On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?
Decrease dopamine at receptor sites
Inhibit GABA production
Prevent destruction of acetylcholine
Increase dopamine sensitivity
The Correct Answer is C
Choice A reason: Decreasing dopamine is used for disorders like schizophrenia, where excess mesolimbic dopamine causes hallucinations. Memory difficulties, often linked to Alzheimer’s, involve cholinergic deficits, not dopamine excess. Reducing dopamine could worsen cognition by disrupting reward and attention pathways, making this approach scientifically inappropriate for memory issues.
Choice B reason: Inhibiting GABA production is irrelevant for memory. GABA regulates neural inhibition, and its reduction could increase excitability, worsening conditions like seizures. Memory deficits, particularly in dementia, stem from reduced acetylcholine in the hippocampus, not GABA, making this option misaligned with the neurobiology of memory impairment.
Choice C reason: Preventing acetylcholine destruction, via cholinesterase inhibitors, enhances cholinergic activity in the hippocampus and cortex, critical for memory in conditions like Alzheimer’s. Low acetylcholine levels impair neural signaling, causing memory deficits. This approach directly addresses the neurochemical basis of memory difficulties, making it scientifically appropriate for treatment.
Choice D reason: Increasing dopamine sensitivity is relevant for disorders like Parkinson’s, not memory deficits. Dopamine affects motivation and movement, not memory, which relies on acetylcholine in the hippocampus. Enhancing dopamine could disrupt cognitive balance, worsening memory without addressing the cholinergic deficits central to memory impairment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Venlafaxine inhibits serotonin and norepinephrine reuptake, enhancing synaptic levels of these neurotransmitters in the prefrontal cortex and amygdala, improving mood and anxiety. This mechanism aligns with SNRIs, making it the correct choice for treating conditions like depression or anxiety with dual neurotransmitter modulation.
Choice B reason: Propranolol is a beta-blocker, reducing sympathetic activity by blocking norepinephrine at beta receptors, not reuptake. It treats physical anxiety symptoms, not mood via serotonin-norepinephrine pathways. This makes it incorrect for an SNRI, as it lacks reuptake inhibition properties.
Choice C reason: Amitriptyline, a tricyclic antidepressant, inhibits serotonin and norepinephrine reuptake but also affects other receptors, causing significant side effects. It is not classified as an SNRI due to its broader mechanism, making it an incorrect choice compared to venlafaxine’s specific SNRI action.
Choice D reason: Fluoxetine is an SSRI, selectively inhibiting serotonin reuptake, not norepinephrine. It enhances serotonin in mood-regulating areas like the hippocampus but lacks norepinephrine modulation, making it incorrect for an SNRI, which requires dual reuptake inhibition for broader neurotransmitter effects.
Correct Answer is D
Explanation
Choice A reason: Medication education addresses self-actualization or esteem needs in Maslow’s hierarchy, which are lower priority. Psychotic symptoms like hallucinations, driven by dopamine dysregulation, pose immediate safety risks, taking precedence over education, which assumes cognitive stability not yet achieved in acute psychosis, per Maslow’s prioritization.
Choice B reason: Alienation relates to belongingness needs, third in Maslow’s hierarchy. While important, psychotic hallucinations, linked to hyperactive mesolimbic dopamine pathways, indicate a safety threat, a basic physiological need. Addressing safety precedes social needs, as unresolved psychosis can exacerbate isolation, making this a lower priority.
Choice C reason: Reluctance for social activities reflects belongingness needs, lower in Maslow’s hierarchy. Hallucinations, driven by neurochemical imbalances like excess dopamine, pose immediate safety risks, a physiological need. Social participation requires cognitive stability, which is compromised in psychosis, making this issue secondary to urgent safety concerns.
Choice D reason: Hearing voices urging self-protection indicates a safety threat, a basic physiological need in Maslow’s hierarchy. Hallucinations, linked to dopamine overactivity in the mesolimbic pathway, can lead to harmful behaviors. Addressing this stabilizes the patient, taking priority over higher-level needs like social connection or education, per Maslow’s framework.
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