A patient presents to the PMHNP with report of having anxiety, frequent occurrences of feeling frozen in place and like his heart is pounding out of his chest, as well as having difficulty sleeping. The PMHNP suspects the patient has an elevated level of which neurotransmitter?

Correct Answer: C

Rationale: The correct answer is C: Norepinephrine. Symptoms described by the patient, such as feeling frozen, heart pounding, and difficulty sleeping, are consistent with increased arousal and anxiety, which are associated with elevated levels of norepinephrine. Norepinephrine is a neurotransmitter involved in the body's stress response, triggering the "fight or flight" reaction. Serotonin (Choice A) is more related to mood regulation and emotions, while GABA (Choice B) is an inhibitory neurotransmitter that helps regulate anxiety. Dopamine (Choice D) is involved in reward and pleasure pathways, not directly associated with the symptoms described. Thus, the correct choice is C, norepinephrine, due to its role in stress response and arousal.

Correct Answer: B

Rationale: Step 1: EPS stands for Extrapyramidal Symptoms, which are side effects commonly associated with antipsychotic medications. Step 2: Tardive dyskinesia is a type of EPS characterized by abnormal, repetitive facial and tongue movements. Step 3: Teaching about tardive dyskinesia is important because it is a serious, potentially irreversible side effect. Step 4: Teaching patients to recognize signs of tardive dyskinesia helps in early detection and management. Step 5: Choices A, C, and D describe other types of EPS symptoms, not tardive dyskinesia, making them incorrect. Step 6: Therefore, the correct teaching about EPS related to tardive dyskinesia aligns with choice B.

Correct Answer: D

Rationale: The correct answer is D, as playacting as a police officer and causing fear in other children could be a potential symptom of traumatization. This behavior may stem from experiencing or witnessing traumatic events, leading the child to reenact them to make sense of their feelings and gain a sense of control. The child may be processing feelings of powerlessness or fear related to trauma through this play. A: The need to dominate others - While the behavior may involve exerting control, it is more likely a coping mechanism for trauma rather than a desire to dominate. B: Inventing traumatic events - There is no indication that the child is inventing traumatic events; rather, the behavior suggests a response to real trauma. C: A need to develop close relationships - The behavior is not indicative of seeking close relationships but rather a way of expressing distress and trying to make sense of traumatic experiences.

Correct Answer: B

Rationale: The correct answer is B: Administering anti-anxiety medication as prescribed. This option is the most appropriate because severe anxiety may require pharmacological intervention to quickly alleviate symptoms and provide relief. Anti-anxiety medication can help regulate neurotransmitters and reduce overwhelming anxiety. Choice A is incorrect as immediate confrontation of fears may exacerbate anxiety symptoms. Choice C is incorrect as simply telling a patient to calm down may not effectively address severe anxiety. Choice D is incorrect as distraction through conversation and humor may not be sufficient for severe anxiety and may not address the underlying issue. In summary, pharmacological intervention is the most effective and immediate approach for managing severe anxiety.

Correct Answer: B

Rationale: The correct answer is B because engaging the patient in a discussion about the benefits of the medications and addressing their concerns is the most appropriate action. This approach promotes patient-centered care, helps to understand the reasons for non-compliance, and allows for collaborative problem-solving. It fosters trust and communication between the patient and healthcare provider, leading to a higher likelihood of adherence to the prescribed treatment plan. Choice A is incorrect because judging the patient may lead to defensive reactions and hinder open communication. Choice C is incorrect as ignoring the issue can result in worsening health outcomes. Choice D is incorrect as providing reassurance without addressing the underlying reasons for non-compliance may not effectively resolve the issue.