A nurse is assisting with teaching a class about the general adaptive syndrome. The nurse should include that which of the following manifestations occur during the exhaustion stage?

Dilation of pupils

Blood pressure increases.

Depression

Blood glucose levels return to the expected reference range.

Answer and Explanation

The Correct Answer is C

A. Dilation of pupils:

Pupillary dilation is a sympathetic response seen in the alarm (and to some extent resistance) stage when the body is mobilizing to cope. In the exhaustion stage, compensatory mechanisms fail and acute sympathetic signs are less prominent.

B. Blood pressure increases:

Elevated blood pressure is typical during the alarm/resistance stages due to sustained sympathetic activity and cortisol. In the exhaustion stage, physiologic resources are depleted and blood pressure may fall or the person becomes more vulnerable to illness and collapse.

C. Depression:

The exhaustion stage reflects long-term stress where adaptive resources are depleted; psychological manifestations such as emotional exhaustion, depression, decreased coping ability, and physical manifestations (fatigue, decreased immunity, increased susceptibility to disease) are common. Chronic stress may precipitate mood disorders or worsen existing depression.

D. Blood glucose levels return to the expected reference range:

During prolonged stress (resistance stage), cortisol and catecholamines raise blood glucose. In exhaustion, metabolic dysregulation can continue or worsen rather than neatly return to normal-the body’s regulatory systems are strained, and glucose abnormalities may persist or decompensate rather than reliably normalize.

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Correct Answer is D

Explanation

A. Irritable bowel syndrome (IBS):

IBS is a functional gastrointestinal disorder that can be exacerbated by stress but is not defined by flashbacks of a traumatic event. It presents with abdominal pain and altered bowel habits, not re-experiencing symptoms.

B. Acute stress disorder (ASD):

Acute stress disorder occurs within the first month after a traumatic event and lasts from 3 days to up to 1 month. Flashbacks occurring a year after the trauma do not meet the timing criteria for ASD.

C. Episodic acute stress:

“Episodic acute stress” is not a formal diagnosis for trauma-related re-experiencing symptoms and would not explain persistent flashbacks occurring a year later. This choice is vague and does not align with diagnostic criteria.

D. Posttraumatic stress disorder (PTSD):

PTSD is characterized by persistent re-experiencing (flashbacks, intrusive memories), avoidance, negative cognitions/mood, and hyperarousal lasting longer than 1 month following exposure to a traumatic event. Because this client reports flashbacks one year after the event, PTSD is the appropriate stress-related disorder to suspect; clinical assessment should confirm other symptom clusters and functional impairment.

A. Dilated pupils B. Decreased blood pressure C. Bronchial airway constriction D. Hypoglycemia

Correct Answer is A

Explanation

A. Dilated pupils:

During sympathetic nervous system activation, pupils dilate (mydriasis) to allow more light into the eyes, enhancing distance vision and improving the ability to detect threats. This is a classic physiological response to stress and danger.

B. Decreased blood pressure:

Blood pressure increases during fight-or-flight due to vasoconstriction, increased heart rate, and increased cardiac contractility. These changes help direct more blood to vital organs and muscles, enabling a rapid physical response.

C. Bronchial airway constriction:

The sympathetic response actually dilates the bronchioles, allowing more air to enter the lungs to support increased oxygen demand. Bronchial constriction occurs in parasympathetic states, not during fight-or-flight.

D. Hypoglycemia:

In a fight-or-flight response, the adrenal glands release epinephrine and cortisol, which stimulate glycogenolysis and gluconeogenesis. This results in increased blood glucose, not hypoglycemia, ensuring the muscles have an immediate energy source.

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A nurse is assisting with teaching a class about the general adaptive syndrome. The nurse should include that which of the following manifestations occur during the exhaustion stage?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

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