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

Choice A reason: Cultural skill refers to the ability to apply cultural knowledge in practice, such as conducting culturally sensitive assessments. It focuses on actionable skills, not self-examination of beliefs, which is a distinct process of internal reflection, making this choice incorrect for the described behavior.

Choice B reason: Cultural knowledge involves understanding cultural facts and differences, not introspective analysis of personal beliefs. It focuses on external information rather than self-awareness, which is critical for examining one’s own values, making this choice incorrect for the nurse’s behavior.

Choice C reason: Cultural awareness involves self-examination of personal beliefs, values, and biases, recognizing their impact on care. This introspective process is essential in psychiatric nursing to ensure unbiased patient interactions, aligning with the described behavior, making this the correct choice.

Choice D reason: Cultural competence encompasses knowledge, skills, and awareness to provide effective care across cultures. While it includes self-examination, it is broader than the specific act of reflecting on personal beliefs, making cultural awareness the more precise term for the described behavior.

Choice A reason: Zolpidem, a nonbenzodiazepine sedative, affects the central nervous system, causing sedation and impaired coordination, particularly in the elderly. Age-related declines in metabolism and balance increase fall risk, a critical nursing consideration. Monitoring mobility and ensuring safety measures are essential to prevent injuries, making this the correct choice.

Choice B reason: While zolpidem may cause daytime drowsiness, this is not the primary nursing consideration compared to fall risk in the elderly. Drowsiness is a general side effect, but the elderly’s heightened vulnerability to falls due to sedation and impaired coordination takes precedence, making this choice less critical.

Choice C reason: Zolpidem has a lower dependence risk than benzodiazepines, and dependence is not inevitable. This assumption overstates the risk and is not the primary nursing consideration. Fall prevention, especially in vulnerable populations like the elderly, is more urgent due to immediate safety concerns, making this choice incorrect.

Choice D reason: Zolpidem induces sedation rapidly, typically within 15–30 minutes, not requiring 4 weeks. This choice is factually incorrect, as prolonged use is not necessary for efficacy. The primary concern is immediate side effects like falls, not a delayed onset, making this an invalid nursing consideration.