A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?

Buspirone (Buspar)

Venlafaxine (Effexor)

Imipramine (Tofranil)

Alprazolam (Xanax)

Answer and Explanation

The Correct Answer is D

Choice A reason: Buspirone enhances serotonin activity, taking weeks to reduce anxiety. Panic attacks, driven by acute norepinephrine surges in the amygdala, require rapid intervention. Buspirone’s delayed onset makes it ineffective for acute symptom relief, unlike fast-acting options targeting immediate neurochemical imbalances.

Choice B reason: Venlafaxine, an SNRI, increases serotonin and norepinephrine over weeks, unsuitable for acute panic attacks. Panic involves rapid sympathetic activation, requiring immediate GABA enhancement or similar fast-acting mechanisms, not gradual reuptake inhibition, making venlafaxine incorrect for rapid relief.

Choice C reason: Imipramine, a tricyclic, modulates serotonin and norepinephrine but takes weeks to act. Acute panic, driven by locus coeruleus norepinephrine spikes, needs immediate relief. Imipramine’s slow onset and side effects make it inappropriate for rapid intervention in acute anxiety episodes.

Choice D reason: Alprazolam, a benzodiazepine, enhances GABA-A receptor activity, rapidly inhibiting excessive neural firing in the amygdala during panic attacks. This provides quick relief from acute anxiety symptoms, like tachycardia, within minutes, making it the correct choice for immediate neurobiological stabilization in panic episodes.

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Correct Answer is A

Explanation

Choice A reason: Confidentiality can be breached if a patient poses a threat to others, as in Tarasoff rulings, due to safety risks from delusions driven by dopamine dysregulation. This legal and ethical exception ensures protection, aligning with psychiatric principles prioritizing harm prevention over absolute confidentiality.

Choice B reason: Absolute confidentiality is incorrect, as exceptions exist for safety. Delusions, linked to mesolimbic dopamine excess, may lead to threats requiring disclosure. Legal frameworks allow breaching confidentiality to protect others, making this response scientifically and ethically inaccurate for psychiatric practice.

Choice C reason: Law enforcement inquiries do not automatically override confidentiality. Disclosure is limited to specific legal mandates, like imminent danger from dopamine-driven delusions. Routine questions do not justify breaches, making this response incorrect for the ethical and legal standards in psychiatric care.

Choice D reason: Confidentiality breaches are not solely at the psychiatrist’s discretion. Legal and ethical guidelines, like those for threats from delusional states, dictate exceptions. This option oversimplifies complex regulations, ignoring standardized protocols for managing risks in psychiatric patients, making it incorrect.

A. It can be administered as needed B. It is faster acting than diazepam C. It may produce blood dyscrasias D. It is not known to cause dependence

Correct Answer is D

Explanation

Choice A reason: Buspirone is not used as needed; it requires weeks for serotonin modulation to reduce anxiety. Diazepam’s rapid GABA enhancement suits acute use. Buspirone’s chronic dosing schedule makes this characteristic incorrect for explaining its preference over diazepam for long-term anxiety management.

Choice B reason: Buspirone is slower-acting, taking weeks to enhance serotonin activity, unlike diazepam’s rapid GABA-mediated effects. For anxiety driven by amygdala hyperactivity, diazepam acts faster, making buspirone’s slower onset an incorrect reason for its prescription over diazepam in this context.

Choice C reason: Blood dyscrasias are not a known side effect of buspirone, which primarily affects serotonin receptors. This is unrelated to its preference over diazepam, which carries dependence risks. This characteristic is inaccurate and irrelevant to the rationale for choosing buspirone.

Choice D reason: Buspirone’s lack of dependence risk, unlike diazepam’s GABA-mediated addiction potential, makes it safer for long-term anxiety management. By enhancing serotonin in the prefrontal cortex, it reduces chronic anxiety without habit-forming effects, aligning with its preference for sustained treatment, making this the correct reason.

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A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?

Correct Answer is A

Explanation

A patient asks the nurse, “Why did my health care provider prescribe buspirone (Buspar) for my anxiety instead of diazepam (Valium)?” The nurse’s reply is based on the knowledge of which characteristic of buspirone?

Correct Answer is D

Explanation

After assessing the patient and formulating the nursing diagnoses for a plan of care, what is the next action a nurse should take?

The nursing student understands that the purpose of completing a process recording for the nurse-patient interview is to:

Which principle should guide the nurse in determining when to use silence during a patient interview?

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Which neurotransmitter is associated with the hallucinations, delusions, and bizarre behavior seen in schizophrenia?

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A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?

A patient is taking a first-generation antipsychotic medication. What should the nurse teach about the drug’s strong dopaminergic effect?