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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Socialization and mutual needs define social relationships, not therapeutic ones. Therapeutic relationships focus on patient needs, like addressing serotonin-driven depression, not reciprocal sharing. This approach risks blurring professional boundaries, making it incorrect for psychiatric nursing’s patient-centered focus.
Choice B reason: Mutual growth and satisfaction characterize social partnerships, not therapeutic relationships. In psychiatric care, the focus is on patient recovery, addressing issues like dopamine imbalances, not nurse satisfaction. This option misaligns with the professional, patient-centered nature of therapeutic relationships.
Choice C reason: The therapeutic relationship centers on the patient, addressing issues like amygdala-driven anxiety through collaborative discussion. Solutions, like medication adherence, are patient-driven to promote autonomy, aligning with neurobiological and psychological recovery principles, making this the correct description of the therapeutic dynamic.
Choice D reason: Shifting focus and mutual advice blur professional boundaries, resembling social relationships. Therapeutic relationships prioritize patient needs, like serotonin stabilization, with nurse guidance, not reciprocal advice. This option misrepresents the patient-centered, evidence-based nature of psychiatric therapeutic relationships.
Correct Answer is B
Explanation
Choice A reason: Serotonin acts on 5-HT receptors, not muscarinic or nicotinic subtypes. It modulates mood and behavior but lacks the receptor diversity of acetylcholine. Serotonin’s receptors are G-protein-coupled or ligand-gated, unrelated to muscarinic or nicotinic mechanisms, making it incorrect for this neurotransmitter classification.
Choice B reason: Acetylcholine binds to muscarinic (G-protein-coupled) and nicotinic (ligand-gated) receptors. Muscarinic receptors regulate parasympathetic functions like heart rate, while nicotinic receptors mediate muscle contraction and CNS signaling. This dual receptor system is unique to acetylcholine, making it the correct neurotransmitter for this question.
Choice C reason: Dopamine acts on D1 and D2 receptors, not muscarinic or nicotinic subtypes. It regulates reward and motor functions but lacks the cholinergic receptor classifications. Dopamine’s receptors are G-protein-coupled, not ligand-gated like nicotinic, making it an incorrect choice for this neurotransmitter property.
Choice D reason: GABA binds to GABA-A (ligand-gated) and GABA-B (G-protein-coupled) receptors, not muscarinic or nicotinic. It inhibits neural activity, unrelated to cholinergic systems. GABA’s receptors mediate inhibitory signaling, not the excitatory or parasympathetic functions of muscarinic/nicotinic receptors, rendering it incorrect for this question.
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