After teaching a class about the rights of persons receiving mental health services, the nurse determines a need for additional discussion when the group wrongly identifies which as a right?

Freedom from restraints or seclusion

Refusal of treatment during an emergency situation

Access to one’s own mental health records upon request

An individualized written treatment plan

Answer and Explanation

The Correct Answer is B

Choice A reason: Freedom from restraints or seclusion is a recognized right unless safety is compromised. Restraints, used for severe agitation linked to dopamine or serotonin imbalances, must be justified and minimized to respect patient dignity, aligning with ethical standards in mental health care, making this a valid right.

Choice B reason: Refusing treatment in emergencies, such as acute psychosis with safety risks, is not a right. Emergency interventions, like antipsychotics for dopamine-driven hallucinations, prioritize safety over autonomy. Legal frameworks allow treatment without consent in such cases, making this an incorrect right, requiring further discussion.

Choice C reason: Access to mental health records is a patient right, supporting autonomy and transparency. Understanding one’s diagnosis, like serotonin-related depression, empowers informed decisions. This right is protected under health privacy laws, ensuring patients can review their neurobiological and treatment data, making it a valid right.

Choice D reason: An individualized treatment plan is a right, ensuring care tailored to specific neurobiological needs, like dopamine modulation in schizophrenia. This promotes effective treatment and patient involvement, aligning with ethical standards. It is a recognized right in mental health care, not requiring further discussion.

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Correct Answer is C

Explanation

Choice A reason: Hydroxyzine, an antihistamine, reduces anxiety via sedation but is not specific for performance anxiety. It blocks histamine receptors, not sympathetic responses like tachycardia in stage fright. Propranolol better targets physical symptoms, making hydroxyzine less effective for this specific anxiety type.

Choice B reason: Imipramine, a tricyclic, treats generalized anxiety or depression via serotonin-norepinephrine reuptake inhibition but is not ideal for performance anxiety. Its slow onset and side effects make it unsuitable for acute, situational sympathetic activation, unlike propranolol’s rapid effect on physical symptoms.

Choice C reason: Propranolol, a beta-blocker, reduces sympathetic symptoms like tachycardia and trembling in performance anxiety by blocking norepinephrine at beta receptors. This calms physical manifestations of amygdala-driven fear, making it the preferred choice for situational anxiety, aligning with evidence-based treatment for performance anxiety.

Choice D reason: Buspirone enhances serotonin for chronic anxiety but takes weeks to act, unsuitable for acute performance anxiety. Sympathetic activation in stage fright requires rapid beta-blockade, not gradual serotonin modulation, making buspirone incorrect for the immediate needs of this condition.

A. “You have lost touch with reality, which is a symptom of your illness.” B. “It sounds like you’re concerned about your privacy.” C. “The government is prohibited from operating in health care facilities.” D. “Let’s talk about something other than the government.”

Correct Answer is B

Explanation

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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After teaching a class about the rights of persons receiving mental health services, the nurse determines a need for additional discussion when the group wrongly identifies which as a right?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient reports experiencing performance anxiety in front of an audience. The nurse should be aware that this type of anxiety is often treated with which medication?

Correct Answer is C

Explanation

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?

Correct Answer is B

Explanation

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?

After a client has been prescribed fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?

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?

A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Which medication would be considered a first-line medication therapy for generalized anxiety disorder (GAD)?

Your patient sometimes forgets to eat. In which part of the nursing care plan would the nurse expect to find this statement: “Offer snacks and finger foods frequently”?

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