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RNSG2213/RNSG 2213 Mental Health Nursing Review for Exam 2 Level 3 (Answered) Latest Fall 2022.
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RNSG2213/RNSG 2213 Mental Health Nursing Review for Exam 2 Level 3 (Answered) Latest Fall 2022.
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RNSG 2213 - Review for Exam 2 Level 3 2022.A patient asks a nurse, "What are neurotransmitters? My doctor says mine are out of balance."
The best reply would be:
a. "You must feel relieved to know that your problem has a physical basis."
b. "Neurotransmitters are chemicals that pass messages between brain cells."
c. "It is a high-level concept to explain. You should ask the doctor to tell you more."
d. "Neurotransmitters are substances we eat daily that influence memory and mood." ✅- B
Stating that neurotransmitters are chemicals that pass messages between brain cells gives the
most accurate information. Neurotransmitters are messengers in the central nervous system.
They are released from the axon terminal, diffuse across the synapse, and attach to specialized
receptors on the postsynaptic neuron. The incorrect responses do not answer the patient's
question, are demeaning, and provide untrue and misleading information.
The parent of an adolescent with schizophrenia asks a nurse, "My child's doctor ordered a
positron-emission tomography (PET) scan. What is that?" Select the nurse's best reply.
a. "PET uses a magnetic field and gamma waves to identify problems areas in the brain. Does
your teenager have any metal implants?"
b. "It's a special type of x-ray image that shows structures of the brain and whether a brain injury
has ever occurred."
c. "PET is a scan that passes an electrical current through the brain and shows brain wave
activity. PET can help diagnose seizures."
d. "PET is a special scan that shows blood flow and activity in the brain." ✅- D
The parent is seeking information about PET scans. It is important to use terms the parent can
understand. The correct option is the only reply that provides factual information relevant to PET
scans. The incorrect responses describe magnetic resonance imaging (MRI), computed
tomographic (CT) scans, and electroencephalography (EEG).
A patient has dementia. The health care provider wants to make a differential diagnosis between
Alzheimer disease and multiple infarctions. Which diagnostic procedure should a nurse expect to
prepare the patient for first?
a. Computed tomography (CT) scan
b. Positron emission tomography (PET) scan
c. Functional magnetic resonance imaging (fMRI)
d. Single-photon-emission computed tomography (SPECT) scan ✅- A
,A CT scan shows the presence or absence of structural changes, including cortical atrophy,
ventricular enlargement, and areas of infarction—information that will be helpful to the health
care provider. The other tests focus on brain activity and are more expensive; they may be
ordered later.
A patient has delusions and hallucinations. Before beginning treatment with a psychotropic
medication, the health care provider wants to rule out the presence of a brain tumor. For which
test will a nurse need to prepare the patient?
a. Cerebral arteriogram
b. Computed tomography (CT) scan or magnetic resonance imaging (MRI)
c. Positron emission tomography (PET) or single photon emission computed tomography
(SPECT)
d. Functional magnetic resonance imaging (fMRI) ✅- B
A CT scan and an MRI visualize neoplasms and other structural abnormalities. A PET scan,
SPECT scan, and fMRI, which give information about brain function, are not indicated. An
arteriogram would not be appropriate.
The nurse wants to assess for disturbances in circadian rhythms in a patient admitted for
depression. Which question best implements this assessment?
a. "Do you ever see or hear things that others do not?"
b. "Do you have problems with short-term memory?"
c. "What are your worst and best times of day?"
d. "How would you describe your thinking?" ✅- C
Mood changes throughout the day are related to circadian rhythms. Questions about sleep pattern
would also be relevant to circadian rhythms. The question about seeing or hearing things is
relevant to the assessment for illusions and hallucinations. The question about thinking is
relevant to the assessment of thought processes. The other question is relevant to assessment of
memory.
A nurse administers a medication that potentiates the action of gamma- aminobutyric acid
(GABA). Which finding would be expected?
a. Reduced anxiety
b. Improved memory
c. More organized thinking
d. Fewer sensory perceptual alterations ✅- A
,Increased levels of GABA reduce anxiety, thus any potentiation of GABA action should result in
anxiety reduction. Memory enhancement is associated with acetylcholine and substance P.
Thought disorganization is associated with dopamine. GABA is not associated with sensory
perceptual alterations.
On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the
treatment plan for a patient with memory difficulties may include medications designed to:
a. inhibit GABA production.
b. increase dopamine sensitivity.
c. decrease dopamine at receptor sites.
d. prevent destruction of acetylcholine. ✅- D
Increased acetylcholine plays a role in learning and memory. Preventing the destruction of
acetylcholine by acetylcholinesterase results in higher levels of acetylcholine with the potential
for improved memory. GABA is known to affect anxiety level rather than memory. Increased
dopamine causes symptoms associated with schizophrenia or mania rather than improves
memory. Decreasing dopamine at receptor sites is associated with Parkinson disease rather than
improving memory.
A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most
likely show dysfunction in which part of the brain?
a. Brainstem
b. Cerebellum
c. Temporal lobe
d. Prefrontal cortex ✅- D
The prefrontal cortex is responsible for intellectual functioning. The temporal lobe is responsible
for the sensation of hearing. The cerebellum regulates skeletal muscle coordination and
equilibrium. The brainstem regulates internal organs.
A nurse should assess a patient taking a medication with anticholinergic properties for inhibited
function of the:
a. parasympathetic nervous system
b. sympathetic nervous system
c. reticular activating system
d. medulla oblongata ✅- A
, Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic nervous
system. When acetylcholine action is inhibited by anticholinergic drugs, parasympathetic
symptoms such as blurred vision, dry mouth, constipation, and urinary retention appear. The
functions of the sympathetic nervous system, the reticular activating system, and the medulla
oblongata are not affected by anticholinergic medications.
The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter
reuptake, causing:
a. increased concentration of neurotransmitters in the synaptic gap
b. decreased concentration of neurotransmitters in serum
c. destruction of receptor sites
d. limbic system stimulation ✅- A
If the reuptake of a substance is inhibited, then it accumulates in the synaptic gap and its
concentration increases, permitting the ease of the transmission of impulses across the synaptic
gap. Normal transmission of impulses across synaptic gaps is consistent with a normal rather
than a depressed mood. The other options are not associated with blocking neurotransmitter
reuptake.
A patient taking medication for mental illness develops restlessness and an uncontrollable need
to be in motion. A nurse can correctly analyze that these symptoms are related to which drug
action?
a. Anticholinergic effects
b. Dopamine-blocking effects
c. Endocrine-stimulating effects
d. Ability to stimulate spinal nerves ✅- B
Medications that block dopamine often produce disturbances of movement such as akathisia
because dopamine affects neurons involved in both the thought processes and movement
regulation. Anticholinergic effects include dry mouth, blurred vision, urinary retention, and
constipation. Akathisia is not caused by endocrine stimulation or spinal nerve stimulation.
A patient has anxiety, increased heart rate, and fear. The nurse would suspect the presence of a
high concentration of which neurotransmitter?
a. GABA
b. Histamine
c. Acetylcholine
d. Norepinephrine ✅- D
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