Chapter 19: Stress and Mental Health

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Apply

Integrated Process: Nursing Process

Objective: 1

Page and Header: 286, Personality Types

1. A nurse performing an assessment interview is told by the client, “I’m a type A personality.” Based on the client’s statement, the nurse would expect which behavior?

A) Appearing relaxed and easy going throughout the interview

B) Wanting the interview to be over as quickly as possible

C) Being pleased with the overall pace of the interview

D) Speaking slowly, requiring time to consider his answers

Page and Header: 286, Social Networks

2. A nurse is assessing a client’s social networks. When evaluating this area, the nurse integrates knowledge that what important component?

A) Blood relationships

B) Bonding with one another

C) Reciprocity

D) Demands

Page and Header: 290, Adaptation

3. A client visiting the clinic tells the nurse about being under a great deal of job-related stress for the past month. Applying the factors that determine the stress response, which question would be most appropriate for the nurse to ask?

A) “What effect is the stress having on your job performance?”

B) “How would you describe the social network within your family?”

C) “What is the specific event that you find most stressful?”

D) “When did you first become aware of experiencing this stress?”

Page and Header: 283, Consequences of Chronic Stress

4. The nurse is caring for a client diagnosed with chronic stress related to financial difficulties. When evaluating the client’s assessment data, the nurse would anticipate finding an elevated antibody titer to which virus?

A) Herpes simplex viruses

B) Herpes zoster viruses

C) Acquired immune deficiency viruses

D) Influenza viruses

Page and Header: 290, Adaptation

5. A nurse is caring for a client who has been under severe stress while caring for a parent who is in the advanced stages of Alzheimer disease. The nurse explains that the client’s ability to adapt to the stress is influenced by what primarily?

A) The ability to survive in the midst of severe stress

B) Acceptance of others’ help in caring for the mother

C) Success at being able to solve problems

D) The capability in setting reasonable personal goals

Page and Header: 292, Psychosocial Assessment

6. The nurse is preparing to care for a client under severe stress, caused by caregiver duties for an older adult relative. When assessing the client’s psychological domain, which question would the nurse ask first?

A) “Let’s talk about what you have been feeling.”

B) “Tell me about your depressed moods.”

C) “How long have you been caring for your relative?”

D) “Are you feeling overwhelmed by caring for your relative?”

Page and Header: 292, Psychosocial Assessment

7. A client initially described the failing of two consecutive tests as “the worst thing that has ever happened to me,” adding, ‘There is absolutely nothing I can do to pass this course now.” The nurse and client collaborate and decide to use interventions to facilitate emotion-focused coping. Which additional comment from the client would the nurse identify as providing support for this decision?

A) “You’ve got to figure out something for me to do to get me out of this situation!”

B) “This is a waste of time because absolutely nothing you or I can do will make it any better.”

C) “I overreacted; surely together we can figure out something for me to do.”

D) “This is the worst thing that could ever happen to me. I’m nothing but a failure.”

Page and Header: 286, Personality Types

8. After reviewing assessment findings, which client would the nurse identify as having a type D personality?

A) A man who threatens the receptionist in the emergency department with bodily harm if a doctor does not see him right away

B) A woman who sits quietly reading in a waiting room before seeing her doctor for her annual physical

C) A quiet teen who drinks a six pack of beer against his better judgment because of peer pressure

D) A man who reacts negatively to almost everything but never discusses his feelings with anyone

Page and Header: 286, Social Networks

9. A client talking to a nurse about a friendship with another person comments, “That person is always there for me, and I am always there for that person. We help each other out; sometimes my friend is helping me, and sometimes I am helping my friend.” The nurse interprets the client’s statements about the social network as best reflecting which concept?

A) Denseness

B) Reciprocity

C) Social support

D) Constraints

Page and Header: 287, Social Support

10. After interviewing a client about social supports, a nurse determines that the client is experiencing emotional support based on which statement?

A) “I’m glad I have someone that I can talk to.”

B) “The person who cut my lawn was great!”

C) “I received a small community grant for groceries.”

D) “The senior center gave me a booklet about my medications.”

Page and Header: 287, Life Events; 288, Table 19.3, Recent Life Changes Questionnaire

11. A nurse is assessing a client and uses the Recent Life Changes Questionnaire as part of an assessment. The nurse determines that the client has experienced a major life crisis when which score is attained?

A) 150

B) 250

C) 350

D) 450

Page and Header: 282, Acute Stress

12. A group of students is reviewing the events associated with the fight-or-flight response. They demonstrate understanding of the information when they identify what outcome as a result of sympathetic nervous stimulation?

A) Hypoglycemia

B) Tachycardia

C) Hypotension

D) Hypercoagulability

Page and Header: 288, Emotional Responses

13. During an interview, the client states, “I feel so guilty, and I’m so ashamed of what I did.” The nurse interprets this statement using what term?

A) Negative emotion

B) Positive emotion

C) Borderline emotion

D) Nonemotion.

Page and Header: 288, Emotional Responses; 289, Table 19.4, Core Relational Themes for Each Emotion

14. A group of nursing students is reviewing information about emotional responses to stress and the themes associated with them. The students demonstrate understanding of the information when they identify which emotion as associated with being moved by another’s suffering and wanting to help?

A) Relief

B) Hope

C) Compassion

D) Love

Page and Header: 290, Healthy Coping

15. A nurse has completed an assessment of a client who is experiencing significant stress. The assessment revealed intense anger and acting-out behaviors, along with statements of negative emotions. Which nursing diagnosis would be most appropriate?

A) Disturbed thought processes

B) Low self-esteem

C) Hopelessness

D) Ineffective coping

Page and Header: 284, Appraisal

16. After educating a group of nurses on appraisal and the stress response, the psychiatric–mental health clinical nurse specialist determines that additional education is needed when the group identifies which aspect as part of the primary appraisal?

A) Relevance of the goal

B) Consistency of the goal with values

C) Personal commitment

D) Outcome explanation

Rationale: In a secondary appraisal, the person explains the outcome of events. During the primary appraisal of a goal, the person determines whether (1) the goal is relevant, (2) the goal is consistent with his or her values and beliefs, and (3) a personal commitment is present.

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Understand

Integrated Process: Teaching/Learning

Objective: 1

Page and Header: 283, General Adaptation Syndrome

17. While leading a student class presentation about general adaptation syndrome, which organ plays a rule in this response to stress?

A) Heart

B) Lungs

C) Pituitary

D) Pancreas

Page and Header: 283, Allostatic Load

18. When describing the concept of allostatic load to a group of students, what would the instructor identify as abnormal, indicative of the overall changes of the biologic regulatory system?

A) Nuclear imaging studies

B) Laboratory test results

C) Bone radiographs

D) Cardiac studies

Page and Header: 292, Psychosocial Assessment

19. A nurse is conducting an assessment of a client’s social network. Which question would be most appropriate for the nurse to ask? Select all that apply.

A) “How big is your network of contacts?”

B) “Who gives you the best advice?”

C) “Who is responsible for providing support?”

D) “Do any of the members know one another?”

E) “What services do you think might be helpful?”

Page and Header: 289, Coping

20. A nurse is providing an in-service presentation on coping and adaptation. What information would the nurse most likely include? Select all that apply.

A) Most coping strategies are similar in their approach.

B) Coping, when effective, leads to adaptation.

C) Reappraisal occurs simultaneously with coping.

D) The same coping strategy is used in each situation.

E) Coping is a deliberate and planned effort to manage stress.