By which mechanism do SSRI medications improve depression?

Correct Answer: B

Rationale: The correct answer is B. SSRI medications improve depression by making more serotonin available at the synaptic gap. This is achieved by blocking the reuptake of serotonin, allowing it to remain in the synaptic gap longer to exert its effects on mood regulation. This mechanism helps to increase serotonin levels in the brain, which is associated with alleviating depressive symptoms. Choices A, C, and D are incorrect. Choice A is incorrect because SSRI medications do not destroy serotonin; they actually increase its availability. Choice C is incorrect because SSRI medications do not influence the production of acetylcholine and dopamine, but rather target serotonin reuptake. Choice D is incorrect because SSRI medications do not block muscarinic and alpha-1 norepinephrine receptors; they specifically target serotonin reuptake to improve depression.

Correct Answer: B

Rationale: The correct answer is B, the corporate accountant who travels frequently. This patient is at the highest risk for sleep problems due to disruptions in circadian rhythms caused by frequent travel across time zones, leading to jet lag. Travel can also result in irregular sleep patterns, poor sleep quality, and difficulty falling asleep. The other choices are less likely to have significant impacts on sleep physiology. A (retiree volunteering) and C (parent with teenagers) may have some sleep disturbances but not as severe as frequent travelers. D (lawn care worker) may have physical exhaustion but is less likely to experience significant disruptions in sleep physiology compared to frequent travelers.

Correct Answer: B

Rationale: The correct answer is B: Electroencephalogram (EEG). An EEG is used to monitor brain activity during sleep, helping to diagnose sleep disorders like sleep apnea or narcolepsy. It measures electrical activity in the brain, providing valuable information on sleep patterns and any abnormalities. Skull x-rays (A) are not useful for evaluating sleep problems. PET (C) and SPECT (D) scans are imaging techniques that show brain activity but are not specifically designed for sleep evaluation. EEG is the most appropriate choice for assessing sleep-related issues due to its ability to directly measure brain activity during sleep.

Correct Answer: B

Rationale: The correct answer is B: have less slow-wave sleep. When a person takes lorazepam, a benzodiazepine, it acts on the central nervous system by enhancing the effects of the neurotransmitter GABA. This results in a decrease in slow-wave sleep, which is the deep restorative stage of sleep. Lorazepam can reduce the time spent in this stage and may lead to more fragmented sleep patterns. This change in sleep architecture is a common effect of benzodiazepines. Other choices are incorrect because: A: There is no direct correlation between lorazepam and the frequency of dreams. C: Lorazepam can actually decrease sleep latency, making it easier to fall asleep. D: Lorazepam usually does not affect the initial stages of sleep, such as REM sleep.

Correct Answer: B

Rationale: Rationale: 1. By going to bed at the usual time, the patient maintains their regular sleep schedule, minimizing external factors that could affect sleep duration. 2. Waking up without an alarm allows the patient's body to naturally wake up, indicating when they have had sufficient rest. 3. Recording the hours slept for a week and calculating the average provides a more accurate estimate of their total sleep requirement. 4. This method is practical, easy to follow, and directly measures the individual's sleep needs. Summary of other choices: A: Dream content and related feelings do not directly measure sleep requirement. C: Alertness rating may fluctuate due to other factors, not solely sleep duration. D: Prescribing a fixed amount of sleep for all adults does not account for individual variability in sleep needs.