A nurse is teaching a class about stress. The nurse should include that which of the following is a manifestation of prolonged stress?

Choice A reason: Anemia results from factors like iron deficiency or chronic disease, not directly from prolonged stress. Stress may elevate cortisol, affecting hematopoiesis indirectly, but anemia is not a primary manifestation. Chronic stress primarily impacts neuroendocrine and immune systems, not red blood cell production or hemoglobin levels. Choice B reason: Prolonged stress typically increases blood pressure via sympathetic activation, releasing catecholamines (e.g., epinephrine), which cause vasoconstriction and elevated heart rate. Decreased blood pressure is not a common stress response, as the hypothalamic-pituitary-adrenal axis drives hypertension, not hypotension, in chronic stress scenarios. Choice C reason: Prolonged stress elevates cortisol and catecholamines, suppressing immune function by inhibiting T-cell proliferation and cytokine production. This reduces the body’s ability to fight infections, increasing susceptibility to illness. Chronic activation of the hypothalamic-pituitary-adrenal axis downregulates immune responses, a well-documented effect of sustained stress. Choice D reason: Hypoglycemia is not a typical manifestation of prolonged stress. Stress hormones (cortisol, glucagon) increase blood glucose by promoting glycogenolysis and gluconeogenesis to provide energy. While acute stress may cause transient glucose fluctuations, chronic stress typically leads to hyperglycemia, not low blood sugar, in most individuals.