A nurse is working with a client who has frequent angry outbursts when he becomes frustrated. Which statement by the nurse is a true statement about anger?

Choice A reason: The amygdala regulates emotional responses like anger and aggression, with excessive norepinephrine and glutamate signaling driving hyperarousal. Its connections to the prefrontal cortex modulate impulsive behaviors, making it the primary structure for aggressive responses in emotional dysregulation.

Choice B reason: The parietal lobe processes sensory and spatial information, not emotions like anger. Aggression involves amygdala-prefrontal cortex interactions, not parietal functions, making this structure irrelevant to the neural basis of anger and aggressive behavior.

Choice C reason: The cerebellum coordinates motor activity and balance, not emotional regulation. Anger and aggression stem from amygdala-driven hyperarousal, not cerebellar function, which lacks direct involvement in emotional processing or behavioral impulsivity.

Choice D reason: The basal ganglia modulate movement and reward, not directly anger or aggression. While dopamine dysregulation may contribute, the amygdala’s role in emotional arousal is primary, making the basal ganglia secondary in this context.

Choice A reason: Neuroleptic malignant syndrome is associated with antipsychotics, not SSRIs like paroxetine, causing muscle rigidity and hyperthermia via dopamine blockade. The client’s symptoms, including hyperreflexia and diarrhea, align with serotonin excess, not dopamine-related issues, making this condition unlikely.

Choice B reason: Agranulocytosis, a severe reduction in white blood cells, is unrelated to paroxetine’s mechanism. SSRIs increase serotonin, not affecting hematopoiesis. The client’s symptoms like hyperpyrexia and hyperreflexia indicate serotonin toxicity, not an immunological or bone marrow disorder.

Choice C reason: Acute dystonic reactions involve muscle spasms from antipsychotics’ dopamine antagonism, not SSRIs. Paroxetine’s serotonin increase causes hyperreflexia and hyperpyrexia, consistent with serotonin syndrome, not extrapyramidal symptoms, making this diagnosis inappropriate for the described clinical presentation.

Choice D reason: Serotonin syndrome results from excessive serotonin due to paroxetine, an SSRI, overstimulating 5-HT receptors, causing hyperreflexia, hyperpyrexia, and autonomic instability. These symptoms reflect serotonin-driven neural excitation, particularly in the brainstem and spinal cord, matching the client’s clinical presentation accurately.