A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Remain silent and add the suggested outcome to the plan

Formulate a more appropriate outcome without the patient’s input

Explore with the patient possible consequences of the outcome

Educate the patient that the outcome is not realistic

Answer and Explanation

The Correct Answer is C

Choice A reason: Silently adding an inappropriate outcome disregards patient safety and autonomy. Outcomes must align with neurobiological needs, like serotonin modulation for depression. This approach fails to engage the patient in decision-making, risking ineffective treatment and neglecting evidence-based collaborative care principles.

Choice B reason: Formulating outcomes without patient input violates autonomy. Collaborative goal-setting, considering neurobiological factors like dopamine imbalances, ensures patient engagement and effective treatment. Excluding the patient disregards their perspective, reducing adherence and therapeutic alliance, making this approach contrary to evidence-based psychiatric nursing.

Choice C reason: Exploring consequences respects autonomy while guiding patients toward safe outcomes. Discussing implications, like medication non-adherence worsening dopamine-driven symptoms, fosters informed decisions. This collaborative approach aligns with cognitive-behavioral principles and neurobiological treatment needs, ensuring effective, patient-centered care in psychiatric practice.

Choice D reason: Educating that an outcome is unrealistic may dismiss patient autonomy. While addressing neurobiological realities, like serotonin deficits, is important, unilateral education risks disengagement. Collaborative exploration of consequences is more effective, promoting informed choices and adherence, making this option less suitable than discussion.

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Correct Answer is C

Explanation

Choice A reason: Denying problems reflects resistance, typical in the orientation phase, where trust is not yet established. Anger management, linked to amygdala-driven impulsivity, requires a therapeutic alliance. This statement indicates avoidance, not readiness for the working phase’s collaborative problem-solving.

Choice B reason: Questioning therapy’s value shows skepticism, common in the orientation phase. The working phase involves active goal-setting, like managing anger tied to serotonin dysregulation. This statement reflects a lack of engagement, not the transition to collaborative therapeutic work, making it incorrect.

Choice C reason: Expressing a goal to manage anger indicates readiness for the working phase, where collaborative problem-solving occurs. Anger, linked to amygdala hyperactivity and serotonin deficits, requires active intervention. This statement shows commitment to addressing neurobiological issues, marking the transition to the working phase.

Choice D reason: Difficulty discussing problems reflects orientation phase challenges, where trust is building. The working phase involves active engagement, like addressing anger’s neurobiological basis. This statement indicates discomfort, not readiness for collaborative work, making it incorrect for the phase transition.

A. Histamine B. Acetylcholine C. GABA D. Norepinephrine

Correct Answer is D

Explanation

Choice A reason: Histamine regulates wakefulness and allergic responses, not anxiety or fear. Its receptors in the brain promote alertness, but excessive histamine does not drive sympathetic activation like increased heart rate. This makes histamine an incorrect choice for the symptoms described, which align with autonomic arousal.

Choice B reason: Acetylcholine mediates parasympathetic responses, like slowing heart rate, not the sympathetic activation seen in anxiety. While it plays a role in attention, it does not primarily cause fear or tachycardia, making it an unsuitable choice compared to norepinephrine’s role in stress responses.

Choice C reason: GABA inhibits neural activity, reducing anxiety via GABA-A receptor activation. Low GABA levels may contribute to anxiety, but the symptoms described (tachycardia, fear) result from sympathetic activation, not GABA excess. This makes GABA incorrect for the neurotransmitter driving these symptoms.

Choice D reason: Norepinephrine, released during stress, activates the sympathetic nervous system, increasing heart rate and inducing fear via locus coeruleus activation. It heightens arousal in the amygdala, contributing to anxiety symptoms. This aligns with the fight-or-flight response, making norepinephrine the correct neurotransmitter for these symptoms.

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A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?

Correct Answer is C

Explanation

A patient presents with anxiety, increased heart rate, and fear. The nurse suspects the activation of which neurotransmitter?

Correct Answer is D

Explanation

A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?

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 prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Which statement shows a nurse has empathy for a patient who made a suicide attempt?

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?

A patient says to the nurse, “I dreamed I was pusillanimous. When I woke up, I felt emotionally drained, as though I hadn’t rested well.” Which comment would be appropriate if the nurse seeks clarification?

On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?

A single parent is experiencing feelings of inadequacy related to work and family since one teenaged child ran away several weeks ago. The parent seeks the help of a therapist specializing in cognitive therapy. What intervention will the psychotherapist introduce?