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Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical Applications 5th Edition Test Bank
Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical Applications 5th Edition Test Bank
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TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY:u u u u u
NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 5TH EDITION
u u u u u u u
Stahl's Essential Psychopharmacology u u
Neuroscientific Basis and Practical Applications TESTBANK/STUDY GUIDE u u u u u u
Chapter 1 Chemical neurotransmission
u u u
MULTIPLE CHOICE u
1. A patient with depression mentions to the nurse, My mother says depression isa
u u u u u u u u u u u u u
chemical disorder. What does she mean? The nurses response is based on the
u u u u u u u u u u u u u
theorythat depression primarily involves which of the following
u u u u u u u u
neurotransmitters?
a. Cortisol and GABA u u
b. COMT and glutamate u u
c. Monamine and glycine u u
d. Serotonin and norepinephrine u u
ANS: D u
One possible cause of depression is thought to involve one or more
u u u u u u u u u u u
uneurotransmitters.Serotonin and norepinephrine have been found to be important u u u u u u u u
in the regulation of depression. There is no research to support that the other
u u u u u u u u u u u u u u
uoptions play a significant role in the development of depression.
u u u u u u u u u
2. A patient has experienced a stroke (cerebral vascular accident) that has
u u u u u u u u u u
uresulted in damage to the Broca area. Which evaluation does the nurse conduct to
u u u u u u u u u u u u u
ureinforce thisdiagnosis? u
a. Observing the patient pick up a spoon u u u u u u
b. Asking the patient to recite the alphabet u u u u u u
c. Monitoring the patients blood pressure u u u u
d. Comparing the patients grip strength in both hands u u u u u u u
ANS: B u
Accidents or strokes that damage Brocas area may result in the inability to speak
u u u u u u u u u u u u u
u(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle strength
u u u u u u u u u u u
are notcontrolled by the Broca area of the left frontal lobe.
u u u u u u u u u u u
3. The patient diagnosed with schizophrenia asks why psychotropic medications
u u u u u u u u
are always prescribed by the doctor. The nurses answer will be based on
u u u u u u u u u u u u u
uinformation thatthe therapeutic action of psychotropic drugs is the result of their
u u u u u u u u u u u
effect on: u
a. The temporal lobe; especially Wernickes area
u u u u u
b. Dendrites and their ability to transmit electrical impulses u u u u u u u
c. The regulation of neurotransmitters especially dopamine
u u u u u
d. The peripheral nervous system sensitivity to the psychotropic medications
u u u u u u u u
,ANS: C u
Medications used to treat psychiatric disorders operate in and around the synaptic
u u u u u u u u u u u
cleftand have action at the neurotransmitter level, especially in the case of
u u u u u u u u u u u u
schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
u u u u u u u u u u
sensitivity of the peripheral nervous system are not relevant to either schizophrenia
u u u u u u u u u u u u
or psychotropic medications.
u u u
4. A student nurse mutters that it seems entirely unnecessary to have to struggle
u u u u u u u u u u u u
withunderstanding the anatomy and physiology of the neurologic system. The
u u u u u u u u u u
mentor would base a response on the understanding that it is:
u u u u u u u u u u u
Necessary but generally for psychiatric nurses who focus primarily u u u u u u u u
a. onbehavioral interventions
u u
A complex undertaking that advance practice psychiatric nurses frequently
u u u u u u u u
b. usein their practice
u u u
Important primarily for the nursing assessment of patients with u u u u u u u u
c. braintraumacaused cognitive symptoms
u u u
Necessary for planning psychiatric care for all patients especially u u u u u u u u
d. thoseexperiencing psychiatric disorders
u u u
ANS: D u
Nurses must understand that many symptoms of psychiatric disorders have a
u u u u u u u u u u
neurologic basis, although the symptoms are manifested behaviorally. This
u u u u u u u u u
understanding facilitates effective care planning. The foundation of knowledge is
u u u u u u u u u u
notused exclusively by advanced practice psychiatric nurses nor is it relevant for
u u u u u u u u u u u u
only behavior therapies or brain trauma since dealing with the results of normal
u u u u u u u u u u u u u
and abnormal brain function is a responsibility of all nurses providing all types of
u u u u u u u u u u u u u u
care tothe psychiatric patient.
u u u u
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
u u u u u u u u u u u u u u
herchronic depression? Which response is supported by research data?
u u u u u u u u u
a. Too much stress has been proven to cause all kinds of cancer.
u u u u u u u u u u u
b. There have been no research studies done on stress and disease yet.
u u u u u u u u u u u
c. Stress does cause the release of factors that suppress the immune system.
u u u u u u u u u u u
d. There appears to be little connection between stress and diseases of the body
u u u u u u u u u u u u
ANS: C u
Research indicates that stress causes a release of corticotropin-releasing factors
u u u u u u u u u
that suppress the immune system. Studies indicate that psychiatric disorders suchas
u u u u u u u u u u u u
mooddisorders are sometimes associated with decreased functioning of the
u u u u u u u u u
immune system.Research does not support a connection between many cancers
u u u u u u u u u u
and stress. There is a significant amount of research about stress and the body.
u u u u u u u u u u u u u u
Research has shown that there are some connections between stress and physical
u u u u u u u u u u u
disease.
u
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric
u u u u u u u u u u u u
urehabilitation needs. Of the aspects of functioning listed, which will the nurse
u u u u u u u u u u u
identifyas a focus of nursing intervention?
u u u u u u
a. Expression of emotion u u
b. Detecting auditory stimuli u u
c. Receiving visual images u u
d. Processing associations u
ANS: D u
The parietal lobe is responsible for associating and processing sensory information
u u u u u u u u u u
that allows for functions such as following directions on a map, reading a clock,
u u u u u u u u u u u u u u
udressing self, keeping appointments, and distinguishing right from left. Emotional
u u u u u u u u u
uexpression is associated with frontal lobe function. Detecting auditory stimuli is a
u u u u u u u u u u u
utemporal lobe function. Receiving visual images is related to occipital lobe
u u u u u u u u u u
ufunction.
7. At admission, the nurse learns that some time ago the patient had an infarct in
u u u u u u u u u u u u u u
theright cerebral cortex. During assessment, the nurse would expect to find that
u u u u u u u u u u u u
uthe patient:
u
a. Demonstrates major deficiencies in speech u u u u
b. Is unable to effectively hold a spoon in the left hand
u u u u u u u u u u
c. Has difficulty explaining how to go about using the telephone
u u u u u u u u u
d. Cannot use his right hand to shave himself or comb his own hair u u u u u u u u u u u u
ANS: B u
The cerebral hemispheres are responsible for functions such as control of muscles.
u u u u u u u u u u u
The right hemisphere mainly controls the motor and sensory functions on the left
u u u u u u u u u u u u u
usideof the body. Damage to the right side would result in impaired function on the
u u u u u u u u u u u u u u
left side of the body. The motor cortex controls voluntary motor activity. Brocas
u u u u u u u u u u u u u
uarea controls motor speech. Cognitive functions are attributed to the association
u u u u u u u u u u
ucortex.
The right side of the bodys motor activity is controlled by the left cerebral cortex.
u u u u u u u u u u u u u u
8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
u u u u u u u u u u
uThepatient will be discharged on low doses of haloperidol. The nurse will need to
u u u u u u u u u u u u u
individualize the patients medication teaching by:
u u u u u u
a. Including the patients caregiver in the education u u u u u u
b. Being careful to stress the importance of taking the medication as prescribed
u u u u u u u u u u u
Providing the education at a time when the patient is emotionally calm
u u u u u u u u u u u
c. andrelaxed
u
Encouraging the patient to crush or dissolve the medication to help u u u u u u u u u u
d. withswallowing
u
ANS: A u
, The hippocampus plays a major role in short-term memory and, hence, in learning.
u u u u u u u u u u u u
Taking the medication as prescribed and providing the education at a time when
u u u u u u u u u u u u u
the patient is calm and relaxed is information or considerations that allpatients
u u u u u u u u u u u u u
should begiven. The medication does not necessarily need to be crushed or
u u u u u u u u u u u u
dissolved since the stroke would not have caused difficulty with swallowing.
u u u u u u u u u u u
9. The physician tells the nurse, The medication Im prescribing for the
u u u u u u u u u u
patient enhances the g-aminobutyric acid (GABA) system. Which patient
u u u u u u u u u
behavior willprovide evidence that the medication therapy is successful?
u u u u u u u u u
a. The patient is actively involved in playing cards with other patients.
u u u u u u u u u u
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
u u u u u u u u u u u u u u u u
c. The patient reports that both auditory and visual hallucinations have
u u u u u u u u u
decreased.
u
d. The patient says that, I am much happier than before I came to the hospital.
u u u u u u u u u u u u u u
ANS: B u
GABA is the principle inhibitory neurotransmitter. The medication should provide
u u u u u u u u u
anantianxiety effect. Alertness, psychotic behaviors, and mood elevation are not
u u u u u u u u u u
generally affected by g-aminobutyric acid.
u u u u u
10. The patients family asks whether a diagnosis of Parkinsons disease creates
u u u u u u u u u u
an increased risk for any mental health issues. What question would the nurse
u u u u u u u u u u u u u
ask toassess for such a comorbid condition?
u u u u u u u
a. Has your father exhibited any signs of depression? u u u u u u u
b. Does your father seem to experience mood swings? u u u u u u u
c. Have you noticed your father talking about seeing things you cant see?
u u u u u u u u u u u
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
u u u u u u u u u u u u u
ANS: A u
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the
u u u u u u u u u u
neurotransmitters that are most widely involved in various forms of depression.
u u u u u u u u u u u
Mostresearchers agree that the immediate cause of parkinsonism is a deficiency
u u u u u u u u u u u
of dopamine and so a patient with Parkinsons disease should be monitored for
u u u u u u u u u u u u u
depression, The other mental health disorders (bipolar disorder, hallucinations,
u u u u u u u u u
and obsessive compulsive disorder) have not been connected to Parkinsons
u u u u u u u u u u
disease.
u
11. Which explanation for the prescription of donepezil (Aricept) would the
u u u u u u u u u
nurseprovide for a patient in the early stage of Alzheimers disease?
u u u u u u u u u u u
a. It will increase the metabolism of excess GABA.
u u u u u u u
b. Excess dopamine will be prevented from attaching to receptor sites. u u u u u u u u u
c. Serotonin deficiency will be managed through a prolonged reuptake period. u u u u u u u u u
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
u u u u u u u u
ANS: D u
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