A nurse is teaching a medication class to a group of psychiatric patients. One
of them asks the nurse why he has so much more trouble learning now when
he's in his 60s than he did when he was younger. Which of the following
concepts would the nurse integrate into the response?
A) The extrapyramidal motor system
B) The amygdala
C) Neuroplasticity
D) Psychoneuroimmunology Right Ans - C) Neuroplasticity
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?
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 Right Ans - b. Asking the
patient to recite the alphabet
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 Wernickes 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
Right Ans - c. The regulation of neurotransmitters especially dopamine
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 advance 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 Right Ans - d. Necessary for planning
psychiatric care for all patients especially those experiencing psychiatric
disorders
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 Right Ans - c. Stress does cause the release of factors that suppress
the immune system.
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 Right Ans - d. Processing associations
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 Right Ans -
b. Is unable to effectively hold a spoon in the left hand
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 to individualize the patients medication teaching by:
a. Including the patients 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 Right Ans - a. Including the patients caregiver in the education
The physician tells the nurse, The medication Im prescribing for the patient
enhances the g-aminobutyric acid (GABA) system. Which patient behavior will
provide evidence that the medication therapy is successful?
a. The patient is actively involved in playing cards with other patients.
b. The patient reports that, I don't feel as anxious as I did a couple of days ago.
c. The patient reports that both auditory and visual hallucinations have
decreased.
d. The patient says that, I am much happier than before I came to the hospital.
Right Ans - b. The patient reports that, I don't feel as anxious as I did a couple
of days ago.
The patients family asks whether a diagnosis of Parkinsons disease creates an
increased risk for any mental health issues. What question would the nurse
ask to assess for such a comorbid condition?
a. Has your father exhibited any signs of depression? b. Does your father seem
to experience mood swings?
c. Have you noticed your father talking about seeing things you cant see?
d. Is your dad preoccupied with behaviors that he needs to repeat over and
over? Right Ans - a. Has your father exhibited any signs of depression?
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?
a. Cortisol and GABA
b. COMT and glutamate
c. Monamine and glycine
d. Serotonin and norepinephrine Right Ans - d. Serotonin and
norepinephrine
Which explanation for the prescription of donepezil (Aricept) would the nurse
provide for a patient in the early stage of Alzheimers disease?
a. It will increase the metabolism of excess GABA.
b. Excess dopamine will be prevented from attaching to receptor sites.
, c. Serotonin deficiency will be managed through a prolonged reuptake period.
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
Right Ans - d. The acetylcholine deficiency will be managed by inhibiting
cholinesterase.
There remains a stigma attached to psychiatric illnesses. The psychiatric
nurse makes the greatest impact on this sociological problem when:
a. Providing educational programming for patients and the public
b. Arranging for adequate and appropriate social support for the patient
c. Assisting the patient to achieve the maximum level of independent
functioning
d. Regularly praising the patient for seeking and complying with appropriate
treatment Right Ans - a. Providing educational programming for patients
and the public
The wife of a patient with paranoid schizophrenia tells the nurse, Ive learned
that my husband has several close relatives with the same disorder. Does this
problem run in families? The response based on recent discoveries in the field
of genetics would be: a. Your children should be monitored closely for the
disorder.
b. Research tends to support a familiar tendency to schizophrenia.
c. There is no concrete evidence; it is just as likely a coincidence.
d. Only bipolar disorder has been identified to have a genetic Right Ans - b.
Research tends to support a familiar tendency to schizophrenia.
A patient whose symptoms of mild depression have been managed with
antidepressants is concerned about the affect of accepting a promotion that
will require working the night shift. What will be the basis of the response the
nurse gives to address the patients concern?
a. The connection between a new job and possible depression does exist.
b. The medication can be adjusted to manage any increase in depression.
c. The interruption in normal wake-sleep patterns can influence mood
disorders.
d. The change in sleep routine can be managed with a healthy sleep hygiene
routine. Right Ans - c. The interruption in normal wake-sleep patterns can
influence mood disorders.
The nurse is discouraged because the patient exhibiting negative symptoms of
schizophrenia has shown no improvement with the planned interventions to
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