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?

It can be administered as needed

It is faster acting than diazepam

It may produce blood dyscrasias

It is not known to cause dependence

Answer and Explanation

The Correct Answer is D

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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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.

A. “Can you give me an example of what you mean by pusillanimous?” B. “I understand what you’re saying. Bad dreams leave me feeling tired, too.” C. “It sounds as though you were uncomfortable with the content of your dream.” D. “So, all in all, you feel as though you had a rather poor night’s sleep?”

Correct Answer is A

Explanation

Choice A reason: Clarifying “pusillanimous” seeks specific meaning, ensuring accurate understanding of the patient’s emotional state. Dreams reflecting fear or inadequacy may involve amygdala hyperactivity or serotonin imbalances. This promotes therapeutic communication, addressing emotional distress linked to neurobiological stress responses, making it the most appropriate response.

Choice B reason: Relating personal experience shifts focus from the patient, reducing therapeutic effectiveness. Emotional drainage, possibly tied to REM sleep disruptions or cortisol spikes, requires exploration, not nurse self-disclosure. This risks dismissing the patient’s unique neurobiological experience, making it inappropriate for clarification.

Choice C reason: Assuming discomfort generalizes the dream’s impact without clarifying “pusillanimous.” Emotional drainage may reflect amygdala-driven stress responses, but this response lacks specificity. Clarification requires direct exploration of the term to understand its emotional and neurobiological significance, making this less effective.

Choice D reason: Summarizing poor sleep oversimplifies the emotional drainage, potentially linked to serotonin dysregulation or heightened stress responses. It fails to explore “pusillanimous,” missing the dream’s specific emotional content. Clarification requires detailed inquiry into the term’s meaning, making this response inadequate.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is D

Explanation

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?

Correct Answer is A

Explanation

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