Chapter 1 Chemical neurotransmission
MULTIPLE CHOICE
1.
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 theorythat 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 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.
2.
A patient has experienced a stroke (cerebral vascular accident) that has resulted indamage to the Broca area. Which
evaluation does the nurse conduct to reinforce thisdiagnosis?
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 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.
3.
The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor.
The nurses answer will be based on information thatthe 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
,Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
Applications 5th Edition Testbank/Study Guide
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 Wernickes area, dendrite function, or
the sensitivity of the peripheral nervous system are not relevant to either schizophrenia or psychotropic medications.
4.
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 onbehavioral interventions
a.
A complex undertaking that advance practice psychiatric nurses frequently usein their practice
b.
Important primarily for the nursing assessment of patients with brain traumacaused cognitive
c. symptoms
Necessary for planning psychiatric care for all patients especially thoseexperiencing psychiatric
d.
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 notused 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 tothe psychiatric patient.
5.
A patient asks the nurse, My wife has breast cancer. Could it be caused by herchronic 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 mooddisorders 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.
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 identifyas 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 theright 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 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.
8. 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:
a. Including the patients caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed
Providing the education at a time when the patient is emotionally calm andrelaxed
c.
Encouraging the patient to crush or dissolve the medication to help withswallowing
d.
ANS: A
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