A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient. What is the nurse’s best response to these feelings?
By suppressing their angry feelings
By discussing their feelings of anger with their nurse manager
By expressing their anger openly and directly with the patient
By telling the nurse manager to assign the patient to another nurse
The Correct Answer is B
Choice A reason: Suppressing anger ignores countertransference, which can impair therapeutic neutrality. Anger may stem from patient behaviors linked to dopamine-driven paranoia, but suppression risks unconscious bias affecting care. Addressing feelings through supervision maintains professionalism, making this response less effective for managing emotions.
Choice B reason: Discussing anger with a manager addresses countertransference, a reaction to patient behaviors like suspicion from dopamine dysregulation. This allows reflection, reducing bias and maintaining therapeutic neutrality. It supports professional care by processing emotions, aligning with evidence-based psychiatric nursing practices for managing countertransference.
Choice C reason: Expressing anger directly risks damaging the therapeutic alliance. Suspicion, tied to mesolimbic dopamine excess, may escalate with confrontation, increasing patient anxiety. This approach disregards professional boundaries and neurobiological sensitivities, making it inappropriate for maintaining effective psychiatric care.
Choice D reason: Reassigning the patient avoids addressing countertransference, neglecting professional growth. Suspicion, linked to neurobiological paranoia, requires consistent care. Reassignment disrupts continuity, potentially worsening patient trust and outcomes, making this an ineffective response compared to processing feelings through supervision.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Medication education addresses self-actualization or esteem needs in Maslow’s hierarchy, which are lower priority. Psychotic symptoms like hallucinations, driven by dopamine dysregulation, pose immediate safety risks, taking precedence over education, which assumes cognitive stability not yet achieved in acute psychosis, per Maslow’s prioritization.
Choice B reason: Alienation relates to belongingness needs, third in Maslow’s hierarchy. While important, psychotic hallucinations, linked to hyperactive mesolimbic dopamine pathways, indicate a safety threat, a basic physiological need. Addressing safety precedes social needs, as unresolved psychosis can exacerbate isolation, making this a lower priority.
Choice C reason: Reluctance for social activities reflects belongingness needs, lower in Maslow’s hierarchy. Hallucinations, driven by neurochemical imbalances like excess dopamine, pose immediate safety risks, a physiological need. Social participation requires cognitive stability, which is compromised in psychosis, making this issue secondary to urgent safety concerns.
Choice D reason: Hearing voices urging self-protection indicates a safety threat, a basic physiological need in Maslow’s hierarchy. Hallucinations, linked to dopamine overactivity in the mesolimbic pathway, can lead to harmful behaviors. Addressing this stabilizes the patient, taking priority over higher-level needs like social connection or education, per Maslow’s framework.
Correct Answer is D
Explanation
Choice A reason: Buspirone enhances serotonin activity, taking weeks to reduce anxiety. Panic attacks, driven by acute norepinephrine surges in the amygdala, require rapid intervention. Buspirone’s delayed onset makes it ineffective for acute symptom relief, unlike fast-acting options targeting immediate neurochemical imbalances.
Choice B reason: Venlafaxine, an SNRI, increases serotonin and norepinephrine over weeks, unsuitable for acute panic attacks. Panic involves rapid sympathetic activation, requiring immediate GABA enhancement or similar fast-acting mechanisms, not gradual reuptake inhibition, making venlafaxine incorrect for rapid relief.
Choice C reason: Imipramine, a tricyclic, modulates serotonin and norepinephrine but takes weeks to act. Acute panic, driven by locus coeruleus norepinephrine spikes, needs immediate relief. Imipramine’s slow onset and side effects make it inappropriate for rapid intervention in acute anxiety episodes.
Choice D reason: Alprazolam, a benzodiazepine, enhances GABA-A receptor activity, rapidly inhibiting excessive neural firing in the amygdala during panic attacks. This provides quick relief from acute anxiety symptoms, like tachycardia, within minutes, making it the correct choice for immediate neurobiological stabilization in panic episodes.
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