Patho Chapter 7

A client is experiencing an increase in cortisol secretion. It would be most important for the nurse to assess the client for:

increased blood glucose

A client's primary care provider has recommended biofeedback in an effort to address chronic stress and reduce the potential for complications. What will be the goal of this intervention?

Teaching the client to consciously control their own physiologic (body) functioning

The psychologist is counseling a client who is overwhelmed by losing his job and the recent death of a parent. Which strategy would be effective for stress reduction?

Teaching the client to systematically contract and relax major muscle groups

A number of responses occur in the body to the release of neurohormones when the body encounters stress, including:

inhibition of reproductive function

Selye suggested that stress could have positive influences on the body, and these periods of positive stress are called:


The client experienced a traumatic event in the past that has caused chronic nightmares in which the event is relived. The client may have increased levels of which of the following?


Which client will have the most efficient adaptation?

A client who has been noticing small amounts of blood in his stool over the past week

Which emergency department client is most likely demonstrating clinical manifestations of acute stress? A client with:

an acute heightened sense of alertness to surroundings and personnel

Which of these is an endocrine regulator of pituitary and adrenal activity and a neurotransmitter involved in autonomic nervous system activity, metabolism, and behavior?

Corticotropin-releasing factor

Two people experience the same stressor, yet only one is able to cope and adapt adequately. Which term do physiologists use to describe this effect, which is correlated to positive health outcomes?


How does the nurse best define hardiness to a client?

Hardiness describes a personality characteristic that assists in the stress response.

Most physiologic control systems function under positive feedback mechanisms. T/F


For the most part, the stress response is meant to be acute and ongoing. T/F


A client who is a performer expends a tremendous amount of energy while on stage, but his body is not harmed by the added stress. Protection against the harmful effects of stress is primarily a result of:

physiologic reserve

A health care provider suspects a client has developed posttraumatic stress disorder (PTSD). Select the necessary criterion to validate the diagnosis.

At least 1 month of clinically significant distress affecting a person after witnessing or experiencing a traumatic event that affects other parts of his or her life

A client diagnosed with posttraumatic stress disorder (PTSD) tells the nurse about having "flashbacks" during waking hours or nightmares in which the past traumatic event is relived, often in vivid and frightening detail. What term for this experience wil


When thyroxine (T4) in the thyroid is low, it triggers the pituitary to increase thyroid stimulating hormone (TSH), which then increases T4 secretion. This is an example of which of the following?

Negative feedback mechanism

A daughter of an older adult client tells the nurse that her mother is not able to handle stress like she used to. The best response by the nurse would be:

This is an expected response.

Which client is experiencing the effects of a positive feedback mechanism?

A pregnant client whose oxytocin levels are rising during the second stage of labor.

Select the factor that may influence a client's relative risk for development of a stress-related pathologic process.


Allostasis incorporates which characteristics when applied to the human body?

Interactive physiologic changes in numerous systems

A nurse is caring for an adolescent with posttraumatic stress syndrome. The client reports having difficulty concentrating and has an increased startle reflex. The nurse's documentation includes the presence of:


What will the nurse assess as the end result of activation of the renin-angiotensin-aldosterone system?

Increased blood pressure

A client presents to the emergency department following a major traffic accident. Though outwardly there are no apparent physical injuries found, the client is experiencing chest pain and heightened alertness, which the health care worker attributes to th


Our body's response to psychological perceived threats is not regulated to the same degree as our body's response to physiologic perceived threats. The psychological responses may be:

inappropriate and sustained

A client is experiencing stress as a nurse prepares to insert a peripheral intravenous catheter into his forearm. The client's locus caeruleus (LC) is consequently producing which hormone?

Norepinephrine (NE)

The client has been admitted to the emergency department following a traumatic motor vehicle accident. The client is hypotensive due to blood loss. Which stress response hormone will aid in fluid replacement?


The client is hospitalized for 4 days with an acute myocardial infarction. After a coronary artery stent is placed, the client is discharged to home in stable condition. This would be an example of which pattern of stress?

Acute time limited

Although stress exposure initiates integrated responses by multiple systems, the functional changes are first manifested in which body system?


A nurse assisting in the assessment of cumulative effects of stress on a client should consider changes in which physiologic component?

Allostatic load

The nurse is caring for an ex-soldier who has been diagnosed with posttraumatic stress disorder (PTSD). The nurse should prioritize which action?

Assessing the client for depression and risk for suicide

The locus caeruleus (LC) is an area in the brain stem that produces which hormone?

Norepinephrine (NE)

The single parent is grieving the recent loss of his only child and has limited coping abilities. Which health problem may be induced by this acute stress? Select all that apply.

Obesity, anxiety, migraines, hypertension

The manifestations of the stress response are strongly influenced by which system?


The psychologist is leading a group session with clients who have recently undergone a variety of stressful events. Which client will have the best adaptation?

50-year-old female who sees her new life as a widow as a challenge rather than a threat

As a nurse prepares to change a client's dressing, the client states that she is afraid that it will be painful. Noting that the client's heart rate and respiratory rate have increased, the nurse adjusts the plan of care to reflect care for a client in wh


The client recently returned from a year of military battle duty and has posttraumatic stress disorder (PTSD). The client experiencing an "intrusion" state will likely exhibit which manifestation?

Repeated relived memories as nightmares

The nurse determines which factors will influence the client's ability to withstand stressors? Select all that apply.

Gender, mental health, nutritional status, sleep-wake cycle

After exposure to poison ivy, the client has hives on his trunk and extremities. In an effort to decrease his immune response the practitioner places him on which medication?


A hostage situation has occurred at a high school campus. The school superintendent and faculty are concerned about the students experiencing posttraumatic stress disorder (PTSD). The most important intervention would be:

debriefing with a crisis team about the event as soon as possible.

The client is receiving chronic glucocorticoid therapy for chronic obstructive pulmonary disease (COPD). Which lab result would the provider expect to see?

Increased blood glucose

Psychosocial factors can impact the body's response to stress either positively or negatively. It has been shown that social networks play a part in the psychosocial and physical integrity of a person. How do social networks affect how a body deals with s

By mobilizing the resources of the person

What feedback system provides stability to the stress response?

Negative feedback mechanism

A child has been experiencing hypoglycemic episodes. The child's mother asks: "How does the body know when to secrete insulin and when to stop secreting it?" The best response by the nurse, explaining the physiologic background, would be:

The body knows that if the blood glucose level falls, it will inhibit insulin secretion and release glycogen to release glucose from the liver.

A client who lives with many psychosocial and physiologic stressors is experiencing the exhaustion stage of stress. The client is likely to develop what consequence of this stage?

Physiologic damage

Negative feedback mechanisms are more common than positive feedback mechanisms. T/F


Under normal circumstances, the neural responses and the hormones that are released during the stress response are not around long enough to cause damage to vital tissues. T/F


A positive feedback mechanism contributes to the restoration of homeostasis.


The means used to achieve a new balance between a stressor and the ability to deal with it is known as a/an __________ mechanism.


__________ is the purposeful maintenance of a stable internal environment.


Stress is normally associated with increased levels of cortisol. T/F


The ability of body systems to increase their function, given the need to adapt, is known as the __________ reserve.


The ability to adapt to stress can be linked to sex. T/F


The first stage of Selye's general adaptation syndrome is __________.


__________ therapy involves soft tissue manipulation to promote muscle relaxation.