A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?
“You have lost touch with reality, which is a symptom of your illness.”
“It sounds like you’re concerned about your privacy.”
“The government is prohibited from operating in health care facilities.”
“Let’s talk about something other than the government.”
The Correct Answer is B
Choice A reason: Labeling paranoia as a loss of reality, while accurate for dopamine-driven delusions, risks alienating the patient. Confronting beliefs directly can increase agitation, as the amygdala amplifies fear responses. A therapeutic response validates emotions, not challenges perceptions, making this less effective.
Choice B reason: Acknowledging privacy concerns validates the patient’s emotions without reinforcing delusions. This reduces anxiety, calming amygdala hyperactivity in paranoia, and builds trust. By focusing on feelings, not the delusion’s content, the nurse fosters a therapeutic alliance, aligning with evidence-based approaches for psychotic disorders.
Choice C reason: Stating government prohibition addresses the delusion’s content, potentially escalating agitation. Paranoia, driven by mesolimbic dopamine excess, resists factual correction. This risks confrontation, undermining trust and therapeutic rapport, making it less effective than validating emotions in managing psychotic symptoms.
Choice D reason: Redirecting to another topic avoids engaging with the patient’s emotional state, missing a therapeutic opportunity. Paranoia, linked to dopamine dysregulation, requires addressing underlying fears to reduce amygdala-driven anxiety. Ignoring the concern can increase mistrust, making this response less therapeutic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Predicting individual recovery is not epidemiology’s role. Recovery from disorders like depression depends on neurobiological factors (e.g., serotonin reuptake) and treatment adherence, not population-level trends. Epidemiology focuses on group patterns, not individual outcomes, making this option scientifically inaccurate for understanding mental disorder impact.
Choice B reason: Epidemiology does not provide theoretical explanations for disorder causes. Etiologies of mental illnesses, such as genetic mutations or dopamine imbalances in schizophrenia, are studied through neurobiology and genetics. Epidemiology quantifies disease prevalence and risk factors, not underlying mechanisms, making this option misaligned with its scientific purpose.
Choice C reason: Explaining neurophysiological causes is outside epidemiology’s scope. Neurophysiology, like altered GABA activity in anxiety, is studied via neuroimaging or biochemical assays. Epidemiology identifies disease patterns and risk factors across populations, not causal mechanisms, rendering this option incorrect for describing its role in mental health.
Choice D reason: Epidemiology studies disease distribution and determinants, such as prevalence of depression or risk factors like socioeconomic stress, which influence neurotransmitter imbalances (e.g., serotonin). By analyzing population data, it informs public health strategies, identifies at-risk groups, and guides interventions, making it critical for understanding mental disorder impact scientifically.
Correct Answer is D
Explanation
Choice A reason: Canceling discharge overrides patient autonomy and recovery progress. Stabilized schizophrenia, managed with antipsychotics targeting dopamine, supports discharge with adherence. This action disregards the patient’s rights and neurobiological stabilization, making it an inappropriate advocacy response.
Choice B reason: Notifying security dismisses family concerns and escalates unnecessarily. Schizophrenia management relies on medication adherence, not coercion. This approach ignores patient rights and family education needs, failing to address neurobiological treatment principles, making it incorrect for advocacy.
Choice C reason: Transferring to long-term care assumes ongoing instability, ignoring current stabilization. Antipsychotics correct dopamine imbalances, supporting outpatient management. This undermines patient autonomy and recovery potential, making it an inappropriate advocacy action for a stabilized patient.
Choice D reason: Explaining medication adherence promotes patient autonomy and recovery. Antipsychotics reduce dopamine-driven hallucinations, ensuring symptom control. Educating the family empowers support for adherence, aligning with patient rights and neurobiological treatment principles, making this the correct advocacy response.
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