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Test Bank.
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, Stahl'sEssentialPsychopharmacology f f
NeuroscientificBasisandPracticalApplications5thEditionTestbank/StudyGuide f f f f f f f f
Chapter1Chemicalneurotransmission f ff f
MULTIPLECHOICE f
1. A patient with depression mentions to the nurse, My mother says depression is a
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chemicaldisorder.Whatdoesshemean?Thenursesresponseisbasedonthetheory that
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depression primarily involves which of the following neurotransmitters?
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a. CortisolandGABA f f
b. COMTandglutamate ff ff
c. Monamineandglycine f f
d. Serotoninandnorepinephrine f f
ANS: D
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Onepossiblecauseofdepressionisthoughttoinvolveoneormoreneurotransmitters.
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Serotonin and norepinephrine have been found to be important in the regulation of
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depression.Thereis noresearchto support thattheotheroptions playasignificant role in
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the development of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in
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damage to the Broca area. Which evaluation does the nurse conduct to reinforce this
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diagnosis?
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a. Observingthepatientpickupaspoon f ff f f ff f
b. Askingthepatienttorecitethealphabet f f ff ff f ff
c. Monitoringthepatientsbloodpressure f f f f
d. Comparingthepatientsgripstrengthinbothhands f f f f f f f
ANS: B
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AccidentsorstrokesthatdamageBrocasareamayresultintheinabilitytospeak(i.e.,
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motoraphasia).Finemotorskills,bloodpressurecontrol,andmusclestrengtharenot controlled by
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the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are
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alwaysprescribedbythedoctor.Thenursesanswerwillbebasedoninformationthat the
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therapeutic action of psychotropic drugs is the result of their effect on:
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a. Thetemporallobe;especiallyWernickesarea f f f f f
b. Dendritesandtheirabilitytotransmitelectricalimpulses f f f f f f f
c. Theregulationofneurotransmittersespeciallydopaminef f f f f
d. Theperipheralnervoussystemsensitivitytothepsychotropicmedications
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,ANS:C ff
Medicationsusedtotreatpsychiatricdisordersoperateinandaroundthesynapticcleft and f f f f f f f f f f f f ff
have action at the neurotransmitter level, especially in the case of schizophrenia, on
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dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral
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nervous system are not relevant to either schizophrenia or psychotropic medications.
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4. Astudentnursemuttersthatitseemsentirelyunnecessarytohavetostrugglewith
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understanding the anatomy and physiology of the neurologic system. The mentor would
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base a response on the understanding that it is:
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Necessarybutgenerallyforpsychiatricnurseswhofocusprimarilyon f f f f f f f f f
a. behavioralinterventions f
Acomplexundertakingthatadvancepracticepsychiatricnursesfrequentlyuse in
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b. their practice
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Importantprimarilyforthenursingassessmentofpatientswithbrain traumacaused f f f f f f f f f ff
c. cognitive symptoms
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Necessaryforplanningpsychiatriccareforallpatientsespeciallythose experiencing f f f f f f f f f ff
d. psychiatric disorders
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ANS:D ff
Nurses must understand that many symptoms of psychiatric disorders have a neurologic
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basis, although the symptoms are manifested behaviorally. This understandingfacilitates
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effectivecareplanning.Thefoundationofknowledgeisnot used exclusively by advanced
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practice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma
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since dealing with the results of normal and abnormalbrainfunction is aresponsibility ofall
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nurses providing all types of careto the psychiatric patient.
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5. Apatientasksthenurse,Mywifehasbreastcancer.Coulditbecausedbyher chronic
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depression? Which response is supported by research data?
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a. Toomuchstresshasbeenproventocauseallkinds ofcancer. ff ff ff f ff ff ff f f ff f
b. Therehavebeennoresearchstudiesdoneonstress anddiseaseyet. f ff ff ff ff ff ff f ff ff ff
c. Stressdoescausethereleaseoffactorsthatsuppresstheimmunesystem. f f ff f f f f f ff f ff
d. Thereappearstobelittleconnectionbetweenstressanddiseasesofthebody ANS: f ff f f f f f f f ff f f ff
C
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Researchindicatesthatstresscausesareleaseofcorticotropin-releasingfactorsthat
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suppress theimmunesystem.Studies indicatethatpsychiatricdisorderssuch asmood
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disordersaresometimesassociatedwithdecreasedfunctioningoftheimmunesystem.
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Research does not support a connection between many cancers and stress. There is a
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significant amount of research about stress and the body. Research has shown that there are
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some connections between stress and physical disease.
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, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation
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needs.Oftheaspectsoffunctioninglisted,whichwillthenurseidentify as a focus of nursing
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intervention?
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a. Expressionofemotion f f
b. Detectingauditorystimuli f f
c. Receivingvisualimages f f
d. Processingassociations ff
ANS: D
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Theparietallobeisresponsibleforassociatingandprocessingsensoryinformation
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that allows for functions such as following directions on a map, reading a clock, dressing
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self, keeping appointments, and distinguishing right from left. Emotional expression is
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associated with frontal lobe function. Detecting auditory stimuli is a temporallobe
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function.Receivingvisualimagesisrelatedtooccipitallobefunction.
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7. Atadmission,thenurselearnsthatsometimeagothepatienthadaninfarctinthe right
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cerebral cortex. During assessment, the nurse would expect to find that the patient:
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a. Demonstratesmajordeficienciesinspeech f f f f
b. Is unabletoeffectivelyholdaspooninthelefthand
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c. Hasdifficultyexplaininghowtogoaboutusingthetelephone
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d. Cannotusehisrighthandtoshavehimselforcombhisownhair ANS: f f ff f f f f f f f ff f ff
B
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Thecerebralhemispheresareresponsibleforfunctionssuchascontrolofmuscles.
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Therighthemispheremainlycontrolsthemotorandsensoryfunctionsontheleftside of the
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body. Damage to the right side would result in impaired function on the left side of the body.
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The motor cortex controls voluntary motor activity. Brocas area controls motor speech.
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Cognitive functions are attributed to the association cortex.
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Therightsideofthebodysmotoractivityiscontrolledbytheleftcerebralcortex.
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8. Apatientwithchronicschizophreniahadastrokeinvolvingthehippocampus.The
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patient will be discharged on low doses of haloperidol. The nurse will need to
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individualize the patients medication teaching by:
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a. Includingthepatientscaregiverintheeducation f f ff f f ff
b. Beingcarefultostresstheimportanceoftakingthemedicationasprescribed f f f f f f f f f f f
Providing the education at a time when the patient is emotionally calm and
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c. relaxed
Encouragingthepatienttocrushordissolvethemedicationtohelpwith swallowing f f f f f f f f f f f ff
d.
ANS:A ff
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