The daughter of a severely depressed client asks the nurse "What do you think about the relationship
between depression and physical illness? Since my mother has been grieving over my father's death,
she has been physically unwell.
She has had a series of colds, an outbreak of shingles, and an
episode of the flu.". The answer that best reflects the current thinking about psychoimmunology is
a. "It is probably a coincidence. Not much evidence is available that the stress of
grieving makes one prone to physical illnesses.".
b. "Your observation might be explained by the fact you are paying more attention
to your mother since your father died and you are noticing things such as minor
illnesses.".
c. "The literature has not dwelt on the relation between mental state and the body
other than to say that one influences the other.".
d. "The immune system is thought to respond to changes in brain chemistry by
suppressing white blood cell production when the person experiences prolonged
stress.".
ANS: D
Option D best explains evidence-based thinking. Research indicates that stress can induce
modulation of the immune system. Activation of the immune system sends proinflammatory
cytokines to the brain. The brain, in turn, releases it own cytokines that signal the central nervous
system to initiate myriad responses to stress. Alteration in neural activity in the brain can alter
everything that flows from neural activity, including behavior, thought, and mood. Prolonged stress
suppresses the immune system and lowers resistance to infections. The other options underplay the
fact that evidence exists that partially explains the effect of stress on the immune system.
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The nurse is caring for a patient with acne vulgaris who has presented to a dermatology clinic. Which of the following applies to the management of acne vulgaris?
A) Wash the face every 3 hours with a cleansing soap. B) Apply benzoyl peroxide to lesions. C) Scarring increases as the grade of acne decreases. D) Diet plays a major role in therapy.
A newborn infant has loose, yellow stools. Although the infant is healthy, his mother is concerned that this means he is allergic to breast milk. You would explain to her that
A) she might try burping the infant more frequently. B) the stools of breastfed infants are normally loose. C) she might consider changing to a soybean formula. D) her child may need to be investigated for bile duct disease.
A patient is prescribed colesevalam (WelChol) 1875 mg twice a day. Available tablets are 625 mg each. How many tablets does the nurse administer to the patient?
a. 2 b. 3 c. 4 d. 5
The nurse would anticipate elevated levels of circulating T3 and T4 in the client with:
1. leukopenia. 2. thrombocytopenia. 3. hypoalbuminemia. 4. hemolytic anemia.