Patho Exame Chapter 9

  1. According to Walter B. Cannon, homeostasis is a stable internal environment achieved through a system of
    • A)Interdependent system-wide adaptive responses
    • B)Variable internal and external conditioning factors
    • C)Coordinated physiologic processes that oppose change
    • D)Compatibility between cells and the internal environment
  2. A child has been experiencing hypoglycemic episodes. “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
    • A)“The body knows that if the blood glucose level falls, it will inhibit insulin secretion and release glycogen to release glucose from the liver.
    • ”B)“It's just a big guessing game; first we give sugar like orange juice, and then we withhold the carbohydrates if the blood glucose level is too high.
    • ”C)“Your pituitary gland in the brain is the 'master gland,' and it controls and regulates all the hormones.
    • ”D)“Once the child starts getting confused, the brain will send a message to the pancreas to stop producing insulin.”
  3. 3.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 the first stage of general adaptation syndrome (GAS). The health care worker concludes the client is experiencing manifestations related to the release of:
    • A)Aldosterone, which interferes with sodium absorption 
    • B)Epinephrine
    •  C)Too little cortisol 
    • D)Thyroid-stimulating hormone
  4. Although stress exposure initiates integrated responses by multiple systems, the functional results are first manifested as: Select all that apply.
    • A)Enhanced respiratory rate/depth
    • B)Cravings for high-carbohydrate foods
    • C)Increased alertness and focus
    • D)Increased glucose utilization
    • E)Increased GI peristalsisAns:
    • A, C, D
  5. A client is experiencing significant stress while awaiting the results of her recent lymph node biopsy. Among the hormonal contributors to this response is a release of aldosterone, resulting in which of the following physiologic effects?
    • A)Decreased release of insulin
    • B)Increased cardiac contractility
    • C)Potentiating effects of epinephrine
    • D)Increased sodium absorption
  6. Allostasis is characterized by
    • A)Organ-specific physiologic responses
    • B)Interactive physiologic changes in numerous systems
    • C)Systems that detect psychological function
    • D)Future expectations as a catalyst for change
  7. A client is experiencing stress as a nurse prepares to insert a peripheral intravenous catheter into his forearm. The client's locus ceruleus (LC) is consequently producing which of the following hormones?
    • A)Norepinephrine (NE)
    • B)Corticotropin-releasing factor (CRF)
    • C)Antidiuretic hormone (ADH)
    • D)Adrenocorticotropic hormone (ACTH)
  8. Which manifestation of stress reflects the nonspecific “fight-or-flight” response?
    • A)Decreased pupillary light response
    • B)Increased gastrointestinal motility
    • C)Decreased short-term memory
    • D)Increased cardiopulmonary rates
  9. Which of the following manifestations would be considered a result of stress-induced cortisol hormone secretion?
    A)Increased blood glucose level to 180 with excess hunger and thirstB)Increased hematopoiesis resulting in hemoglobin levels in the 20s with blood clots in legsC)Increased thyroid-stimulating hormone secretions resulting in signs of hyperthyroidismD)Depressed CNS function exhibited by drowsiness and change in level of consciousness
  10. A college student has just learned that her latest Pap smear revealed atypical cells, a fact that has resulted in stress and an accompanying release of angiotensin II. How would the effects of this hormone be objectively demonstrated
    A)Increased respiratory rateB)Increased blood pressureC)Decreased oxygen saturationD)Decreased blood sugar
  11. As a nurse working in the newborn nursery and intensive care unit, when an infant has been diagnosed with failure to thrive, which of the following statements about hormones' effect on the body will the nurse explain to the family?
    A)The catecholamine norepinephrine is primarily responsible for the failure to thrive.B)CRF increases somatostatin levels, which inhibits secretion of growth hormone.C)ACTH release from the pituitary causes babies to not gain weight.D)Antidiuretic hormone is involved in the stress response and can increase water retention.
  12. A nursing student's current clinical placement has been a source of stress due to high client acuity combined with interpersonal conflict with some of the unit staff. At the same time, the student has been fighting a cold for more than 2 weeks and has been unable to regain a normal feeling of health. How might these two phenomena be related?
    • A)Epinephrine and norepinephrine inhibit the release and action of lymphocytes.
    • B)Stress and illness lack a statistical correlation, though they are often thought to coexist.
    • C)The effects of stress on the cerebellum initiate a decrease in immunity.
    • D)Endocrine–immune interactions may suppress the student's immune response.
  13. A student is participating in an extended fast as part of a charitable fundraising effort. Which of the following is an example of the physiologic reserve that will facilitate the student's adaptation to the stress of this sudden change in diet?
    • A)The student has experience in demonstrating perseverance from previous participation in competitive sports.
    • B)The student's adipose tissue contains large and accessible stores of energy.
    • C)The student is young, is a male, and has no preexisting medical conditions.D)The student is utilizing guided imagery to achieve a sense of “mind over matter.”
  14. Which of the following clients will be more able to adapt to a stressor based on an individual's ability to adapt? Select all that apply.
    • A)A Muslim male experiencing abnormal GI bleeding
    • B)An infant with decreased water intake due to diarrhea
    • C)A child living in a crowded apartment with his financially poor, immediate family
    • D)A male client producing increased corticotropin-releasing factor (CRF)E)A client with known CAD, expressing problems affording all his prescribed medication
  15. A nurse working at nights is constantly complaining of being tired and sick. It seems like she catches every illness that is on the unit. One possible reason for this may relate to:
    • A)She does not contain the “hardiness” gene in her system.
    • B)Alterations in sleep–wake cycle have decreased her immune function.
    • C)She is stressing too much about being tired and sleepy.
    • D)Maybe she should get tested for sleep apnea.
  16. Two people experience the same stressor, yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:
    • A)A sense of purpose in life
    • B)Circadian rhythm disruption
    • C)Age-related renal dysfunction
    • D)Excessive weight gain
  17. Which of the following emergency department clients  is most likely demonstrating clinical manifestations of acute stress? A client with:
    • A)An acute heightened sense of alertness to surroundings and personnel
    • B)Inattention to details of the accident with memory issues
    • C)Negative feedback overactivity resulting in mental instability
    • D)Muscle impairment and fatigue
  18. A 70-year-old client admitted to a hospital for a prostatectomy is surprised to learn that his physician has prescribed insulin on a sliding scale, despite the fact that the client successfully manages his type 2 diabetes using diet and oral antihyperglycemics when at home. Which of the following facts may underlie the physician's action?
    • A)The stress of illness stimulates the hypothalamus to release corticotropin-releasing factor (CRF).
    • B)Stress-induced release of vasopressin increases serum blood glucose.
    • C)Stress and illness can increase glycogenolysis and insulin resistance.
    • D)Increased levels of epinephrine and norepinephrine cause alterations in glucose metabolism.
  19. A client asks, “Why do I keep getting these cold sores on my lips? Am I kissing people too much?” The nurse will base her response by saying:
    • A)“These sores usually develop when you are not sleeping well or are emotionally upset.
    • ”B)“Have you been forgetting to wash your hands after going to the restroom?
    • ”C)“Have you been going outside with a wet head?
    • ”D)“Maybe you should stay away from crowds for the next few weeks.”
  20. The client recently returned from a year of military battle duty and has posttraumatic stress disorder (PTSD). This disorder includes an “intrusion” state that is experienced
    A)Excessive anxiety and safety concernsB)Repeated relived memories as nightmaresC)Loss of concentration and increased vigilanceD)Emotional numbing and feelings of depression
  21. A female client experienced a random assault several months earlier, and her recent vigilance around her own safety is described as “obsessive” by her friends and family. Which of the following aspects of posttraumatic stress disorder (PTSD) characterizes the client's behavior?
    • A)Avoidance
    • B)Intrusion
    • C)Hyperarousal
    • D)Flashbacks
  22. Following a school shooting, many of the children want to talk about the traumatic event. The school nurse knows this is very therapeutic and would be called:
    • A)Nonadaptive functioning
    • B)Fatalism
    • C)Debriefing
    • D)Guided imagery
  23. A client is extremely anxious about his impending surgery. Which of the following measures should the nurse implement to create an atmosphere for effective use of relaxation techniques?
    • A)A quiet, dim environment
    • B)A soothing, warm foot soak
    • C)Gentle muscle stroking
    • D)Repetitive questioning
  24. An occupational therapist is preparing to begin a relaxation program on an oncology unit of a hospital. Which of the following variables will assist in the success of the program?
    • A)Verbal rapport between the therapist, staff, and clients
    • B)The therapist's own ability to demonstrate relaxation techniques
    • C)A quiet, calm, and therapeutic environment
    • D)Appropriate use of pharmacologic agents for clients prior to attending the program
  25. A client's primary care provider has recommended biofeedback in an effort to address her chronic stress and reduce the potential for complications. What will be the goal of this intervention?
    • A)Using exercise to control the client's endocrine function
    • B)Helping the client to accommodate continued nervous stimulation
    • C)Relieving tension by using tactile stimulation
    • D)Teaching the client to consciously control her own body functioning
  26. What is the definition of the reactive response?
    Mounting a response in reaction to a stressor
  27. A stress response is initiated in what part of the nervous system?
    Central nervous system
  28. A stress response results in the stimulation of which sympathetic nervous system receptors?
    α-Adrenergic receptors
  29. Which statement is true regarding the effects of circulating epinephrine in the body?
    Transient hyperglycemia will result
  30. Which statement is true regarding how cortisol reacts when activated by ACTH?
    Cortisol increases blood glucose
  31. Which statement is true regarding the immune system in response to stress?
    Cortisol is released.
  32. Which of the following is a function of norepinephrine?
    Constricts smooth muscle in all blood vessels
  33. Which statement regarding corticotropin-releasing hormone (CRH) and its influence on the immune system is true
    CRH is also released from peripheral inflammatory sites. Correct
  34. Which statement is true regarding stress and the immune system?
    Cardiovascular disease is one condition that is related to stress.
  35. Which of the following are stages in the development of the general adaptation syndrome? (Select all that apply.)
    • Alarm
    • Resistance 
    • Exhaustion
Card Set
Patho Exame Chapter 9
Exame 1