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?
“Can you give me an example of what you mean by pusillanimous?”
“I understand what you’re saying. Bad dreams leave me feeling tired, too.”
“It sounds as though you were uncomfortable with the content of your dream.”
“So, all in all, you feel as though you had a rather poor night’s sleep?”
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is D
Explanation
Choice A reason: Linking mental illness to brain disorders, like dopamine imbalances in schizophrenia, is factual and reduces stigma by emphasizing neurobiological causes. This aligns with scientific understanding, not perpetuating blame or stereotypes, making it an incorrect choice for reflecting stigma.
Choice B reason: Genetic predisposition, such as serotonin transporter gene variations, is a scientific explanation for mental illness. This reduces stigma by highlighting biological causes, not personal failings, aligning with evidence-based understanding and making it an incorrect choice for stigmatizing mental illness.
Choice C reason: Recognizing mental illness in children, like ADHD with dopamine deficits, normalizes early diagnosis and treatment. This factual statement reduces stigma by acknowledging neurobiological conditions across ages, making it an incorrect choice for reflecting stigmatizing attitudes toward mental illness.
Choice D reason: Blaming mental illness on family breakdown ignores neurobiological causes, like serotonin or dopamine imbalances, and perpetuates stigma by implying personal or social failure. This judgmental view misrepresents scientific evidence, making it the correct choice for reflecting stigmatizing attitudes toward mental illness.
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