Which of the following statements is true of Fetal Alcohol Syndrome

Choice A reason: Tranylcypromine is a Monoamine Oxidase Inhibitor (MAOI) used primarily for treatment-resistant depression. It has a slow onset of action, requiring weeks to reach therapeutic levels, and carries significant risks of hypertensive crises if dietary tyramine is ingested, making it entirely inappropriate for acute, as-needed (PRN) use.

Choice B reason: Buspirone is an anxiolytic that lacks the sedative or muscle-relaxant properties of benzodiazepines. However, its primary drawback in an acute setting is that it requires 2 to 4 weeks of consistent daily dosing to achieve an effective therapeutic response. It cannot provide the immediate relief required for a sudden anxiety episode.

Choice C reason: Lorazepam is a high-potency, intermediate-acting benzodiazepine that enhances the inhibitory effects of gamma-aminobutyric acid (GABA) in the central nervous system. It has a rapid onset of action, typically within 15 to 30 minutes, making it the gold standard for the immediate pharmacological management of acute severe anxiety or panic.

Choice D reason: Phenelzine is another MAOI antidepressant. Like tranylcypromine, it is not an anxiolytic for acute distress. Using an MAOI as a PRN would be dangerous and ineffective, as these drugs work by permanently inhibiting enzymes over time rather than providing immediate modulation of the neurotransmitters responsible for the acute stress response.

Choice A reason: Environmental safety, such as locking kitchens or laundry rooms, is a necessary "milieu management" strategy. However, a determined patient can still find ways to self-harm in "safe" areas (e.g., using bedsheets or water). It is a secondary measure compared to direct, active surveillance of the patient.

Choice B reason: Removing "sharps," belts, and shoelaces is a standard safety protocol (contraband check). While this reduces the availability of lethal means, it does not prevent a patient from attempting self-harm through other methods, such as jumping, head-banging, or choking, unless they are being actively watched.

Choice C reason: One-to-one (1:1) observation is the most effective and highest level of suicide precaution. It ensures that a staff member is within arm's length or direct line of sight at all times, including during sleep and hygiene. This allows for immediate physical intervention the moment a self-harm attempt begins.

Choice D reason: Visitor education is an important auxiliary safety measure to prevent the accidental introduction of contraband (like glass or medication). However, it relies on the compliance of non-professionals and does not address the patient's internal impulses or actions when visitors are not present.