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Toxic stress in children

Impact over a lifetime

Nursing made Incredibly Easy: March/April 2019 - Volume 17 - Issue 2 - p 1
doi: 10.1097/01.NME.0000553650.01337.43
CE Connection

GENERAL PURPOSE: To provide information on childhood stress and its sequelae and prevention. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Explain how a child's brain is more susceptible to greater harm from toxic stress than an adult's brain. 2. Discern between the various types of stress that occur throughout life and how these exposures can lead to unfavorable health outcomes. 3. Explain the importance of resilience and actions that can be taken to help reduce the harmful effects of toxic stress.

  1. During a child's first year of life, the brain will
    1. weigh 25% of an adult size brain.
    2. double in weight.
    3. triple in weight.
  2. Brain architecture affects all of the following except
    1. learning.
    2. behavior.
    3. emotions.
  3. Initial steps of brain development are guided by
    1. genes.
    2. environmental factors.
    3. the neuroendocrine system.
  4. Plasticity of the brain is most prominent during
    1. early life.
    2. adolescence.
    3. early adulthood.
  5. Toxic stress leads to the HPA axis
    1. staying activated.
    2. being deactivated.
    3. reducing cortisol levels.
  6. Changes in the brain from toxic stress exposure can cause
    1. decreased pituitary responsiveness.
    2. increased brain weight.
    3. decreased dendritic spines.
  7. What physiologic change occurs during a positive stress response?
    1. decreased heart rate
    2. prolonged stress response activation
    3. brief, mild elevation of stress hormones
  8. An example of tolerable stress is
    1. a natural disaster.
    2. receiving immunizations.
    3. caregiver substance abuse.
  9. Toxic stress response
    1. often occurs when a child starts school.
    2. can disrupt brain architecture development.
    3. is necessary for healthy brain development.
  10. Outcomes of adults exposed to toxic stress as children include all of the following except
    1. cancer.
    2. premature death.
    3. reduced inflammatory markers.
  11. Toxic stress in children can lead to lifelong
    1. HPA axis dysfunction.
    2. immune hyperactivity.
    3. brain plasticity.
  12. Individuals exposed to trauma as children are more likely to
    1. have financial difficulties.
    2. avoid risky behaviors.
    3. make long-lasting relationships.
  13. The process of adapting effectively to stressful situations is termed
    1. cognition.
    2. plasticity.
    3. resilience.
  14. Effective coping strategies for children and adults involve all of the following except
    1. cognitive flexibility.
    2. redefining traumatic events.
    3. viewing problems as other people's fault.
  15. Which is one of the seven Cs of resilience?
    1. caring
    2. community
    3. contribution
  16. To help children develop confidence,
    1. focus on their strengths.
    2. offer praise even when it isn't deserved.
    3. encourage taking on excess responsibility.
  17. To help children develop character,
    1. build a sense of security in the home.
    2. recognize when they've done a good job.
    3. show them how their behaviors affect others.
  18. For gaining resilience, one of the most important factors is for children to
    1. understand the value of helping others.
    2. have someone who loves them unconditionally.
    3. know the importance of avoiding hateful statements.
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