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TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY: NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION
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Neuroscientific Basis and Practical Application
,Chapter 01: Chemical neurotransmission
MULTIPLE CHOICE
1. A patient with depression mentions to the nurse, my mother says depression isa
chemical disorder. What does she mean? The nurse’s response is based on the
theory that depression primarily involves which of the following
neurotransmitters?
a. Cortisol and GABA
b. COMT and glutamate
c. Monamine and glycine
d. 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 importantin
the regulation of depression. There is no research to support that the other options
play a significant role in the development of depression.
2. A patient has experienced a stroke (cerebral vascular accident) that has resultedin
damage to the Broca area. Which evaluation does the nurse conduct to reinforce
this diagnosis?
a. Observing the patient pick up a spoon
b. Asking the patient to recite the alphabet
c. Monitoring the patients’ blood pressure
d. Comparing the patients grip strength in both hands
Ans: B
Accidents or strokes that damage Broca’s area may result in the inability to speak (i.e.,
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not
controlled by the Broca area of the left frontal lobe.
3. 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
a. The temporal lobe; especially Wernicke’s area
b. Dendrites and their ability to transmit electrical impulses
c. The regulation of neurotransmitters especially dopamine
d. The peripheral nervous system sensitivity to the psychotropic medications
Ans: C
Medications used to treat psychiatric disorders operate in and around the synaptic
cleft and have action at the neurotransmitter level, especially in the case of
,schizophrenia, on dopamine. The Wernicke’s area, dendrite function, or the
sensitivity of the peripheral nervous system are not relevant to either schizophreniaor
psychotropic medications.
4. A student nurse mutters that it seems entirely unnecessary to have to struggle
with understanding the anatomy and physiology of the neurologic system. The
mentor would base a response on the understanding that it is:
a. Necessary but generally for psychiatric nurses who focus primarily on behavioral
interventions
b. A complex undertaking that advances practice psychiatric nurses frequently use in
their practice
c. Important primarily for the nursing assessment of patients with brain trauma caused
cognitive symptoms
d. Necessary for planning psychiatric care for all patients especially those experiencing
psychiatric disorders
Ans: D
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.
5. A patient asks the nurse, my wife has breast cancer. Could it be caused by
her chronic depression? Which response is supported by research data?
a. Too much stress has been proven to cause all kinds of cancer.
b. There have been no research studies done on stress and disease yet.
c. Stress does cause the release of factors that suppress the immune system.
d. There appears to be little connection between stress and diseases of the body
ANS: 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 immunesystem.
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.
, 6. 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
identify as a focus of nursing intervention?
a. Expression of emotion
b. Detecting auditory stimuli
c. Receiving visual images
d. Processing 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.
7. At admission, the nurse learns that some time ago the patient had an infarct in
the right cerebral cortex. During assessment, the nurse would expect to find that
the patient:
a. Demonstrates major deficiencies in speech
b. Is unable to effectively hold a spoon in the left hand
c. Has difficulty explaining how to go about using the telephone
d. Cannot use his right hand to shave himself or comb his own hair
ANS: 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
side of 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. Broca’s
area controls motor speech. Cognitive functions are attributed to the association
cortex.
The right side of the body’s motor activity is controlled by the left cerebral cortex.
8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
The patient will be discharged on low doses of haloperidol. The nurse will need
toindividualize the patient’s medication teaching by:
a. Including the patient’s caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed
c. Providing the education at a time when the patient is emotionally calm and relaxed
d. Encouraging the patient to crush or dissolve the medication to help
With swallowing
ANS: A
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