A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." To support the patient to reframe this overgeneralization, the nurse's best response is:

I really doubt that one person can be blamed for all the bad things that happen.

Let's look at one bad thing that happened to see if another explanation exists.

How does your belief in fate relate to your cultural heritage?

You are being exceptionally hard on yourself when you say those things.

Answer and Explanation

The Correct Answer is B

Choice A reason: This response dismisses the patient’s cognitive distortion without engaging in therapeutic exploration. Major depressive disorder involves negative cognitive biases due to altered serotonin and dopamine signaling in the prefrontal cortex, impairing rational attribution of causality. This choice fails to facilitate cognitive restructuring, missing the opportunity to address neurocognitive mechanisms underlying overgeneralization.

Choice B reason: This response uses cognitive-behavioral techniques to challenge overgeneralization, a distortion linked to dysfunctional prefrontal cortex activity and low serotonin levels in depression. Examining a specific event encourages re-evaluation of faulty attributions, promoting neuroplasticity through cognitive restructuring, which can enhance rational thinking and reduce depressive symptoms by altering maladaptive neural pathways.

Choice C reason: This response shifts focus to cultural beliefs, irrelevant to the patient’s cognitive distortion. Depression involves altered amygdala-prefrontal cortex interactions, leading to negative self-attribution. Exploring cultural heritage does not address serotonin deficiency or facilitate cognitive reframing, making it ineffective for correcting overgeneralized thinking driven by neurochemical imbalances.

Choice D reason: This response acknowledges self-criticism but fails to engage in active cognitive restructuring. Depression involves hyperactive amygdala responses and reduced prefrontal inhibition, perpetuating negative self-perceptions. Without guiding the patient to explore alternative explanations, this choice misses the chance to alter maladaptive neural pathways, limiting its therapeutic impact on distorted thinking.

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Correct Answer is A

Explanation

Choice A reason: In PTSD, glutamate drives excitatory signaling in the amygdala, enhancing fear memory consolidation, while norepinephrine heightens arousal via locus coeruleus activation, strengthening traumatic memory encoding. This hyperactive glutamatergic-noradrenergic interaction sustains fear responses, contributing to PTSD’s persistent hyperarousal and intrusive memories.

Choice B reason: GABA inhibits neural activity, counteracting excitation, but its role in PTSD is secondary, modulating rather than driving fear memory formation. Glutamate is critical for memory consolidation in the amygdala, but pairing with GABA does not fully explain PTSD’s hyperarousal and fear encoding mechanisms.

Choice C reason: Histamine regulates wakefulness and arousal but is not directly involved in PTSD’s fear memory encoding. GABA modulates inhibition but does not drive the excitatory processes in the amygdala critical for trauma-related memory consolidation, making this pair irrelevant to PTSD’s core neurochemistry.

Choice D reason: Acetylcholine modulates attention and memory but is not a primary driver of PTSD’s fear responses. Serotonin influences mood but plays a secondary role in trauma memory encoding compared to glutamate and norepinephrine, which directly mediate amygdala hyperactivity in PTSD.

A. The mania symptoms of bipolar II disorder have less effect on functioning. B. Bipolar II is more often recognized than bipolar I. C. Unlike bipolar II, bipolar I disorder involves no symptoms of mania, but only depression. D. Both disorders are the same, except the risk for suicide is greater with bipolar I disorder.

Correct Answer is A

Explanation

Choice A reason: Bipolar II involves hypomania, which is less severe than bipolar I’s mania, causing milder dopamine-driven limbic hyperactivity. Hypomania impairs functioning less, as it lacks psychosis and severe impulsivity, allowing better prefrontal cortex regulation compared to bipolar I’s intense manic episodes.

Choice B reason: Bipolar II is less often recognized than bipolar I due to hypomania’s subtlety, often mistaken for normal mood. Bipolar I’s severe mania, driven by dopamine excess, is more noticeable, leading to earlier diagnosis, making this statement factually incorrect.

Choice C reason: Bipolar I includes severe mania, not just depression, driven by dopamine and norepinephrine surges in the limbic system. Bipolar II involves hypomania and depression, so this statement inaccurately describes bipolar I’s clinical features, which include prominent manic episodes.

Choice D reason: Bipolar I and II differ in mania severity, not just suicide risk. Bipolar I’s severe mania increases impulsivity via dopamine dysregulation, but both have suicide risks. This statement oversimplifies the disorders’ neurochemical and clinical distinctions, making it incorrect.

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A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." To support the patient to reframe this overgeneralization, the nurse's best response is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The experience of trauma causes neurochemical changes in the brain that play a role in encoding fear memories that are implicated in Post Traumatic Stress Disorder. The nurse identifies the involvement of which neurotransmitters?

Correct Answer is A

Explanation

When teaching a group of new mental health nurses about the major difference between bipolar I and bipolar II disorders, which would be most appropriate to include?

Correct Answer is A

Explanation

A nurse is preparing to administer lactated Ringer's 100 mL IV over 15 minutes. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)

A nurse is preparing to administer acetaminophen 320 mg PO every four hours as needed for pain. The amount available from the pharmacy is acetaminophen liquid 160 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest whole number.)

The plan of care for a patient in the manic state of bipolar disorder should include which intervention?

A patient diagnosed with schizophrenia has auditory hallucinations, delusions of grandeur, poor personal hygiene, and threatening behavior. Which assessment finding would the nurse regard as a negative symptom of schizophrenia?

A nurse states, "I evaluated a new patient using the modified SAD PERSONS scale and got a score of 10. Should I send the patient home?" Select the best reply.

A client is suspected to have dissociative identity disorder. Which characteristic does the nurse identify that the disturbed personal identity is most likely related to?

A hospitalized client diagnosed with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which medication would the nurse expect to administer?

A patient diagnosed with major depressive disorder began taking citalopram (Celexa) 4 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to: