The most appropriate response by the nurse when a despondent patient says "Nothing matters anymore" would be:

Tell me more about the things that interested you before you began to feel depressed.

You have a lot to live for. You have a good mind. Your children love you.

Are you experiencing thoughts of suicide?

Try to stay hopeful. Things have a way of working out.

Answer and Explanation

The Correct Answer is C

Choice A reason: Exploring past interests is therapeutic but does not directly address the immediate suicide risk implied by hopelessness. Depression’s serotonin deficit heightens amygdala-driven despair, and assessing suicidal ideation is critical to prioritize safety over general exploration of interests.

Choice B reason: Reassuring the patient about reasons to live is dismissive and risks alienating them. Hopelessness in depression reflects serotonin and prefrontal cortex dysregulation, and this response fails to assess suicide risk, missing critical amygdala-driven warning signs.

Choice C reason: Asking about suicidal thoughts directly assesses risk, critical in depression with low serotonin and heightened amygdala activity driving hopelessness. This prioritizes safety, engaging prefrontal cortex reflection to identify immediate danger and guide intervention, making it the most appropriate response.

Choice D reason: Encouraging hope is vague and does not assess suicide risk. Depression’s serotonin deficit and amygdala hyperactivity require direct evaluation of suicidal ideation, as hopelessness signals potential danger, making this response inadequate for ensuring patient safety.

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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. Touch the patient to provide reassurance. B. Design activities that require the patient's concentration. C. Invite the patient to lead a community meeting. D. Provide a safe structured environment for the patient.

Correct Answer is D

Explanation

Choice A reason: Touching a manic patient may escalate agitation due to hyperarousal from elevated dopamine and norepinephrine in the limbic system. Physical contact can overstimulate the amygdala, increasing irritability, making it an inappropriate intervention for mania management.

Choice B reason: Activities requiring concentration are unsuitable for mania, as elevated dopamine impairs prefrontal cortex focus, leading to distractibility. Structured, low-stimulation interventions are needed to calm limbic hyperactivity, not tasks that exacerbate cognitive overload in a manic state.

Choice C reason: Leading a meeting is inappropriate for a manic patient, as heightened dopamine and norepinephrine drive impulsivity and grandiosity, impairing leadership ability. This could worsen agitation via limbic overstimulation, making a structured environment a better choice.

Choice D reason: A safe, structured environment reduces stimuli, calming limbic hyperactivity driven by dopamine and norepinephrine excess in mania. This stabilizes the patient’s behavior, minimizes triggers, and supports prefrontal cortex regulation, promoting safety and effective management of manic symptoms.

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The most appropriate response by the nurse when a despondent patient says "Nothing matters anymore" would be:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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