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?

Hydroxyzine (Vistaril)

Imipramine (Tofranil)

Propranolol (Inderal)

Buspirone (Buspar)

Answer and Explanation

The Correct Answer is C

Choice A reason: Hydroxyzine, an antihistamine, reduces anxiety via sedation but is not specific for performance anxiety. It blocks histamine receptors, not sympathetic responses like tachycardia in stage fright. Propranolol better targets physical symptoms, making hydroxyzine less effective for this specific anxiety type.

Choice B reason: Imipramine, a tricyclic, treats generalized anxiety or depression via serotonin-norepinephrine reuptake inhibition but is not ideal for performance anxiety. Its slow onset and side effects make it unsuitable for acute, situational sympathetic activation, unlike propranolol’s rapid effect on physical symptoms.

Choice C reason: Propranolol, a beta-blocker, reduces sympathetic symptoms like tachycardia and trembling in performance anxiety by blocking norepinephrine at beta receptors. This calms physical manifestations of amygdala-driven fear, making it the preferred choice for situational anxiety, aligning with evidence-based treatment for performance anxiety.

Choice D reason: Buspirone enhances serotonin for chronic anxiety but takes weeks to act, unsuitable for acute performance anxiety. Sympathetic activation in stage fright requires rapid beta-blockade, not gradual serotonin modulation, making buspirone incorrect for the immediate needs of this condition.

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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. Venlafaxine (Effexor) B. Propranolol (Inderal) C. Amitriptyline (Elavil) D. Fluoxetine (Prozac)

Correct Answer is A

Explanation

Choice A reason: Venlafaxine inhibits serotonin and norepinephrine reuptake, enhancing synaptic levels of these neurotransmitters in the prefrontal cortex and amygdala, improving mood and anxiety. This mechanism aligns with SNRIs, making it the correct choice for treating conditions like depression or anxiety with dual neurotransmitter modulation.

Choice B reason: Propranolol is a beta-blocker, reducing sympathetic activity by blocking norepinephrine at beta receptors, not reuptake. It treats physical anxiety symptoms, not mood via serotonin-norepinephrine pathways. This makes it incorrect for an SNRI, as it lacks reuptake inhibition properties.

Choice C reason: Amitriptyline, a tricyclic antidepressant, inhibits serotonin and norepinephrine reuptake but also affects other receptors, causing significant side effects. It is not classified as an SNRI due to its broader mechanism, making it an incorrect choice compared to venlafaxine’s specific SNRI action.

Choice D reason: Fluoxetine is an SSRI, selectively inhibiting serotonin reuptake, not norepinephrine. It enhances serotonin in mood-regulating areas like the hippocampus but lacks norepinephrine modulation, making it incorrect for an SNRI, which requires dual reuptake inhibition for broader neurotransmitter effects.

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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?

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 client is prescribed a serotonin-norepinephrine reuptake inhibitor. The nurse would identify that which of the following will be prescribed?

Correct Answer is A

Explanation

Which of the following side effects is associated with the blockade of attachment of norepinephrine to alpha-1 receptors?

A client is newly prescribed a medication that will block the effects of histamine for the treatment of a mental health disorder. The client asks, “What side effects should I anticipate with this new medication?” Which response by the nurse is accurate?

A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client to use relaxation techniques while gradually exposing the client to getting on an elevator. Which technique is the nurse using?

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?

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

Which medication would be considered a first-line medication therapy for generalized anxiety disorder (GAD)?

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

Which principle should guide the nurse in determining when to use silence during a patient interview?