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Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical Applications 5th Edition Test Bank

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TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY:
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NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION
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, Stahl's Essential Psychopharmacology jj jj




Neuroscientific Basis and Practical Applications TESTBANK/STUDY GUIDE jj j jj jj jj j




Chapter 1 Chemical neurotransmissionjj jj jj


MULTIPLE CHOICE jj



1. A patient with depression mentions to the nurse, My mother says depression isa
jj jj jj jj jj jj jj jj jj jj jj jj j



chemical disorder. What does she mean? The nurses response is based on the
jj jj jj jj jj jj jj jj jj jj jj jj jj



theorythat depression primarily involves which of the following
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neurotransmitters?
a. Cortisol and GABA jj jj




b. COMT and glutamate jj jj




c. Monamine and glycine jj jj



d. Serotonin and norepinephrine jj jj



ANS: D jj


One possible cause of depression is thought to involve one or more
jj jj jj jj jj jj jj jj jj jj jj



neurotransmitters.Serotonin and norepinephrine have been found to be
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importantin the regulation of depression. There is no research to support that the
jj j jj jj jj jj jj jj jj jj jj jj jj jj



other 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
jj jj jj j j j j j j j j j j j j



j has resulted in damage to the Broca area. Which evaluation does the nurse conduct to
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reinforce thisdiagnosis?
jj jj



a. Observing the patient pick up a spoon jj jj jj jj jj jj




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




c. Monitoring the patients blood pressure jj jj jj jj



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



ANS: B jj



Accidents or strokes that damage Brocas area may result in the inability to speak
jj jj jj jj jj jj jj jj jj jj jj jj jj



(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle
jj jj jj jj jj jj jj jj jj jj jj



strengthare notcontrolled by the Broca area of the left frontal lobe.
jj j jj jj jj jj jj jj jj jj jj jj



3. The patient diagnosed with schizophrenia asks why psychotropic
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medicationsare always prescribed by the doctor. The nurses answer will be
jj j jj jj jj jj jj jj jj jj jj jj



based on information thatthe therapeutic action of psychotropic drugs is the
jj jj jj jj jj jj jj jj jj jj jj



result of their
jj jj jj



effect on: jj



a. The temporal lobe; especially Wernickes area jj jj jj jj jj




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




c. The regulation of neurotransmitters especially dopamine
jj jj jj jj jj



d. The peripheral nervous system sensitivity to the psychotropic medications
jj jj jj jj jj jj jj jj

,ANS: C jj



Medications used to treat psychiatric disorders operate in and around the synaptic
jj jj jj jj jj jj jj jj jj jj jj



cleftand have action at the neurotransmitter level, especially in the case of
jj jj jj jj jj jj jj jj jj jj jj jj



schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
jj jj jj jj jj jj jj jj jj jj



sensitivity of the peripheral nervous system are not relevant to either
jj jj jj jj jj jj jj jj jj jj jj



schizophreniaor psychotropic medications.
jj j jj jj



4. A student nurse mutters that it seems entirely unnecessary to have to
jj jj jj jj jj jj jj jj jj jj jj



strugglewithunderstanding the anatomy and physiology of the neurologic
jj j jj jj jj jj jj jj jj



system. The mentor would base a response on the understanding that it is:
jj jj jj jj jj jj jj jj jj jj jj jj jj



Necessary but generally for psychiatric nurses who focus jj jj jj jj jj jj jj


a. primarilyonbehavioral interventions
jj j jj




A complex undertaking that advance practice psychiatric nurses
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b. frequentlyusein their practice jj j jj jj




Important primarily for the nursing assessment of patients jj jj jj jj jj jj jj


c. withbraintraumacaused cognitive symptoms
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Necessary for planning psychiatric care for all patients jj jj jj jj jj jj jj


d. especiallythoseexperiencing psychiatric disorders
jj j jj jj



ANS: D jj



Nurses must understand that many symptoms of psychiatric disorders have a
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neurologic basis, although the symptoms are manifested behaviorally. This
jj jj jj jj jj jj jj jj jj



understanding facilitates effective care planning. The foundation of knowledge
jj jj jj jj jj jj jj jj jj



isnotused exclusively by advanced practice psychiatric nurses nor is it relevant
jj j jj jj jj jj jj jj jj jj jj jj



for only behavior therapies or brain trauma since dealing with the results of
jj jj jj jj jj jj jj jj jj jj jj jj jj



normal and abnormal brain function is a responsibility of all nurses providing all
jj jj jj jj jj jj jj jj jj jj jj jj jj



types ofcare tothe psychiatric patient.
jj jj j jj jj jj



5. A patient asks the nurse, My wife has breast cancer. Could it be caused
jj jj jj jj jj jj jj jj jj jj jj jj jj



byherchronic depression? Which response is supported by research data?
jj j jj jj jj jj jj jj jj jj



a. Too much stress has been proven to cause all kinds of cancer. jj jj jj jj jj jj jj jj jj jj jj




b. There have been no research studies done on stress and disease yet.
jj jj jj jj jj jj jj jj jj jj jj




c. Stress does cause the release of factors that suppress the immune system. jj jj jj jj jj jj jj jj jj jj jj



d. There appears to be little connection between stress and diseases of the body jj jj jj jj jj jj jj jj jj jj jj jj



ANS: C jj



Research indicates that stress causes a release of corticotropin-releasing factors
jj jj jj jj jj jj jj jj jj



that suppress the immune system. Studies indicate that psychiatric disorders suchas
jj jj jj jj jj jj jj jj jj jj jj j



mooddisorders are sometimes associated with decreased functioning of the
jj jj jj jj jj jj jj jj jj



immune system.Research does not support a connection between many cancers
jj jj jj jj jj jj jj jj jj jj



and stress. There is a significant amount of research about stress and the body.
jj jj jj jj jj jj jj jj jj jj jj jj jj jj



Research has shown that there are some connections between stress and
jj jj jj jj jj jj jj jj jj jj



physicaldisease.
jj j

, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
jj jj jj jj jj jj jj jj jj jj jj jj



rehabilitation needs. Of the aspects of functioning listed, which will the
jj jj jj jj jj jj jj jj jj jj jj



nurseidentifyas a focus of nursing intervention?
jj j jj jj jj jj jj



a. Expression of emotion jj jj




b. Detecting auditory stimuli jj jj




c. Receiving visual images jj jj



d. Processing associations jj



ANS: D jj



The parietal lobe is responsible for associating and processing sensory
jj jj jj jj jj jj jj jj jj



informationthat allows for functions such as following directions on a map, reading
jj j jj jj jj jj jj jj jj jj jj jj jj



a clock, dressing self, keeping appointments, and distinguishing right from left.
jj jj jj jj jj jj jj jj jj jj jj



Emotional expression is associated with frontal lobe function. Detecting auditory
jj jj jj jj jj jj jj jj jj jj



stimuli is a temporal lobe function. Receiving visual images is related to occipital
jj jj jj jj jj jj jj jj jj jj jj jj jj



lobe function.
jj jj



7. At admission, the nurse learns that some time ago the patient had an infarct
jj jj jj jj jj jj jj jj jj jj jj jj jj



intheright cerebral cortex. During assessment, the nurse would expect to find
jj j jj jj jj jj jj jj jj jj jj jj



that the patient:
jj jj jj



a. Demonstrates major deficiencies in speech jj jj jj jj




b. Is unable to effectively hold a spoon in the left hand
jj jj jj jj jj jj jj jj jj jj




c. Has difficulty explaining how to go about using the telephone jj jj jj jj jj jj jj jj jj



d. Cannot use his right hand to shave himself or comb his own hair jj jj jj jj jj jj jj jj jj jj jj jj



ANS: B jj



The cerebral hemispheres are responsible for functions such as control of
jj jj jj jj jj jj jj jj jj jj



muscles.The right hemisphere mainly controls the motor and sensory functions on
jj j jj jj jj jj jj jj jj jj jj jj



the left sideof the body. Damage to the right side would result in impaired function
jj jj jj jj jj jj jj jj jj jj jj jj jj jj jj



on theleft side of the body. The motor cortex controls voluntary motor activity.
jj jj j jj jj jj jj jj jj jj jj jj jj jj



Brocas area controls motor speech. Cognitive functions are attributed to the
jj jj jj jj jj jj jj jj jj jj jj



association cortex.
jj jj


The right side of the bodys motor activity is controlled by the left cerebral cortex.
jj jj jj jj jj jj jj jj jj jj jj jj jj jj



8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
jj jj jj jj jj jj jj jj jj jj



Thepatient will be discharged on low doses of haloperidol. The nurse will need
jj jj jj jj jj jj jj jj jj jj jj jj jj



toindividualize the patients medication teaching by:
jj j jj jj jj jj jj



a. Including the patients caregiver in the education jj jj jj jj jj jj




b. Being careful to stress the importance of taking the medication as prescribed
jj jj jj jj jj jj jj jj jj jj jj




Providing the education at a time when the patient is emotionally jj jj jj jj jj jj jj jj jj jj


c. calmandrelaxed
jj j



Encouraging the patient to crush or dissolve the medication to jj jj jj jj jj jj jj jj jj


d. helpwithswallowing
jj j



ANS: A jj

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