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: Muscarinic receptor blockers inhibit parasympathetic activity, reducing salivary gland secretion via acetylcholine pathways. This causes dry mouth, as muscarinic receptors in salivary glands are blocked, decreasing saliva production. This anticholinergic effect is common in drugs like benztropine, requiring assessment to manage discomfort and prevent oral health issues.
Choice B reason: Orthostatic hypotension is linked to alpha-1 adrenergic blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic pathways, not vascular tone regulated by norepinephrine. While autonomic effects occur, hypotension is not a primary consequence, making this side effect unrelated to muscarinic receptor antagonism.
Choice C reason: Pseudoparkinsonism results from dopamine receptor blockade, common in antipsychotics, not muscarinic blockers. Muscarinic receptors regulate parasympathetic functions like salivation, not motor control. Blocking muscarinic receptors may alleviate parkinsonism by balancing cholinergic-dopaminergic activity, making this an incorrect side effect for assessment.
Choice D reason: Gynecomastia is associated with hormonal imbalances or dopamine blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic systems, not prolactin or estrogen pathways. This side effect is unrelated to muscarinic antagonism, which primarily causes anticholinergic effects like dry mouth, not endocrine changes.
Correct Answer is B
Explanation
Choice A reason: Discussing ego states is rooted in transactional analysis, not cognitive therapy. Ego states involve conscious and unconscious personality aspects, unrelated to addressing cognitive distortions like negative self-perception in inadequacy. Cognitive therapy targets thought patterns, not personality structures, making this approach scientifically irrelevant for the described intervention.
Choice B reason: Cognitive therapy focuses on identifying and modifying distorted thoughts, such as irrational beliefs about inadequacy, which are linked to altered serotonin and dopamine signaling in depression. By restructuring these thoughts, the therapy improves emotional regulation and behavior, aligning with evidence-based treatment for addressing feelings of inadequacy.
Choice C reason: Negative reinforcement is a behavioral therapy technique, not cognitive therapy. It involves removing aversive stimuli to increase desired behaviors, unrelated to addressing cognitive distortions like self-blame. Cognitive therapy targets thought patterns, not behavioral conditioning, making this approach scientifically inappropriate for the described therapeutic context.
Choice D reason: Focusing on unconscious processes is psychoanalytic, not cognitive, therapy. Inadequacy feelings stem from conscious cognitive distortions, not unconscious conflicts. Cognitive therapy corrects faulty thinking linked to neurotransmitter imbalances, not repressed memories, making this option misaligned with the scientific basis of the therapy described.
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