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Test bank for Stahl’s EssentialPsychopharmacology 5thEdition||
Complete Test Bank|| Rated A++.
Chapter 1 Chemical neurotransmission
MULTIPLE CHOICE
• A patient with depression mentions to the nurse, My mother
says depression is a chemical disorder. What does she mean? The
nurses response is based on the theory
that depression primarily involves which of the following
neurotransmitters?
• Cortisol and GABA
• COMT and glutamate
• Monamine and glycine
• Serotonin
and norepinephrine
ANS: D
One possible cause of depression is thought to involve one or more
neurotransmitters.
Serotonin and norepinephrine have been found to be important in
the regulation of depression. There is no research to support that
the other options play a significant role in the development of
depression.
• A patient has experienced a stroke (cerebral vascular accident) that
has resulted in damage to the Broca area. Which evaluation does the
nurse conduct to reinforce this diagnosis?
• Observing the patient pick up a spoon
• Asking the patient to recite the alphabet
• Monitoring the patients blood pressure
• Comparing the patients grip
strength in both hands ANS: B
, Accidents or strokes that damage Brocas area may result in the inability to
speak (i.e.,
motor aphasia). Fine motor skills, blood pressure control, and muscle
strength are notcontrolled by the Broca area of the left frontal lobe.
• The patient diagnosed with schizophrenia asks why psychotropic
medications are always prescribed by the doctor. The nurses answer
will be based on information that
the therapeutic action of psychotropic drugs is the result of their effect on:
• The temporal lobe; especially Wernickes area
• Dendrites and their ability to transmit electrical impulses
• The regulation of neurotransmitters especially dopamine
• The peripheral nervous system sensitivity to the psychotropic
medications
ANS: C
Medications used to treat psychiatric disorders operate in and around
the synaptic cleftand have action at the neurotransmitter level,
especially in the case of schizophrenia, on dopamine. The Wernickes
area, dendrite function, or the sensitivity of the peripheral nervous
system are not relevant to either schizophrenia or psychotropic
medications.
• A student nurse mutters that it seems entirely unnecessary to
have to struggle withunderstanding the anatomy and physiology of
the neurologic system. The mentor would base a response on the
understanding that it is:
Necessary but generally for psychiatric nurses who focus primarily
on
a.
b.
c.
d.
ANS: D
behavioral interventions
,A complex undertaking that advance practice psychiatric nurses frequently usein
their practice
Important primarily for the nursing assessment of patients with braintraumacaused
cognitive symptoms
Necessary for planning psychiatric care for all patients especially those
experiencing psychiatric disorders
Nurses must understand that many symptoms of psychiatric
disorders have a neurologic basis, although the symptoms are
manifested behaviorally. This understanding facilitates effective care
planning. The foundation of knowledge is not used exclusively by
advanced practice psychiatric nurses nor is it relevant for only
behavior therapies or brain trauma since dealing with the results of
normal and abnormal brain function is a responsibility of all nurses
providing all types of care to the psychiatric patient.
• A patient asks the nurse, My wife has breast cancer. Could it
be caused by herchronic depression? Which response is
supported by research data?
• Too much stress has been proven to cause all kinds of cancer.
• There have been no research studies done on stress and disease yet.
• Stress does cause the release of factors that suppress the immune
system.
• There appears to be little connection between stress and
diseases of the bodyANS: C
Research indicates that stress causes a release of corticotropin-releasing
factors that
suppress the immune system. Studies indicate that psychiatric
disorders such as mood disorders are sometimes associated with
decreased functioning of the immune system.Research does not
support a connection between many cancers and stress. There is a
significant amount of research about stress and the body. Research
has shown that there are some connections between stress and
physical disease.
• A patient who has a parietal lobe injury is being evaluated for
psychiatric rehabilitation needs. Of the aspects of functioning listed,
which will the nurse identifyas a focus of nursing intervention?
• Expression of emotion
• Detecting auditory stimuli
, • Receiving visual images
• Proces
sing
associations
ANS: D
The parietal lobe is responsible for associating and processing sensory
information
that allows for functions such as following directions on a map,
reading a clock, dressing self, keeping appointments, and
distinguishing right from left. Emotional expression is associated
with frontal lobe function. Detecting auditory stimuli is a temporal
lobe function. Receiving visual images is related to occipital lobe
function.
• At admission, the nurse learns that some time ago the patient
had an infarct in theright cerebral cortex. During assessment, the
nurse would expect to find that the patient:
• Demonstrates major deficiencies in speech
• Is unable to effectively hold a spoon in the left hand
• Has difficulty explaining how to go about using the telephone
• Cannot use his right hand to shave himself or
comb his own hairANS: B
The cerebral hemispheres are responsible for functions such as control of
muscles.
The right hemisphere mainly controls the motor and sensory
functions on the left sideof the body. Damage to the right side
would result in impaired function on the left side of the body. The
motor cortex controls voluntary motor activity. Brocas area controls
motor speech. Cognitive functions are attributed to the association
cortex.
The right side of the bodys motor activity is controlled by the left cerebral
cortex.
• A patient with chronic schizophrenia had a stroke involving the
hippocampus. Thepatient will be discharged on low doses of
haloperidol. The nurse will need to individualize the patients
medication teaching by:
• Including the patients caregiver in the education
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