After assessing the patient and formulating the nursing diagnoses for a plan of care, what is the next action a nurse should take?

Determine the goals and outcome criteria

Design interventions to include in the plan of care

Implement the nursing plan of care

Complete the spiritual assessment

Answer and Explanation

The Correct Answer is A

Choice A reason: After diagnosis, setting goals and outcomes guides care, addressing issues like serotonin-driven depression. Goals, like “improve mood stability,” align with neurobiological needs, ensuring measurable, patient-centered targets. This step precedes interventions, forming the foundation for effective psychiatric treatment planning.

Choice B reason: Designing interventions follows goal-setting. Interventions, like therapy for dopamine imbalances, are based on established outcomes. Acting prematurely without goals risks misaligned care, as neurobiological targets must be defined first, making this step incorrect as the immediate next action.

Choice C reason: Implementation occurs after goals and interventions are set. Acting before defining outcomes, like stabilizing GABA for anxiety, risks ineffective care. The nursing process requires sequential planning to address neurobiological deficits, making implementation premature and incorrect at this stage.

Choice D reason: Spiritual assessment, while valuable, is part of initial data collection, not the next step after diagnosis. Goals addressing neurobiological issues, like serotonin deficits, take precedence to ensure targeted care. This option is irrelevant to the immediate planning phase of the nursing process.

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Correct Answer is B

Explanation

Choice A reason: Flooding involves intense, immediate exposure to the feared stimulus, like elevators, overwhelming amygdala-driven fear responses. This contrasts with gradual exposure, which calms norepinephrine surges incrementally. Flooding is less controlled and riskier, making it incorrect for the described gradual relaxation technique.

Choice B reason: Systematic desensitization pairs gradual exposure to a fear, like elevators, with relaxation to reduce amygdala hyperactivity and norepinephrine-driven panic. This counterconditions fear responses, promoting calm neural pathways, aligning with the described technique and making it the correct choice for this therapeutic approach.

Choice C reason: Combination therapy involves multiple modalities, like medication and psychotherapy, not specifically gradual exposure with relaxation. The described technique targets phobia-specific amygdala responses, not a broad approach, making combination therapy too vague and incorrect for this targeted intervention.

Choice D reason: Cognitive restructuring modifies thought patterns, not exposure-based fear responses. While it addresses distorted beliefs, the described technique uses relaxation with gradual exposure to reduce norepinephrine-driven panic, not cognitive reframing, making this incorrect for the specific therapeutic method described.

A. To arise slowly from bed B. To report muscle stiffness C. To chew sugarless gum D. To increase dietary fiber

Correct Answer is B

Explanation

Choice A reason: Arising slowly addresses orthostatic hypotension, a side effect of alpha-1 receptor blockade, not dopamine effects. First-generation antipsychotics primarily block D2 receptors, affecting motor and cognitive pathways, not vascular tone. Hypotension is unrelated to dopaminergic effects, making this teaching point scientifically inaccurate.

Choice B reason: Dopamine D2 receptor blockade in the nigrostriatal pathway causes extrapyramidal symptoms, like muscle stiffness, in first-generation antipsychotics. This mimics Parkinson’s disease due to reduced dopamine signaling, impairing motor control. Teaching patients to report stiffness ensures early detection and management, aligning with the neuropharmacological impact of these drugs.

Choice C reason: Chewing sugarless gum addresses dry mouth, an anticholinergic side effect, not dopaminergic. First-generation antipsychotics block muscarinic receptors, not dopamine, causing reduced salivation. While common, this is unrelated to dopaminergic effects, making this teaching point irrelevant for the specified drug mechanism.

Choice D reason: Increasing dietary fiber addresses constipation, another anticholinergic effect, not dopaminergic. Dopamine blockade affects motor and reward systems, not gastrointestinal motility, which is regulated by muscarinic receptors. This teaching point does not correspond to the dopaminergic effects of first-generation antipsychotics, rendering it incorrect.

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After assessing the patient and formulating the nursing diagnoses for a plan of care, what is the next action a nurse should take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client to use relaxation techniques while gradually exposing the client to getting on an elevator. Which technique is the nurse using?

Correct Answer is B

Explanation

A patient is taking a first-generation antipsychotic medication. What should the nurse teach about the drug’s strong dopaminergic effect?

Correct Answer is B

Explanation

Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?

The nursing student understands that the purpose of completing a process recording for the nurse-patient interview is to:

A client is newly prescribed a medication that will block the effects of histamine for the treatment of a mental health disorder. The client asks, “What side effects should I anticipate with this new medication?” Which response by the nurse is accurate?

A patient presents with anxiety, increased heart rate, and fear. The nurse suspects the activation of which neurotransmitter?

A single parent is experiencing feelings of inadequacy related to work and family since one teenaged child ran away several weeks ago. The parent seeks the help of a therapist specializing in cognitive therapy. What intervention will the psychotherapist introduce?

How can the mental health nurse best advocate for individuals with mental illness and prevent stigmatization?

A patient asks the nurse, “Why did my health care provider prescribe buspirone (Buspar) for my anxiety instead of diazepam (Valium)?” The nurse’s reply is based on the knowledge of which characteristic of buspirone?

Which neurotransmitter is associated with the hallucinations, delusions, and bizarre behavior seen in schizophrenia?