A nurse is preparing to administer methylprednisolone 10 mg IV bolus. The amount available from the pharmacy is 40 mg/mL. How many mL should the nurse administer? (Round to the nearest tenth.)

Choice A reason: Attachment-Based Therapy focuses on interpersonal relationships, not trauma-specific processing, and is less effective for PTSD’s amygdala-driven fear memories. Mirtazapine enhances serotonin and norepinephrine but lacks strong evidence for PTSD, as it primarily addresses depression by modulating alpha-2 adrenergic receptors, not trauma-specific neural hyperactivity.

Choice B reason: Dialectical Behavior Therapy targets emotional regulation for personality disorders, not PTSD’s trauma-specific memories. Lorazepam, a benzodiazepine, enhances GABA activity but is not recommended for PTSD, as it may suppress rather than process trauma-related amygdala hyperactivity, risking dependency and impairing long-term recovery.

Choice C reason: Cognitive Processing Therapy restructures trauma-related cognitive distortions, reducing amygdala hyperactivity and enhancing prefrontal control in PTSD. Sertraline, an SSRI, increases serotonin levels, stabilizing mood and reducing hyperarousal by modulating amygdala-prefrontal circuits, making it a first-line treatment for PTSD’s neurochemical and cognitive symptoms.

Choice D reason: Applied Behavior Analysis is used for autism, not PTSD, and does not address trauma-related neural changes. Atomoxetine, a norepinephrine reuptake inhibitor, targets ADHD by enhancing prefrontal norepinephrine but lacks efficacy for PTSD’s amygdala-driven fear responses, making it unsuitable for trauma treatment.

Choice A reason: Delusions of persecution in schizophrenia involve hyperactive dopamine pathways in the mesolimbic system, leading to irrational fears like poisoning. Tasting food directly addresses the delusion by demonstrating safety, potentially reducing anxiety and engaging the patient’s trust, which can modulate amygdala hyperactivity and promote acceptance of nutrition without invasive measures.

Choice B reason: Tube feedings or parenteral nutrition are invasive and may reinforce the patient’s delusional fears of harm, as they bypass voluntary control. Schizophrenia’s dopamine dysregulation heightens suspicion, and forced interventions could exacerbate paranoia by stimulating the amygdala, increasing stress responses and potentially worsening the patient’s mental state and compliance.

Choice C reason: Allowing restaurant delivery does not directly address the poisoning delusion, as external food sources may still be perceived as unsafe due to hyperactive dopamine-driven paranoia in schizophrenia. This option fails to engage the patient’s trust or reduce amygdala-driven fear responses, making it unlikely to resolve the refusal to eat.

Choice D reason: Supervised vending machine access may not alleviate the patient’s delusional belief in poisoning, as the source remains external and unverified. Schizophrenia’s dopamine excess in the mesolimbic pathway sustains mistrust, and this intervention does not directly counter the delusion, potentially leaving amygdala-driven fear responses unaddressed, reducing its effectiveness.