Factors Affecting Stress and Adaptation

Every question here, with the answer

1. A nurse is assessing a preschool child who becomes highly anxious with minor changes in routine. Which history findings would increase concern for maladaptive stress and coping responses? Select all that apply.

   1. Parental mental illness
   2. History of neglect or maltreatment
   3. Exposure to abuse
   4. Ongoing financial woes in the household
   5. A supportive environment with well-adjusted family members

   Answer: Parental mental illness, History of neglect or maltreatment, Exposure to abuse, Ongoing financial woes in the household

   Neglect, maltreatment or abuse, financial woes, and parental mental illness are identified as stressful exposures that place neonates and young children at risk for abnormal cortisol levels and future psychopathology. A supportive environment is protective and tends to foster functional coping skills.

2. A patient tells the clinic nurse, “I lost my job and insurance, so I stopped refilling my blood pressure medication.” Which nursing action best addresses the stressor affecting this patient’s adaptation?

   1. Advise the patient to wait until employment resumes before restarting care
   2. Assess socioeconomic needs and connect the patient with affordable medication and community resources
   3. Tell the patient that medication adherence is a personal responsibility and end the visit
   4. Focus only on documenting the blood pressure reading because financial issues are outside nursing care

   Answer: Assess socioeconomic needs and connect the patient with affordable medication and community resources

   The section emphasizes assessing social determinants of health and socioeconomic influences to identify stressors and support coping within the patient’s means. Connecting the patient with medication and resource options directly addresses the financial barrier contributing to stress and health risk.

3. The parent of a child starting school asks how to help the child handle new social challenges. Which response by the nurse is most appropriate?

   1. “A supportive environment can help your child develop positive coping adaptations.”
   2. “Avoid new social activities until your child no longer feels stressed.”
   3. “Children usually develop maladaptive coping even when their environment is supportive.”
   4. “School stress is always harmful and should be eliminated.”

   Answer: “A supportive environment can help your child develop positive coping adaptations.”

   Starting school broadens the child’s social circle and may create both challenges and stress. The section states that a supportive environment helps children establish positive coping adaptations, whereas negative or abusive surroundings increase the risk for maladaptive coping.

4. A patient reports anxiety related to repeated stressful events and wants strategies to improve coping. Which nurse-recommended activities are consistent with enhancing self-awareness? Select all that apply.

   1. Reflection or journaling to reduce anxiety and enhance focus
   2. Setting healthy boundaries to foster positive relationships and commitments
   3. Relaxation, meditation, deep breathing, mindfulness, physical activity, and setting goals
   4. Psychotherapy to identify defense mechanisms and improve adaptive strategies
   5. Ignoring anxious emotions until they pass

   Answer: Reflection or journaling to reduce anxiety and enhance focus, Setting healthy boundaries to foster positive relationships and commitments, Relaxation, meditation, deep breathing, mindfulness, physical activity, and setting goals, Psychotherapy to identify defense mechanisms and improve adaptive strategies

   The section lists psychotherapy, reflection/journaling, healthy boundaries, and relaxation-related practices as methods for enhancing self-awareness. Ignoring anxious emotions is not listed and does not reflect the emphasis on recognizing, managing, and adapting to stressors.

5. A patient with a chronic health diagnosis says, “My illness makes me stressed, and when I’m stressed my symptoms feel harder to manage.” Which nurse response best reflects the relationship described in the section?

   1. “Stress and health are unrelated, so we should discuss them separately.”
   2. “This can become a cycle because health problems can be stressors, and persistent stress can contribute to diseases and disorders.”
   3. “Stress only causes emotional symptoms, not physiological changes.”
   4. “Once a diagnosis is present, coping strategies no longer affect the situation.”

   Answer: “This can become a cycle because health problems can be stressors, and persistent stress can contribute to diseases and disorders.”

   The section describes the relationship between stress and health as intertwined or cyclical. Persistent stress can accumulate into diseases and disorders, while diagnoses themselves can become stressors that reduce the ability to manage stressful circumstances.

6. A nurse is planning stress-focused teaching for a group of older adults. Which topics reflect stressors commonly associated with older adulthood in the section? Select all that apply.

   1. Major growth spurts with accompanying hormonal changes
   2. Changes related to health and wellness
   3. Ultimately death
   4. Losing abilities
   5. Losing physical strength

   Answer: Changes related to health and wellness, Ultimately death, Losing abilities, Losing physical strength

   The section identifies health and wellness changes, loss of physical strength, loss of abilities, and death as likely stressors for older adults. Major growth spurts with hormonal changes are described as stressors of puberty and adolescence, not older adulthood.