A fearful patient has an increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?

Choice A reason: Fraudulent bankruptcy is a legal or ethical violation, not a psychiatric emergency. Involuntary hospitalization requires evidence of imminent danger to self or others due to a mental disorder. This behavior, while illegal, does not inherently indicate a mental health crisis necessitating forced psychiatric intervention, making this choice incorrect.

Choice B reason: Threatening harm to self and others meets legal and clinical criteria for involuntary hospitalization, as it indicates imminent danger due to a psychiatric condition. Mental health laws, such as the Baker Act, prioritize safety when a patient’s mental state poses significant risk, making this the correct choice for forced admission.

Choice C reason: Selling and distributing illegal drugs is a criminal act, not necessarily linked to a mental health crisis requiring involuntary hospitalization. While substance use disorders may involve psychiatric issues, this behavior alone does not demonstrate imminent danger due to mental illness, making it inappropriate for forced treatment.

Choice D reason: Noncompliance with treatment, while concerning, does not inherently indicate imminent danger or severe mental instability requiring involuntary hospitalization. It may reflect patient autonomy or other factors, not acute psychiatric risk. This choice fails to meet the legal or clinical threshold for forced admission, making it incorrect.

Choice A reason: GABA is an inhibitory neurotransmitter that reduces neuronal activity, promoting calm. In fear, the sympathetic nervous system activates, increasing heart rate and blood pressure, driven by excitatory neurotransmitters, not GABA, which would counteract these effects, making this choice incorrect.

Choice B reason: Norepinephrine, a catecholamine, activates the sympathetic nervous system during fear, increasing heart rate and blood pressure via the fight-or-flight response. Its heightened activity in stress aligns with the patient’s symptoms, making this the correct neurotransmitter choice.

Choice C reason: Histamine regulates arousal and allergic responses but is not primarily responsible for cardiovascular changes in fear. Its role in the brain is less direct than norepinephrine in driving sympathetic activation, making this choice incorrect for the symptoms described.

Choice D reason: Serotonin modulates mood and anxiety but does not directly cause acute cardiovascular changes like increased heart rate and blood pressure in fear. These are driven by norepinephrine’s sympathetic activation, making serotonin an incorrect choice for this scenario.