1.1 A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of
... [Show More] 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
ANSWER: C
RATIONALE: the Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment 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. (However, positive coping mechanisms and strong social support can limit susceptibility to stress-related illnesses.)
1.2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: "Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art degree." How should the nurse characterize the client's appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANSWER: D
RATIONALE: the client perceives the situation of job loss as a challenge and an opportunity for growth.
1.3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.
ANSWER: A
RATIONALE: Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems.
1.4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Fight-or-flight stage
ANSWER: C
RATIONALE: 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.
1.5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The clients mother states, That's not something to be stressed about! Which is the most appropriate nursing response?
A. Teenagers! They don't know a thing about real stress.
B. Stress occurs only when there is a loss.
C. When you are in poor physical condition, you cant experience psychological well-being.
D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
ANSWER: D
RATIONALE: Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change.
1.6. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
A. Meditation
B. Problem-solving training
C. Relaxation
D. Journaling
ANSWER: B
RATIONALE: The student must assess his or her situation and determine the best course of action. Problem-solving training, by providing structure and objectivity, can assist in decision making.
1.7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
A. Encourage the student to use the alternative coping mechanism of relaxation exercises.
B. Complete the problem-solving process for the client.
C. Work through the problem-solving process with the client.
D. Encourage the client to keep a journal.
ANSWER: C
RATIONALE: During times of high anxiety and stress, clients will need more assistance in problem-solving and decision making. [Show Less]