Multiple Choice
1. A client has experienced the death of a close family member and at the same time becomes unemployed.
This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should
the nurse evaluate this client data?
A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of
stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of 
coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.
ANS: C
The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the 
Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 
or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social support
can limit susceptibility to stress-related illnesses.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Psychosocial Integrity
2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a 
nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the
nurse characterize the clients appraisal of the job loss stressor?
A. Irrelevant
B. Harm/loss
C. Threatening
D. Challenging
ANS: D
The client perceives the situation of job loss as a challenge and an opportunity for growth.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Psychosocial Integrity
3. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
A. Ive found that avoiding contact with others helps me cope.
B. I really enjoy journaling; its my private time.
C. I signed up for a yoga class this week.
D. I made an appointment to meet with a therapist.