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

Patients withdraw if silences are prolonged

Nurses are responsible for breaking silences

Silence can provide meaningful moments for reflection

Silence helps patients know that what they said is understood

Answer and Explanation

The Correct Answer is C

Choice A reason: Prolonged silences may cause withdrawal in some patients, as anxiety from serotonin or GABA imbalances can heighten discomfort. However, this does not guide silence’s use. Silence is therapeutic when timed appropriately, not avoided due to potential withdrawal, making this principle incorrect.

Choice B reason: Nurses breaking silences assumes discomfort, ignoring therapeutic benefits. Silence allows processing, potentially calming amygdala hyperactivity in anxiety. The nurse’s role is to use silence strategically, not to interrupt it routinely, making this principle misaligned with effective interview techniques.

Choice C reason: Silence facilitates reflection, allowing patients to process emotions, reducing stress via hypothalamic calming. In disorders like depression, it supports cognitive restructuring by giving time to integrate thoughts. This principle guides therapeutic silence, aligning with neurobiological benefits of reflective pauses in interviews.

Choice D reason: Silence does not inherently confirm understanding. It may allow emotional processing, but assuming it signals comprehension risks miscommunication. In conditions like anxiety, silence supports reflection, not validation, making this principle less accurate than reflection for guiding its therapeutic use.

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Correct Answer is A

Explanation

Choice A reason: Blocking norepinephrine at alpha-1 receptors inhibits vasoconstriction, reducing vascular tone. This disrupts baroreceptor-mediated blood pressure regulation, causing orthostatic hypotension when standing. The autonomic nervous system fails to compensate for positional changes, leading to dizziness and fainting, a common side effect of alpha-1 blockers like prazosin.

Choice B reason: Increased psychotic symptoms are linked to dopamine dysregulation, not alpha-1 receptor blockade. Norepinephrine blockade affects autonomic functions, not psychosis, which involves mesolimbic dopamine hyperactivity. This side effect is unrelated to alpha-1 receptors, making this option scientifically inaccurate for the described mechanism.

Choice C reason: Appetite disturbance is typically associated with serotonin or histamine receptor effects, not alpha-1 norepinephrine blockade. Norepinephrine at alpha-1 receptors regulates vascular tone, not appetite control, which involves hypothalamic signaling. This side effect is not a direct consequence of alpha-1 blockade, rendering this option incorrect.

Choice D reason: Hypertensive crisis results from excessive norepinephrine activity, often due to monoamine oxidase inhibitors, not alpha-1 receptor blockade. Blocking alpha-1 receptors causes vasodilation, lowering blood pressure, not raising it. This makes hypertensive crisis an unlikely side effect, contrary to the pharmacological mechanism of alpha-1 blockers.

A. “Am I correct in understanding that…?” B. “What are the common elements here?” C. “Tell me everything from the beginning.” D. “Tell me again about your experiences.”

Correct Answer is A

Explanation

Choice A reason: This question verifies the nurse’s interpretation, ensuring accurate understanding of concerns linked to emotional dysregulation, possibly from serotonin imbalances. It promotes therapeutic communication, engaging prefrontal cortex processing to clarify patient emotions, reducing miscommunication and fostering trust in psychiatric interactions.

Choice B reason: Asking for common elements seeks patterns, not clarification of specific concerns. Emotional concerns, tied to amygdala hyperactivity, require precise understanding. This question is too vague, risking misinterpretation of neurobiological emotional cues, making it less effective for therapeutic clarification in psychiatric care.

Choice C reason: Requesting a full recount is inefficient and may overwhelm patients with anxiety or cognitive deficits, like those from dopamine dysregulation. Clarification needs targeted questions to confirm specific concerns, not a broad restart, making this approach inappropriate for effective therapeutic communication.

Choice D reason: Asking to repeat experiences may frustrate patients and fail to clarify specific points. Emotional concerns, linked to stress-induced cortisol spikes, need focused verification. This vague request risks missing neurobiological nuances, making it less effective than direct confirmation for therapeutic clarification.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following side effects is associated with the blockade of attachment of norepinephrine to alpha-1 receptors?

Correct Answer is A

Explanation

A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?

Correct Answer is A

Explanation

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

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?

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 nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

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?

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

A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient. What is the nurse’s best response to these feelings?

Which of the following options best describes the basic elements of the communication model?