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?

Choice A reason: Histamine blockade, as in antipsychotics like olanzapine, promotes sedation, not weight loss. Weight gain is common due to histamine’s role in appetite regulation via hypothalamic signaling. Weight loss is not a typical side effect, making this response inaccurate for histamine-blocking medications.

Choice B reason: Histamine receptor blockade, common in medications like quetiapine, reduces wakefulness by inhibiting histamine’s alerting effects in the cortex. This causes drowsiness, a frequent side effect in psychiatric treatments, aligning with the pharmacological mechanism and making this the correct response.

Choice C reason: Insomnia is not typical with histamine blockade, which promotes sedation. Histamine enhances alertness; blocking it, as in antihistaminic antipsychotics, induces sleepiness, not wakefulness. This response contradicts the neuropharmacological effect, making it incorrect for expected side effects.

Choice D reason: Blood pressure increase is unrelated to histamine blockade. Histamine affects wakefulness and appetite, not vascular tone directly. Antihistaminic drugs may cause orthostatic hypotension via other receptors, not hypertension, making this response inaccurate for histamine-blocking medication effects.

Choice A reason: Minimizing suicide as drastic dismisses the patient’s emotional pain, linked to serotonin deficits and amygdala hyperactivity in depression. This lacks empathy, risking alienation and worsening despair, as it fails to acknowledge the neurobiological severity of suicidal ideation, making it inappropriate.

Choice B reason: Acknowledging intense upset validates the patient’s emotional state, reflecting serotonin-driven despair in suicide attempts. Empathy, engaging mirror neurons, fosters trust and reduces isolation, aligning with therapeutic principles to support neurobiological stabilization and emotional recovery in psychiatric care.

Choice C reason: Offering to solve problems focuses on solutions, not empathy. Suicidal ideation, tied to prefrontal cortex dysfunction, requires emotional validation first. This statement risks dismissing feelings, reducing therapeutic connection, and is less effective than acknowledging the patient’s emotional distress.

Choice D reason: Expressing personal sadness shifts focus to the nurse’s feelings, not the patient’s. Empathy requires reflecting the patient’s emotional state, like despair from serotonin imbalances, to build rapport. This statement, while sympathetic, is less empathic, making it incorrect for demonstrating true empathy.