Chapter 08: Stress and Stress Management
Lewis: Medical-Surgical Nursing in Canada
MULTIPLE CHOICE
1. A young adult arrives in the emergency department (ED) with multiple abrasions after a
motor vehicle accident and has an initial blood pressure (BP) of 180/98. Which of the
following interventions should the nurse implement?
a. Discuss the need for hospital admission to control blood pressure.
b. Change the dressing on the abrasions and discuss the risks associated with
hypertension.
c. Recheck the blood pressure before the client’s discharge from the ED.
d. Start an intravenous (IV) line to administer antihypertensive medications.
ANS: C
Because hypertension is expected when a client has experienced an acute stressor, the nurse
should plan to check the BP before discharge, which will provide a more accurate idea of the
client’s usual blood pressure. Hypertension that occurs in response to acute stress does not
increase risk for health problems such as stroke, indicate a need for hospitalization, or indicate
a need for IV antihypertensive medications.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
2. A hospitalized client who is usually well organized and calm is receiving diabetic teaching
after being newly diagnosed with diabetes. The client is forgetful, irritable, and has poor
NURSI
concentration. Which action should
GTB.C
theNnurse OM
take?
a. Ask the health care provider for a psychiatric referral.
b. Administer the PRN sedative medication every 4 hours.
c. Suggest the use of a home caregiver to the client’s family.
d. Plan to reinforce and repeat teaching about diabetes management.
ANS: D
Since behavioural responses to stress include temporary changes such as irritability, changes
in memory, and poor concentration, client teaching will need to be repeated. Psychiatric
referral or home caregiver referral will not be needed for these expected short-term cognitive
changes. Sedation will decrease the client’s ability to learn the necessary information for
self-management.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Psychosocial Integrity
3. The nurse is caring for a client who has been hospitalized following a heart attack and tells the
nurse, “I didn’t sleep last night because I worried about missing work 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 behaviour
Lewis: Medical-Surgical Nursing in Canada
MULTIPLE CHOICE
1. A young adult arrives in the emergency department (ED) with multiple abrasions after a
motor vehicle accident and has an initial blood pressure (BP) of 180/98. Which of the
following interventions should the nurse implement?
a. Discuss the need for hospital admission to control blood pressure.
b. Change the dressing on the abrasions and discuss the risks associated with
hypertension.
c. Recheck the blood pressure before the client’s discharge from the ED.
d. Start an intravenous (IV) line to administer antihypertensive medications.
ANS: C
Because hypertension is expected when a client has experienced an acute stressor, the nurse
should plan to check the BP before discharge, which will provide a more accurate idea of the
client’s usual blood pressure. Hypertension that occurs in response to acute stress does not
increase risk for health problems such as stroke, indicate a need for hospitalization, or indicate
a need for IV antihypertensive medications.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
2. A hospitalized client who is usually well organized and calm is receiving diabetic teaching
after being newly diagnosed with diabetes. The client is forgetful, irritable, and has poor
NURSI
concentration. Which action should
GTB.C
theNnurse OM
take?
a. Ask the health care provider for a psychiatric referral.
b. Administer the PRN sedative medication every 4 hours.
c. Suggest the use of a home caregiver to the client’s family.
d. Plan to reinforce and repeat teaching about diabetes management.
ANS: D
Since behavioural responses to stress include temporary changes such as irritability, changes
in memory, and poor concentration, client teaching will need to be repeated. Psychiatric
referral or home caregiver referral will not be needed for these expected short-term cognitive
changes. Sedation will decrease the client’s ability to learn the necessary information for
self-management.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Psychosocial Integrity
3. The nurse is caring for a client who has been hospitalized following a heart attack and tells the
nurse, “I didn’t sleep last night because I worried about missing work 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 behaviour
