While talking with a client diagnosed with major depressive disorder, a nurse notices the client is unable to maintain eye contact.
The client's chin lowers to the chest.
The client looks at the floor.
Which aspect of communication has the nurse assessed?
Inadequate social skills.
A message filter.
Nonverbal communication.
A cultural barrier.
The Correct Answer is C
Choice A rationale
Inadequate social skills refer to a deficit in learned behaviors required to interact effectively and appropriately in social situations, often leading to social anxiety or isolation. While the observed behaviors may stem from poor social skills, the nurse is directly assessing observable actions and physical presentation, not inferring the client's underlying social competence or skill set.
Choice B rationale
A message filter is a psychological mechanism or bias through which an individual interprets or "filters" incoming communication, often based on personal experiences, emotions, or preconceived notions. The nurse is observing the client's outward expression (posture, gaze) rather than a cognitive process or interpretation occurring within the client's mind.
Choice C rationale
Nonverbal communication encompasses all aspects of message exchange that do not involve spoken or written words, including body language (kinesics) such as posture, facial expressions, and eye contact. The client's lowered chin and averted gaze are clear, observable examples of nonverbal cues conveying emotional state or engagement level.
Choice D rationale
A cultural barrier occurs when differing values, beliefs, or social norms between individuals interfere with the accurate transfer or interpretation of a message. Although eye contact norms vary culturally, the nurse is primarily identifying a specific behavioral cue in the immediate interaction, not necessarily attributing it to a cultural difference.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
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.
Correct Answer is C
Explanation
Choice A rationale
Occasional sleeplessness and anxiety are common, transient responses to stress or life events and do not, in isolation, suggest a diagnosable mental illness. These symptoms are often within the normal spectrum of human emotional and physiological responses, reflecting coping mechanisms that do not necessarily constitute a pathological syndrome causing significant functional impairment.
Choice B rationale
The ability to differentiate between "as if" (e.g., imagination, metaphor) and "for real" (e.g., reality) demonstrates an intact reality testing capacity, which is a hallmark of mental health. Impaired reality testing, such as experiencing hallucinations or delusions, would be a much stronger indicator of a potential mental illness, particularly psychosis.
Choice C rationale
A consistently sad, discouraged, and hopeless mood that persists over time and potentially impairs daily functioning is a cardinal symptom complex of Major Depressive Disorder. This constellation of persistent negative affect and cognitive distortion significantly deviates from typical emotional responses and suggests a pathological change in mood regulation and perception.
Choice D rationale
Experiencing difficulty with major life decisions is a normal, albeit stressful, part of the human experience. Indecisiveness can stem from various non-pathological factors, such as fear of commitment or evaluating complex variables. It only becomes indicative of mental illness if it is severe, pervasive, and accompanied by other clinical features, like profound anxiety or depression.
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