Which principle should guide the nurse in determining when to use silence during a patient interview?

Choice A reason: Buspirone is not used as needed; it requires weeks for serotonin modulation to reduce anxiety. Diazepam’s rapid GABA enhancement suits acute use. Buspirone’s chronic dosing schedule makes this characteristic incorrect for explaining its preference over diazepam for long-term anxiety management.

Choice B reason: Buspirone is slower-acting, taking weeks to enhance serotonin activity, unlike diazepam’s rapid GABA-mediated effects. For anxiety driven by amygdala hyperactivity, diazepam acts faster, making buspirone’s slower onset an incorrect reason for its prescription over diazepam in this context.

Choice C reason: Blood dyscrasias are not a known side effect of buspirone, which primarily affects serotonin receptors. This is unrelated to its preference over diazepam, which carries dependence risks. This characteristic is inaccurate and irrelevant to the rationale for choosing buspirone.

Choice D reason: Buspirone’s lack of dependence risk, unlike diazepam’s GABA-mediated addiction potential, makes it safer for long-term anxiety management. By enhancing serotonin in the prefrontal cortex, it reduces chronic anxiety without habit-forming effects, aligning with its preference for sustained treatment, making this the correct reason.

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.