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?

Calmly ask the patient why he turned the table over.

Escort the patient to a quiet area.

Encourage the patient to discuss his feelings.

Demand that the patient pick up the table.

Answer and Explanation

The Correct Answer is B

Choice A reason: Asking why may escalate agitation, as anger involves amygdala-driven norepinephrine surges. In a crowded area, this risks further overstimulation, not addressing the immediate need to reduce environmental triggers and stabilize neural hyperactivity for safety.

Choice B reason: Escorting to a quiet area reduces sensory input, calming amygdala-driven anger and norepinephrine release. This de-escalates the situation, engaging prefrontal cortex regulation to prevent further aggression, prioritizing safety in a crowded, stimulating environment.

Choice C reason: Discussing feelings is therapeutic but not the priority in a crowded area. Anger’s amygdala hyperactivity requires immediate de-escalation to reduce norepinephrine-driven impulsivity, making a quiet environment the first step before verbal processing.

Choice D reason: Demanding the patient pick up the table is confrontational, risking escalation of amygdala-driven aggression and norepinephrine surges. It does not address immediate safety or de-escalation needs, making it inappropriate in a volatile, crowded situation.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A reason: Haloperidol, a typical antipsychotic, blocks dopamine D2 receptors in the mesolimbic pathway, rapidly reducing agitation and psychosis-driven aggression in schizophrenia. This addresses the acute delusional behavior and amygdala hyperactivity, making it the preferred choice for immediate control.

Choice B reason: Hydroxyzine, an antihistamine, reduces anxiety via histamine and mild anticholinergic effects but lacks antipsychotic properties. It cannot address dopamine-driven delusions or aggression in schizophrenia, making it ineffective for controlling acute psychotic agitation.

Choice C reason: Valproate stabilizes mood in bipolar disorder via GABA enhancement but is not indicated for acute psychotic aggression. Schizophrenia’s dopamine excess requires rapid receptor blockade, which valproate cannot provide, making it unsuitable for this scenario.

Choice D reason: Lithium stabilizes mood in bipolar disorder by modulating sodium channels and inositol, not acute psychosis. Schizophrenia’s mesolimbic dopamine hyperactivity requires antipsychotic intervention, making lithium ineffective for controlling delusional aggression in this acute situation.

A. Explain the time lag before antidepressants relieve symptoms. B. Discuss with the health care provider the need to increase the dose. C. Critically assess the patient for symptoms of improvement. D. Reassure the patient that the medication will be effective soon.

Correct Answer is A

Explanation

Choice A reason: Citalopram, an SSRI, increases serotonin levels, requiring 4-6 weeks to upregulate serotonin receptors and modulate prefrontal-amygdala circuits for mood improvement. Explaining this delay addresses patient expectations, reducing frustration and enhancing adherence by clarifying the neurochemical timeline of antidepressant action.

Choice B reason: Increasing the dose after 4 days is premature, as SSRIs like citalopram require weeks to alter serotonin signaling and neural plasticity. Premature dose escalation risks side effects like serotonin syndrome without addressing the expected therapeutic lag, making it an inappropriate intervention.

Choice C reason: Assessing for improvement after 4 days is unlikely to yield significant findings, as citalopram’s serotonin modulation takes weeks to impact mood via prefrontal cortex changes. This approach may reinforce the patient’s frustration without addressing the neurochemical basis of the delayed response.

Choice D reason: Reassuring effectiveness without explaining the delay is misleading. Citalopram’s action on serotonin pathways requires time for receptor upregulation and neural circuit adaptation. This vague reassurance does not educate the patient on the neurochemical timeline, potentially reducing trust and adherence.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client on an inpatient psychiatric unit yells "My roommate is Satan's crafty minion" and attempts to strangle him. The patient is refusing redirection. What medication should the nurse expect the on-call provider to order?

Correct Answer is A

Explanation

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:

Correct Answer is A

Explanation

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?

Which central nervous system structure is associated with anger and aggression?

Which patient meets the criteria for hospice services?

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.)

Which scenario best demonstrates an example of eustress?

A client tells the nurse that he has bugs in his brain and asks the nurse if the nurse can see them. Which response by the nurse is most therapeutic?

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.)