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TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY: NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION

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TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY: NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION

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  • January 29, 2025
  • 136
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • 9781107686465
  • 4th edition
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  • STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY
  • STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY
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Stahl's Essential Psychopharmacology te te



Neuroscientific teBasis teand tePractical teApplications teTESTBANK/STUDY teGUIDE

Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE te


1. A patient with depression mentions to the nurse, My mother says depression
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is a chemical disorder. What does she mean? The nurses response is based on
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the theory that depression primarily involves which of the following
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neurotransmitters?
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a. Cortisol and GABA te te



b. COMT and glutamate te te



c. Monamine and glycine te te



d. Serotonin and norepinephrine te te


ANS: D te


One possible cause of depression is thought to involve one or more
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neurotransmitters. Serotonin and norepinephrine have been found to be important
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in the regulation of depression. There is no research to support that the other
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options play a significant role in the development of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has resulted
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in damage to the Broca area. Which evaluation does the nurse conduct to
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reinforce this diagnosis?
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a. Observing the patient pick up a spoon te te te te te te



b. Asking the patient to recite the alphabet te te te te te te



c. Monitoring the patients blood pressure te te te te



d. Comparing the patients grip strength in both hands te te te te te te te


ANS: B te


Accidents or strokes that damage Brocas area may result in the inability to speak
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(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle
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strength are not controlled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications
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are always prescribed by the doctor. The nurses answer will be based on
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information that the therapeutic action of psychotropic drugs is the result of their
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effect on:
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a. The temporal lobe; especially Wernickes area te te te te te



b. Dendrites and their ability to transmit electrical impulses te te te te te te te



c. The regulation of neurotransmitters especially dopamine
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d. The peripheral nervous system sensitivity to the psychotropic medications
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,ANS: C te


Medications used to treat psychiatric disorders operate in and around the synaptic
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cleft and have action at the neurotransmitter level, especially in the case of
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schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
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sensitivity of the peripheral nervous system are not relevant to either schizophrenia
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or psychotropic medications.
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4. A student nurse mutters that it seems entirely unnecessary to have to struggle
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with understanding the anatomy and physiology of the neurologic system. The
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mentor would base a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily on te te te te te te te te te


a. behavioral interventions
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A complex undertaking that advance practice psychiatric nurses frequently
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b. use in their practice
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Important primarily for the nursing assessment of patients with brain
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c. traumacaused cognitive symptoms
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Necessary for planning psychiatric care for all patients especially those te te te te te te te te te


d. experiencing psychiatric disorders
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ANS: D te


Nurses must understand that many symptoms of psychiatric disorders have a
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neurologic basis, although the symptoms are manifested behaviorally. This
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understanding facilitates effective care planning. The foundation of knowledge is
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not used exclusively by advanced practice psychiatric nurses nor is it relevant for
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only behavior therapies or brain trauma since dealing with the results of normal
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and abnormal brain function is a responsibility of all nurses providing all types of
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care to the psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
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her chronic depression? Which response is supported by research data?
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a. Too much stress has been proven to cause all kinds of cancer.
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b. There have been no research studies done on stress and disease yet.
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c. Stress does cause the release of factors that suppress the immune system.
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d. There appears to be little connection between stress and diseases of the body
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ANS: C te


Research indicates that stress causes a release of corticotropin-releasing factors
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that suppress the immune system. Studies indicate that psychiatric disorders such
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as mood disorders are sometimes associated with decreased functioning of the
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immune system. Research does not support a connection between many cancers
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and stress. There is a significant amount of research about stress and the body.
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Research has shown that there are some connections between stress and physical
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disease.
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,6. A patient who has a parietal lobe injury is being evaluated for psychiatric
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rehabilitation needs. Of the aspects of functioning listed, which will the nurse
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identify as a focus of nursing intervention?
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a. Expression of emotion te te



b. Detecting auditory stimuli te te



c. Receiving visual images te te



d. Processing associations te


ANS: D te


The parietal lobe is responsible for associating and processing sensory information
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that allows for functions such as following directions on a map, reading a clock,
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dressing self, keeping appointments, and distinguishing right from left. Emotional
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expression is associated with frontal lobe function. Detecting auditory stimuli is a
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temporal lobe function. Receiving visual images is related to occipital lobe
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function.
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7. At admission, the nurse learns that some time ago the patient had an infarct in
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the right cerebral cortex. During assessment, the nurse would expect to find that
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the patient:
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a. Demonstrates major deficiencies in speech te te te te



b. Is unable to effectively hold a spoon in the left hand
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c. Has difficulty explaining how to go about using the telephone
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d. Cannot use his right hand to shave himself or comb his own hair
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ANS: B te


The cerebral hemispheres are responsible for functions such as control of muscles.
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The right hemisphere mainly controls the motor and sensory functions on the left
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side of the body. Damage to the right side would result in impaired function on
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the left side of the body. The motor cortex controls voluntary motor activity.
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Brocas area controls motor speech. Cognitive functions are attributed to the
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association cortex.
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The right side of the bodys motor activity is controlled by the left cerebral cortex.
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8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
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The patient will be discharged on low doses of haloperidol. The nurse will need
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to individualize the patients medication teaching by:
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a. Including the patients caregiver in the education te te te te te te



b. Being careful to stress the importance of taking the medication as prescribed
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Providing the education at a time when the patient is emotionally calm and
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c. relaxed
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Encouraging the patient to crush or dissolve the medication to help with te te te te te te te te te te te


d. swallowing
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ANS: A te

, The hippocampus plays a major role in short-term memory and, hence, in
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learning. Taking the medication as prescribed and providing the education at a
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time when the patient is calm and relaxed is information or considerations that all
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patients should be given. The medication does not necessarily need to be crushed
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or dissolved since the stroke would not have caused difficulty with swallowing.
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9. The physician tells the nurse, The medication Im prescribing for the
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patient enhances the g-aminobutyric acid (GABA) system. Which patient
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behavior will provide evidence that the medication therapy is successful?
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a. The patient is actively involved in playing cards with other patients.
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b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
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c. The patient reports that both auditory and visual hallucinations have
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decreased.
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d. The patient says that, I am much happier than before I came to the hospital.
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ANS: B te


GABA is the principle inhibitory neurotransmitter. The medication should provide
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an antianxiety effect. Alertness, psychotic behaviors, and mood elevation are not
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generally affected by g-aminobutyric acid.
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10. The patients family asks whether a diagnosis of Parkinsons disease creates
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an increased risk for any mental health issues. What question would the nurse
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ask to assess for such a comorbid condition?
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a. Has your father exhibited any signs of depression?
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b. Does your father seem to experience mood swings?
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c. Have you noticed your father talking about seeing things you cant see?
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d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
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ANS: A te


Serotonin and its close chemical relatives, dopamine and norepinephrine, are the
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neurotransmitters that are most widely involved in various forms of depression.
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Most researchers agree that the immediate cause of parkinsonism is a deficiency
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of dopamine and so a patient with Parkinsons disease should be monitored for
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depression, The other mental health disorders (bipolar disorder, hallucinations, and
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obsessive compulsive disorder) have not been connected to Parkinsons disease.
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11. Which explanation for the prescription of donepezil (Aricept) would the
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nurse provide for a patient in the early stage of Alzheimers disease?
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a. It will increase the metabolism of excess GABA.
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b. Excess dopamine will be prevented from attaching to receptor sites.
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c. Serotonin deficiency will be managed through a prolonged reuptake period.
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d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
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ANS: D te

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