When assessing patients at a mental health clinic, how should their current level of overall functioning be judged?

Choice A reason: Serotonin modulates mood and anxiety but is not primarily linked to schizophrenia’s core symptoms. While serotonin imbalances contribute to depression, schizophrenia’s hallucinations and delusions stem from dopamine hyperactivity in the mesolimbic pathway, making serotonin an incorrect choice for this disorder’s pathophysiology.

Choice B reason: GABA inhibits neural activity, and its dysfunction is linked to anxiety or seizures, not schizophrenia’s positive symptoms. Schizophrenia involves dopamine excess in the mesolimbic pathway, not GABA deficits. GABA’s role is secondary, making it an inaccurate choice for explaining hallucinations and delusions.

Choice C reason: Dopamine hyperactivity in the mesolimbic pathway causes hallucinations, delusions, and bizarre behavior in schizophrenia. Excess dopamine signaling disrupts cognitive and perceptual processes, leading to positive symptoms. Antipsychotics target D2 receptors to reduce these effects, confirming dopamine’s central role in schizophrenia’s pathophysiology.

Choice D reason: Acetylcholine is involved in memory and attention, not schizophrenia’s core symptoms. While cholinergic deficits occur in dementia, schizophrenia’s hallucinations and delusions are driven by dopamine dysregulation, not acetylcholine. This makes acetylcholine an incorrect choice for the neurotransmitter associated with these symptoms.

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.