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?

Choice A reason: Lack of support systems may warrant outpatient intervention, not hospitalization. Inpatient care targets acute risks, like suicidal ideation from serotonin deficits. Community support addresses social needs, not immediate safety, making this insufficient for justifying hospitalization in mental health care.

Choice B reason: Hospitalization is reserved for clear danger to self or others, like suicidal or aggressive behaviors from dopamine-driven psychosis. Inpatient settings stabilize acute neurobiological crises, ensuring safety and medication adherence, making this the correct criterion for psychiatric hospitalization.

Choice C reason: New symptoms may require evaluation, but hospitalization is prioritized for safety risks. Symptom changes, like increased anxiety, can often be managed outpatient unless dangerous. This criterion is secondary to immediate risk, making it incorrect for hospitalization justification.

Choice D reason: Medication non-compliance may exacerbate symptoms but does not automatically warrant hospitalization. Outpatient interventions can address adherence unless safety risks, like dopamine-driven aggression, arise. This is not the primary criterion for inpatient care, making it incorrect.

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.