In managing stress for a client with a psychotic disorder, why might deep breathing exercises be recommended?
They reduce physiological arousal through relaxation.
They are primarily used to increase alertness.
They increase dopamine receptor activation.
They mimic the physiological state of high stress.
The Correct Answer is A
Choice A reason: Deep breathing exercises stimulate the vagus nerve, which activates the parasympathetic nervous system. This reduces heart rate, lowers blood pressure, and decreases cortisol levels. For a client with a psychotic disorder, reducing this physiological arousal can help mitigate the intensity of hallucinations or delusions exacerbated by stress.
Choice B reason: Deep breathing exercises are designed to induce a state of calm and tranquility rather than increased alertness or hyper-vigilance. While mindful breathing can improve focus, its primary therapeutic utility in stress management for psychiatric populations is the reduction of the "fight or flight" response.
Choice C reason: There is no clinical evidence that deep breathing exercises increase dopamine receptor activation. In fact, in psychotic disorders, the goal is often to modulate or decrease overactive dopaminergic pathways. Deep breathing is a peripheral nervous system intervention and does not directly target dopamine receptor sensitivity in the brain.
Choice D reason: Deep breathing is intended to be the physiological opposite of the high-stress state. High stress is characterized by shallow, rapid chest breathing (tachypnea). Slow, diaphragmatic breathing disrupts the feedback loop of anxiety, signaling the brain that the environment is safe, thereby reducing the psychological perception of threat.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While social withdrawal is a symptom of major depressive disorder, assessing adherence to social activities does not directly address the immediate physiological and behavioral causes of insomnia. The priority for sleep disturbances is to identify factors that directly interfere with the initiation or maintenance of the sleep cycle.
Choice B reason: Dietary habits, such as caffeine intake, can certainly influence sleep quality. However, a comprehensive assessment of sleep hygiene specifically requires looking at the broader context of the client's behaviors during the pre-sleep period. Rituals and routines provide a more direct window into the client's sleep-wake regulation.
Choice C reason: Family history is important for establishing a genetic predisposition to depression, but it offers little utility in managing acute, persistent insomnia. The clinical focus must remain on modifiable behavioral factors and the current symptom profile to develop an effective nursing care plan for sleep restoration.
Choice D reason: Assessing nighttime rituals and routines is a critical component of evaluating sleep hygiene. The nurse must identify behaviors that may be disrupting the circadian rhythm, such as irregular sleep schedules, blue light exposure from screens, or stimulating activities late in the evening, to provide targeted educational interventions.
Correct Answer is C
Explanation
Choice A reason: Guided imagery requires a high level of abstract thinking and internal focus. For a client with a psychotic disorder, particularly those experiencing active hallucinations or delusions, focusing on internal mental images can inadvertently trigger or worsen thought disorganization, making it a potentially counterproductive or overstimulating intervention.
Choice B reason: Journaling is often used in cognitive behavioral therapy to track patterns; however, for a client struggling with impulsive thoughts and psychosis, the solitary nature of journaling may provide a platform for reinforcing delusional content. It lacks the immediate reality testing and external feedback necessary to manage acute impulsivity safely.
Choice C reason: Group therapy provides a structured, external environment where social modeling and reality testing occur in real-time. For individuals with psychotic disorders, the presence of peers and facilitators helps ground the client, providing immediate feedback on impulsive thoughts and encouraging the development of more stable, socially appropriate coping mechanisms.
Choice D reason: While physical activity is healthy, high-intensity exercise can significantly increase physiological arousal. In a client already struggling with impulsivity and psychosis, this elevated autonomic state may lower the threshold for behavioral outbursts or agitation, making it less suitable than structured, calming, or socially grounded therapeutic interventions
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