A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

“You have lost touch with reality, which is a symptom of your illness.”

“It sounds like you’re concerned about your privacy.”

“The government is prohibited from operating in health care facilities.”

“Let’s talk about something other than the government.”

Answer and Explanation

The Correct Answer is B

Choice A reason: Labeling paranoia as a loss of reality, while accurate for dopamine-driven delusions, risks alienating the patient. Confronting beliefs directly can increase agitation, as the amygdala amplifies fear responses. A therapeutic response validates emotions, not challenges perceptions, making this less effective.

Choice B reason: Acknowledging privacy concerns validates the patient’s emotions without reinforcing delusions. This reduces anxiety, calming amygdala hyperactivity in paranoia, and builds trust. By focusing on feelings, not the delusion’s content, the nurse fosters a therapeutic alliance, aligning with evidence-based approaches for psychotic disorders.

Choice C reason: Stating government prohibition addresses the delusion’s content, potentially escalating agitation. Paranoia, driven by mesolimbic dopamine excess, resists factual correction. This risks confrontation, undermining trust and therapeutic rapport, making it less effective than validating emotions in managing psychotic symptoms.

Choice D reason: Redirecting to another topic avoids engaging with the patient’s emotional state, missing a therapeutic opportunity. Paranoia, linked to dopamine dysregulation, requires addressing underlying fears to reduce amygdala-driven anxiety. Ignoring the concern can increase mistrust, making this response less therapeutic.

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Correct Answer is D

Explanation

Choice A reason: Flow and expression are not standard communication model elements. Communication involves sender, receiver, message, and feedback, with neural processing in the cortex enabling understanding. This option omits message, critical for transmitting meaning, making it scientifically incomplete for the communication process.

Choice B reason: Flow is not a recognized component of communication models. Sender, receiver, message, and feedback facilitate information exchange, with neural pathways like the auditory cortex processing signals. Omitting feedback, essential for verifying understanding, renders this option inaccurate for describing communication dynamics.

Choice C reason: Gesture is a channel, not a core element. The communication model includes sender, receiver, message, and feedback, processed via sensory and cognitive neural networks. Excluding the receiver, critical for decoding messages, makes this option incomplete and incorrect for the model’s structure.

Choice D reason: Sender, receiver, message, and feedback are core elements of communication. The sender encodes the message, the receiver decodes it via cortical processing, and feedback confirms understanding. This model reflects neurobiological communication processes, making it the accurate description of the communication framework.

A. Structure of the therapeutic milieu of most behavioral health units B. Assessment tools based on age-appropriate versus arrested behaviors C. Frequent use of restraint and seclusion for behavior modification D. Use of the nursing process to determine the best sequence for nursing actions

Correct Answer is A

Explanation

Choice A reason: Sullivan’s interpersonal theory emphasizes therapeutic relationships and social environments to foster mental health. The therapeutic milieu, structured to promote safety and interaction, aligns with Sullivan’s focus on interpersonal dynamics, reducing symptoms like anxiety through supportive settings, which stabilize neurotransmitter imbalances, enhancing patient recovery on psychiatric units.

Choice B reason: Sullivan’s theory does not focus on age-appropriate versus arrested behaviors. It emphasizes interpersonal relationships, not developmental stages. Assessment tools for behavior typically rely on other frameworks, like Erikson’s, which address developmental milestones, not Sullivan’s interpersonal model, making this option scientifically inaccurate for the theory’s application.

Choice C reason: Restraint and seclusion are not part of Sullivan’s theory, which promotes therapeutic relationships to reduce anxiety, not coercive measures. These interventions contradict Sullivan’s focus on supportive environments, as they may exacerbate stress and neurotransmitter dysregulation, such as increased cortisol, worsening mental health outcomes in psychiatric settings.

Choice D reason: The nursing process is a general framework, not specific to Sullivan’s theory. Sullivan’s interpersonal model focuses on relationships to alleviate symptoms, not on sequencing nursing actions. While the nursing process guides care, it is not derived from Sullivan’s principles, making this option unrelated to his theoretical application.

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A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following options best describes the basic elements of the communication model?

Correct Answer is D

Explanation

A nursing student says, “Little of what takes place on the behavioral health unit seems to be theory-based.” A nurse educates the student by identifying which is a common use of Sullivan’s theory on the inpatient psychiatric unit?

Correct Answer is A

Explanation

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