A troubled adolescent pulled out a gun in a school cafeteria, fatally shot three people, and injured many others. Hundreds of parents come to the school after hearing news reports. After police arrest the shooter, which action should occur next?

Announce over the loudspeakers, "The campus is now secure. Please return to your classrooms."

Designate zones according to the alphabet and direct students to the zones based on their last names to reunite them with their parents.

Require parents to pass through metal detectors and then allow them to look for their children in the school.

Ask police to encircle the school campus with yellow tape to prevent parents from entering.

The correct answer is: b) Designate zones according to the alphabet and direct students to the zones based on their last names to reunite them with their parents.

Answer and Explanation

The Correct Answer is B

Choice A reason: Announcing campus security may reduce anxiety but does not address reunification. Acute stress elevates cortisol and amygdala activity, and without structured reunification, parents’ distress persists, as prefrontal cortex-mediated organization is needed for effective crisis management.

Choice B reason: Designating zones for reunification organizes chaos, reducing amygdala-driven panic and cortisol surges in parents and students. This structured approach engages prefrontal cortex planning, ensuring safe, efficient reunification, addressing the immediate emotional and logistical needs post-crisis.

Choice C reason: Metal detectors ensure safety but delay reunification, prolonging amygdala-driven anxiety and cortisol release. Parents searching independently may increase chaos, as lack of structured reunification hinders prefrontal cortex-mediated organization, making this less effective than zoning.

Choice D reason: Blocking parents with tape escalates distress by preventing reunification, heightening amygdala activity and cortisol levels. This approach disregards emotional needs, impairing prefrontal cortex-mediated coping, and is counterproductive to resolving the crisis efficiently and compassionately.

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Correct Answer is A

Explanation

Choice A reason: Availability and lethality of suicide means are critical, as they determine immediate risk. Serotonin deficits and amygdala-driven impulsivity heighten the likelihood of acting on accessible, lethal methods, making this the priority to prevent fatal outcomes in suicidal patients.

Choice B reason: Insight into suicidal motivation is important but secondary to immediate risk. Serotonin dysregulation drives impulsivity, and without addressing access to lethal means, insight alone cannot prevent action, making it less urgent in acute suicide assessment.

Choice C reason: Abuse history increases suicide risk via trauma-related amygdala hyperactivity but is not the priority. Immediate access to lethal means poses a greater acute risk, as serotonin deficits drive impulsivity, necessitating focus on preventing action first.

Choice D reason: Social support is a protective factor but secondary to immediate risk. Serotonin-driven impulsivity and amygdala hyperactivity make access to lethal means the priority, as support cannot prevent action if means are readily available.

A. Clomipramine (Anafranil). B. Risperidone (Risperdal). C. Clonidine (Catapres). D. Carbamazepine (Tegretol).

Correct Answer is D

Explanation

Choice A reason: Clomipramine, a tricyclic antidepressant, targets serotonin and norepinephrine reuptake for depression, not bipolar mood stabilization. It risks triggering mania by overstimulating monoamine pathways, making it unsuitable for rapid-cycling bipolar disorder, which requires mood-stabilizing anticonvulsants.

Choice B reason: Risperidone, an antipsychotic, blocks dopamine and serotonin receptors, managing acute mania but not rapid cycling. Anticonvulsants like carbamazepine stabilize mood by modulating sodium channels, making risperidone less effective for long-term control of bipolar mood fluctuations.

Choice C reason: Clonidine, an alpha-2 agonist, reduces norepinephrine release for hypertension or ADHD, not bipolar disorder. It lacks mood-stabilizing properties, unlike anticonvulsants, which modulate neuronal excitability, making it inappropriate for managing rapid-cycling bipolar mood changes.

Choice D reason: Carbamazepine, an anticonvulsant, stabilizes mood in rapid-cycling bipolar disorder by inhibiting voltage-gated sodium channels, reducing neuronal excitability in the limbic system. This prevents manic and depressive episodes, making it a first-line choice for stabilizing rapid mood cycles.

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A troubled adolescent pulled out a gun in a school cafeteria, fatally shot three people, and injured many others. Hundreds of parents come to the school after hearing news reports. After police arrest the shooter, which action should occur next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing a patient's plan for suicide, what aspect has priority?

Correct Answer is A

Explanation

A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. Which drug should the nurse anticipate will be prescribed?

Correct Answer is D

Explanation

A primary intervention strategy for coping with a maturational crisis includes:

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 client who has attempted suicide has an underlying diagnosis of depression. Based on the biochemical function that is most associated with suicidal behavior, the nurse anticipates which medication classification will be ordered for the client?

After being told that his family will not be attending visitation, a 70-year-old patient turns over a table in a crowded common area. Which action takes priority?

A nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed bupropion (Wellbutrin). The client asks, "What kind of medication is this anyway?" The nurse would inform the client this agent is a:

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 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:

The nurse conducts a health history assessment for a client who is depressed. Which question should the nurse include to determine the client’s protective factors for suicide?