Chapter 1. The Concept of Stress Adaptation
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. This situation has resulted in a 6-month score of 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.
ANS: C
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.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client
Need: Psychosocial Integrity
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

ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
3. Which client statement should alert a nurse that a client may be responding maladaptively to
stress?
A. “I’ve found that avoiding contact with others helps me cope.”
B. “I really enjoy journaling; it’s my private time.”
C. “I signed up for a yoga class this week.”
D. “I made an appointment to meet with a therapist.”
ANS: A
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.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client
Need: Psychosocial Integrity
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
ANS: C
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.

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Test Bank For Psychiatric Mental Health Nursing: Concepts Of Care In Evidence-Based Practice, 8th Edition

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