying concern the client is expressing.
CON: Stress and Coping
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mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
8. The school nurse is assessing a high school student who is distraught because her parents can-
not afford horseback riding lessons. The nurse recognizes the student’s perception is that the
problem is:
1. Endangering her well-being
2. Personally relevant
3. Based on immaturity
4. Challenging to her
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Explain the concept of stress as a transaction between the individual and the environ-
ment.
Page: 7
Heading: Stress as a Transaction Between the Individual and the Environment
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Moderate
Feedback
1. This is incorrect. The student is not expressing that it endangers her well-being; the
distress is related to the fact that she sees it as personally significant.
2. This is correct. Determination of an event as stressful depends on the individual’s
cognitive appraisal of the situation. An event becomes relevant to an individual
when the outcome holds personal significance.
3. This is incorrect. The distress the client is feeling is not related to immaturity; rather,
she sees it as having personal significance and therefore relevant.
4. This is incorrect. The emotions associated with challenging events tend to be posi-
tive, such as eagerness and excitement, rather than being distraught.
CON: Stress and Coping
9. Meditation has been shown to be an effective stress management technique. Which finding
indicates meditation has been effective?
1. Achieving a state of relaxation
2. Attaining insight into one’s feelings
3. Demonstrating appropriate role behaviors
4. Enhanced problem-solving skills
ANS: 1
Chapter: Chapter 1, The Concept of Stress Adaptation
Copyright © 2024 by F.A. Davis Company
All rights reserved. This material is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or trans-
mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
,Morgan
PMHN, 11e
Chapter 1 - ETB
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies > Meditation
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is correct. Meditation produces relaxation by creating a special state of con-
sciousness through focused concentration.
2. This is incorrect. Meditation does not necessarily result in attaining insight into
one’s feelings.
3. This is incorrect. Meditation does not help to demonstrate appropriate role behav-
iors.
4. This is incorrect. Meditation does not necessarily enhance one’s ability to solve
problems.
CON: Stress and Coping
10.Which client is at the highest risk of having a high score on the Recent Life Changes Ques-
tionnaire (RLCQ)?
1. An older married man
2. An unmarried young adult woman
3. An older unmarried woman
4. A married young man
ANS: 2
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective Stress as an environmental event.
Page: 8-9
Heading: Stress Management > Adaptive Coping Strategies
Integrated Processes: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Married and older people rate lower levels of stress than unmarried
and younger people.
Copyright © 2024 by F.A. Davis Company
All rights reserved. This material is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or trans-
mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
, Morgan
PMHN, 11e
Chapter 1 - ETB
2. This is correct. People who are unmarried, young, and female rate higher levels of
stress than those who are married, older, and male.
3. This is incorrect. Women rate higher levels of stress, but older adults rate lower lev-
els of stress than younger people.
4. This is incorrect. People who are married and male rate lower levels of stress even
though younger people rate higher levels of stress than older people.
CON: Stress and Coping
11. The client is hospitalized with coronary artery disease and demonstrates other conditions of-
ten associated with diseases of adaptation, including headaches and depression. Currently, the
client is demonstrating anxiety and states he is
“really worried” about his spouse. Which is the most appropriate nursing response to the situa-
tion?
1. Inform the client that he has to learn to cope with stressors.
2. Teach the client how to meditate when he is feeling anxious.
3. Encourage the client to talk through his concerns about his spouse.
4. Ask the client if he has a pet he would like to see while in the hospital.
ANS: 3
Chapter: Chapter 1, The Concept of Stress Adaptation
Objective: Discuss adaptive coping strategies in the management of stress.
Page: 9
Heading: Stress Management > Interpersonal Communication
Integrated Processes: Nursing Process: Evaluation
Client Need: Psychological Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Stress and Coping
Difficulty: Easy
Feedback
1. This is incorrect. Informing the client that he needs to learn something new at this
time will likely increase his stress and is not helpful to the immediate situation.
2. This is incorrect. Teaching the client meditation is not appropriate at this time, when
he is expressing anxiety and concerns about his spouse.
3. This is correct. Interpersonal communication can assist the nurse to understand the
client’s concerns and allows the client to reduce the escalation of stress at this time.
4. This is incorrect. While this may be helpful in some situations, it is not something
that can address the client’s immediate needs.
CON: Stress and Coping
Copyright © 2024 by F.A. Davis Company
All rights reserved. This material is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or trans-
mitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission
from the publisher. Use of this content outside your academic institution is expressly prohibited and enforceable by law.
