Expected Outcome: In 1 month, by 10/10/12, patient
will report that she feels better about herself, based
on new socialization experiences with peers and
improved body image.
Nursing Interventions:
a.Help patient develop workable self-care strategies
to lose weight and enhance physical appearance.
b.Explore patient’s interest in activities that will
serve two goals: (1) enable patient to develop
friendships and (2) improve her body image
(e.g., sports, dancing, hiking clubs).
c. Counsel patient about peer relationships, sexual-
ity, and dating.
Evaluative Statement: 10/10/12: Goal partially met—
patient states that she feels “great” about losing
weight (150 pounds, down to 145 pounds) and likes
her “new look” but still feels shy with peers and is
not dating. Revision: Celebrate new self-care behav-
iors and reevaluate efforts to enhance peer relation-
ships.—M. Stenulis, RN
3.Patient strengths: Physically attractive; past history
of achieving personal goals; strongly self-motivated;
has trusting relationships with adults (parents and
teachers).
Personal strengths: Ability to establish trusting
nurse–patient relationships with high school
students; knowledge of teen social “norms”;
successful history of motivating teens to develop
and take pride in health self-care behaviors
4.10/10/12: Met with patient 1 month after initial
meeting. In that time, she lost 5 pounds, which she
attributes to decreased snacking and increased
activity (joined field hockey team). She walked
into the office with erect posture and exhibited
more interest/vitality than at last meeting. She
reports still feeling very shy with her peers and is
uncomfortable with boys. She is very interested,
however, in participating in group activities in
which she can overcome her shyness and hopes to
make new friends.—M. Stenulis, RNCHAPTER 42
PRACTICING FOR NCLEX
MULTIPLE CHOICE QUESTIONS
1.a 2.c 3.b 4.b 5.a
6.d 7.c 8.c 9.a 10.a
11.d 12.a 13.b
ALTERNATE-FORMAT QUESTIONS
Multiple Response Questions
1.b, d, f
2.a, d, e
3.c, e, f
4.c, d, f
5.a, e, fPrioritization Question
1.Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:412 ANSWER KEY
idcegbaf hDEVELOPING YOUR KNOWLEDGE BASE
FILL-IN-THE-BLANKS
1.Stressor
2.Local adaptation
3.Inflammatory
4.Fight-or-flight
5.Psychosomatic
6.Anxiety
7.Coping mechanisms
8.Caregiver burden
MATCHING EXERCISES
1.c 2.i 3.l 4.f 5.b
6.e 7.a 8.d 9.g 10.h
11.j 12.c 13.i 14.b 15.h
16.a 17.e 18.f 19.g
SHORT ANSWER- a.Mind–body interaction: Humans react to threats
of danger as if they were real. The person
perceives the threat on an emotional level, and
the body prepares itself either to resist it or turn
away and avoid the danger. For example: An
executive has an important presentation to
make in the morning and is restless the night
before, cannot eat breakfast, and feels apprehen-
sive and has a rapid heartbeat before the presen-
tation.
b.Local adaptation syndrome: A localized
response of the body to stress. It does not
involve the entire body, only a body part. LAS is
an adaptive response, primarily homeostatic
and short term. For example: Reflex pain
response and inflammatory response.
c. General adaptation syndrome: A biochemical
model of stress developed by Hans Selye that
describes the body’s general response to stress
and serves as part of the knowledge base essen-
tial to all areas of nursing care. For example:
Alarm reaction—various defense mechanisms
are activated; resistance—body attempts to
adapt to the stressor; exhaustion—the body
either rests and mobilizes its defenses to return
to normal or reaches total exhaustion and dies. - a.Bleeding is controlled initially by vasoconstric-
tion of blood vessels at the injury site.
Histamines are released and capillary
permeability increases, allowing increased
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