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 C

Explanation

Choice A reason: Projection involves attributing one’s issues to others, not ignoring symptoms. The patient’s dismissal of serious symptoms, like weight loss, suggests denial, not projection. These symptoms may indicate physiological issues, not psychological attribution, making projection incorrect for this defense mechanism.

Choice B reason: Regression involves reverting to childish behaviors, not ignoring symptoms. The patient’s claim of a minor cold despite weight loss and fatigue reflects denial, not regression. These symptoms suggest a serious condition, not immature coping, making this an incorrect defense mechanism.

Choice C reason: Denial involves refusing to acknowledge serious symptoms, like weight loss and fatigue, which may indicate a medical condition. By attributing them to a minor cold, the patient avoids reality, a common defense in stress-related cortisol spikes, making this the correct mechanism.

Choice D reason: Displacement redirects emotions to another target, not ignoring symptoms. The patient’s minimization of serious health issues, like fatigue, reflects denial, not redirected feelings. This mechanism is unrelated to dismissing physical symptoms, making it incorrect for the described behavior.

A. Involuntary, excessive continuation or repetition of a single response or idea B. Has a lack of a logical relationship between thoughts, making the speech vague, diffuse, and unfocused C. Overproductive speech which rapidly moves from topic to topic with a tenuous logical link between topics D. Provides a lot of unnecessary detail, never returns to the central point, and never answers the question

Correct Answer is D

Explanation

Choice A reason: Involuntary repetition, or perseveration, involves repeating a single idea, often due to frontal lobe dysfunction in disorders like schizophrenia. Unlike tangential thinking, it fixates on one thought without divergence, making it distinct and incorrect for describing the diffuse, off-point speech of tangentially.

Choice B reason: Lacking logical relationships describes loose associations, not tangential thinking. Loose associations, seen in schizophrenia, reflect disorganized thoughts due to dopamine dysregulation, jumping illogically between ideas. Tangentiality diverges with excessive detail, staying somewhat related but off-point, making this option incorrect.

Choice C reason: Overproductive speech with tenuous links describes flight of ideas, common in mania with elevated dopamine. Unlike tangentiality, it involves rapid topic shifts with loose connections, not excessive detail missing the point. This distinction makes it an incorrect choice for tangential thinking.

Choice D reason: Tangential thinking involves excessive, irrelevant details, failing to return to the original question, often seen in schizophrenia or mania. This reflects disrupted executive function in the prefrontal cortex, impairing focus. The description matches this pattern, making it the correct choice for tangential speech.

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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 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?

Correct Answer is C

Explanation

Which of the following speech patterns is an example of tangential thinking?

Correct Answer is D

Explanation

A patient reports experiencing performance anxiety in front of an audience. The nurse should be aware that this type of anxiety is often treated with which medication?

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

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?

Which patient would a nurse refer to partial hospitalization?

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

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Which neurotransmitter has both muscarinic and nicotinic receptor subtypes?