The nurse is caring for a patient who is a well-known surgeon at the hospital. The nurse notices the patient becoming more agitated and withdrawn with each group of surgeon visitors. The nurse and patient agree to place a “Do not disturb” sign on the door. A few hours later, the nurse notices a surgeon who is not involved in the patient’s care attempting to enter the room. Which response by the nurse is most appropriate?

Choice A reason: Low blood pressure is not typically associated with prolonged stress. Chronic stress elevates cortisol, which can increase blood pressure via sympathetic activation. Hypotension may occur in acute stress response (e.g., shock), but prolonged stress more commonly causes hypertension, making this an incorrect condition to monitor.

Choice B reason: Prolonged stress suppresses immune function by elevating cortisol, reducing lymphocyte activity and increasing infection risk. Conditions like respiratory or urinary tract infections become more likely. Monitoring for infections is essential, as stress weakens the body’s ability to fight pathogens, making this a correct condition to assess.

Choice C reason: Alopecia, or hair loss, can result from prolonged stress due to elevated cortisol disrupting hair follicle cycles, leading to telogen effluvium. Stress-induced autoimmune conditions like alopecia areata may also occur. Monitoring for hair loss is appropriate, as it reflects stress’s physiological impact, making this a correct choice.

Choice D reason: Prolonged stress increases diabetes risk by raising cortisol and catecholamines, which elevate blood glucose and impair insulin sensitivity. This can exacerbate or precipitate type 2 diabetes. Monitoring glucose levels is critical, as stress contributes to metabolic dysregulation, making this a correct condition to assess.

Choice E reason: Chronic stress is linked to cancer through immune suppression and inflammation, which may promote tumor growth. Elevated cortisol and stress hormones can impair DNA repair mechanisms. Monitoring for cancer risk, especially in high-stress patients, is warranted, as stress is a known risk factor, making this a correct choice.

Choice A reason: Non-Hispanic Blacks are projected to grow, but their growth rate is slower than Hispanics due to lower birth rates and immigration patterns. By 2060, they will remain a significant group, but demographic data indicate they will not outpace Hispanics, making this incorrect for the fastest-growing ethnic group.

Choice B reason: Multiracial individuals are increasing due to intermarriage, but their growth rate is lower than Hispanics. Projections show they will form a smaller population share by 2060 compared to Hispanics, driven by high birth rates and immigration. This choice is incorrect, as it underestimates Hispanic growth trends.

Choice C reason: Asians are a fast-growing group due to immigration, but their growth rate is surpassed by Hispanics, who benefit from both immigration and higher fertility rates. By 2060, Asians will increase significantly, but demographic forecasts confirm Hispanics as the fastest-growing group, making this choice incorrect.

Choice D reason: Hispanics are projected to be the fastest-growing racial/ethnic group by 2060, driven by high birth rates, immigration, and a younger population. Census projections estimate they will account for nearly 30% of the US population, surpassing other groups in growth rate due to demographic trends, making this the correct choice.