Which action would the nurse take during the termination phase of the therapeutic relationship with the patient?

Choice A rationale

Glutamate is the primary excitatory neurotransmitter in the central nervous system. Its facilitation would increase neuronal activity, which is generally contrary to the desired calming and sedative effects of anxiolytic medications, which typically aim to reduce nervous system overactivity to manage anxiety.

Choice B rationale

Dopamine is a monoamine neurotransmitter involved in reward, motivation, and motor control. While involved in various psychiatric conditions, decreasing excess dopamine is the primary mechanism of action for some antipsychotic medications, not the typical mechanism for anxiolytics, which primarily target anxiety symptoms.

Choice C rationale

Serotonin, a monoamine, modulates mood, sleep, and appetite. Increasing its release or effects is the primary mechanism for some classes of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), which are also used for anxiety, but is not the defining or typical mechanism of benzodiazepine anxiolytics.

Choice D rationale

γ-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the brain. Anxiolytic drugs, particularly the benzodiazepine class, exert their effect by binding to the GABA_A receptor. This binding enhances GABA's inhibitory effects, leading to hyperpolarization of the neuron, thereby reducing overall neuronal excitability and promoting an anxiolytic (calming) effect.

Choice A rationale

The use of silence in communication is significantly influenced by cultural norms. In some cultures, prolonged silence may signify respect, thoughtfulness, or contemplation, whereas in others, it may be interpreted as disagreement, withdrawal, anger, or anxiety. Nurses must be sensitive to these diverse cultural interpretations to avoid misjudging a patient's emotional or mental state during therapeutic interaction.

Choice B rationale

Personal appearance, encompassing clothing, adornments, and grooming, is undeniably influenced by culture but is primarily related to social expression and identity, not a direct nonverbal communication behavior within a clinical interaction. While it may indicate socioeconomic status or cultural affiliation, it's not a behavior that differs in the communication process in the same manner as the other choices.

Choice C rationale

The perception of touch and its acceptability is highly variable across cultures, representing a crucial nonverbal difference. A touch that may be interpreted as caring and supportive in one culture could be considered intrusive, disrespectful, or a violation of personal space in another, necessitating careful cultural assessment before using touch as an intervention.

Choice D rationale

Communication style is a broad concept encompassing various verbal and nonverbal elements. While culture profoundly affects style, this choice is less specific than the others. The actual behaviors that vary are the individual components, like eye contact, use of space, and silence, which are more precise examples of nonverbal behaviors that differ based on cultural background.

Choice E rationale

Use of eye contact is one of the most significant nonverbal behaviors that differs across cultural backgrounds. In some cultures, direct eye contact conveys interest, honesty, and confidence, while in others, particularly those emphasizing respect for elders or authority, sustained eye contact may be seen as challenging, disrespectful, or aggressive, requiring nurses to adapt their approach.