Psychopharmacology Drugs the Brain and Behavior 3rd Edition Meyer Nursing Test Bank (2)

TEST BANKTO ACCOMPANYPSYCHOPHARM ACOLOGY, THIRD EDITIONMEYER • QUENZER WWW.THENURSINGMASTERY.COM Page 1 of 247 Test Bank to accompany Psychopharmacology, Third Edition Meyer • Quenzer Chapter 1: Principles of Pharmacology Multiple Choice 1. refer(s) to specific molecular changes that occur when a drug binds to a particular target site or receptor, while are the resulting widespread alterations in function. a. Drug action; therapeutic effects b. Side effects; drug effects c. Therapeutic effects; side effects d. Drug action; drug effects Answer: d Textbook Reference: Pharmacology: The Science of Drug Action 2. After drug administration has occurred, the amount of drug in the blood that is free to bind at specific target sites is referred to as a. the therapeutic dose. b. first-pass effects. c. bioavailability. d. ED50. Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 3. The specific molecular changes that occur when a drug binds to a particular target site or receptor are referred to as a. drug effects. b. drug action. c. side effects. d. placebo effects. Answer: b Textbook Reference: Pharmacology: The Science of Drug Action 4. Which of the following is not a possible explanation for placebo effects? a. Pavlovian conditioning b. Genetic variation c. Drug competition d. Expectation of outcome Answer: c Textbook Reference: Pharmacology: The Science of Drug Action WWW.THENURSINGMASTERY.COM Page 2 of 247 5. The administration of oxytocin has been proposed as a treatment for autism. a. intravenous b. oral c. intranasal d. intracerebral Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 6. Which factor does not affect the pharmacokinetics of a drug? a. Route of administration b. Lipid solubility c. Depot binding d. Drug action Answer: d Textbook Reference: Pharmacokinetic Factors Determining Drug Action 7. First-pass metabolism occurs when drugs are taken a. orally. b. intravenously. c. subcutaneously. d. nasally. Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 8. The area postrema is one area in the brain where the is not complete. a. cerebrospinal fluid b. blood–brain barrier c. choroid plexus d. phospholipid membrane Answer: b Textbook Reference: Pharmacokinetic Factors Determining Drug Action 9. First-pass metabolism occurs with orally administered drugs because a. their absorption is slowed by food. b. drugs absorbed into the bloodstream from the stomach go to the liver on the way to general circulation. c. drugs must first survive the acidic environment of the stomach. d. salivary enzymes in the mouth begin the process of metabolism. Answer: b Textbook Reference: Pharmacokinetic Factors Determining Drug Action 10. Toxic substances in the blood trigger a vomiting response by activating the a. blood–brain barrier. b. choroid plexus. c. area postrema. d. median eminence. WWW.THENURSINGMASTERY.COM Page 3 of 247 Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 11. Drugs administered _ have the most rapid onset of action. a. subcutaneously b. intramuscularly c. orally d. intravenously Answer: d Textbook Reference: Pharmacokinetic Factors Determining Drug Action 12. Ionization of a drug depends on the of the solution and the ofthe drug. a. pH; pKa b. pKa; pH c. concentration; lipid solubility d. pH; concentration Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 13. The absorption of a drug depends on all of the following except a. lipid solubility. b. ionization. c. body temperature. d. the concentration of the drug. Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 14. Drugs that are should be avoided by women of childbearing age. a. teratogenic b. able to cross the placental barrier c. psychoactive d. highly lipid-soluble Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 15. Agents that induce developmental abnormalities in a fetus are known as a. psychoactive drugs. b. illicit drugs. c. teratogens. d. placental drugs. Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 16. Depot binding is said to occur when drugs a. bind to their target sites. WWW.THENURSINGMASTERY.COM Page 4 of 247 b. bind to inactive sites. c. compete for binding sites. d. are excreted before binding. Answer: b Textbook Reference: Pharmacokinetic Factors Determining Drug Action 17. Which statement about depot binding is false? a. It reduces the concentration of drug at its site of action. b. It may delay the onset of drug action. c. It may prolong drug action by disrupting normal metabolism. d. It increases the concentration of drug at its site of action by releasing large quantities at once. Answer: d Textbook Reference: Pharmacokinetic Factors Determining Drug Action 18. Drug metabolism mostly occurs in the and usually makes a drug more soluble. a. kidneys; fat b. liver; fat c. liver; water d. kidneys; water Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 19. Which statement about drug clearance by first-order kinetics is false? a. Molecules of a drug are cleared at a constant rate regardless of drug concentration. b. Molecules of a drug are cleared at an exponential rate. c. A constant fraction of the free drug in the blood is removed in each time interval. d. Clearance of most drugs occurs in this manner. Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 20. Ethyl alcohol (ethanol) is an example of a drug that is eliminated a. by first-order kinetics. b. by zero-order kinetics. c. by second-order kinetics. d. at the point that six half-lives have passed. Answer: b Textbook Reference: Pharmacokinetic Factors Determining Drug Action 21. Biotransformation of drugs in the liver often occurs in two stages; phase I changes are and include . a. nonsynthetic; conjugation b. synthetic; conjugation c. nonsynthetic; oxidation d. synthetic; oxidation WWW.THENURSINGMASTERY.COM Page 5 of 247 Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 22. Biotransformation of drugs can result in the formation of , which enter the circulation and cause . a. inactive metabolites; sensitization b. active metabolites; prolonged drug action c. active metabolites; tolerance d. enzymes; tolerance Answer: b Textbook Reference: Pharmacokinetic Factors Determining Drug Action 23. Which statement about water-soluble metabolites formed in the liver is false? a. They may return to the circulation and act on target tissues. b. They may be filtered out by the kidneys. c. They may be excreted into bile. d. They may be eliminated with the feces. Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 24. Which statement about microsomal enzymes in the liver is false? a. They are highly specific and act only on certain compounds. b. They are located on the smooth endoplasmic reticulum. c. The cytochrome P450 family is one of the most important. d. They can metabolize toxins and environmental pollutants as well as drugs. Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 25. Repeated use of many psychoactive drugs can cause , which can speed up the rate of biotransformation of these drugs as well as others. a. drug competition b. enzyme inhibition c. enzyme induction d. tolerance Answer: c Textbook Reference: Pharmacokinetic Factors Determining Drug Action 26. Due to , antidepressants known as monoamine oxidase inhibitors (MAOIs) can cause cardiac arrhythmias and high blood pressure in patients that consume foods high in tyramine. a. sensitization b. tolerance c. drug competition d. enzyme inhibition Answer: d Textbook Reference: Pharmacokinetic Factors Determining Drug Action WWW.THENURSINGMASTERY.COM Page 6 of 247 27. While drugs can be excreted from the body by several routes, the most important route of elimination is through the a. breath. b. sweat. c. feces. d. urine. Answer: d Textbook Reference: Pharmacokinetic Factors Determining Drug Action 28. The liver and kidneys work together to _ and drugs, respectively. a. metabolize; excrete b. excrete; metabolize c. bind; metabolize d. absorb; excrete Answer: a Textbook Reference: Pharmacokinetic Factors Determining Drug Action 29. For drugs that have a narrow therapeutic window or potentially serious side effects, therapeutic drug monitoring uses to determine the optimum dosage for a new patient. a. body temperature b. urine testing c. brain scans d. blood sampling Answer: d Textbook Reference: Therapeutic Drug Monitoring 30. While pharmacokinetics describes how the body deals with drugs, describes how drug molecules interact with their targets. a. drug effect b. pharmacodynamics c. antagonist action d. agonist action Answer: b Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 31. In order for a drug to have an effect, it must first bind to a a. ligand. b. depot site. c. receptor. d. neurotransmitter. Answer: c Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 32. Most drugs and neurotransmitters act upon WWW.THENURSINGMASTERY.COM Page 7 of 247 a. intracellular receptors. b. membrane-bound receptors. c. protein synthesis. d. second messengers. Answer: b Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 33. While most receptors are membrane-bound on the cell surface, many receptors are intracellular. a. drug; neurotransmitter b. hormone; drug c. neurotransmitter; hormone d. agonist; antagonist Answer: c Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 34. Ligands that have no effect on a receptor after binding are called a. antagonists. b. agonists. c. neurotransmitters. d. null ligands. Answer: a Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 35. Both agonists and antagonists have but only agonists have appreciable . a. interactions; affinity b. affinity; bioavailability c. efficacy; affinity d. affinity; efficacy Answer: d Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 36. A dose–response curve shows that noncompetitive antagonists alter both the and the of the agonist, while competitive antagonists alter only the . a. potency; efficacy; potency b. bioavailability; metabolism; bioavailability c. efficacy; potency; efficacy d. depot binding; metabolism; metabolism Answer: a Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 37. In the dose–response curve, a decrease in potency is indicated by a shift a. to the left. b. to the right. c. upward. WWW.THENURSINGMASTERY.COM Page 8 of 247 d. downward. Answer: b Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 38. Which of the following describes the interaction of two drugs when the combined drug effects are greater than would be predicted from that combination? a. Addictive effects b. Physiological antagonism c. Potentiation d. Tolerance Answer: c Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 39. After chronic use, the need to administer more of a drug to achieve the same drug effect is known as a. sensitization. b. antagonism. c. potentiation. d. tolerance. Answer: d Textbook Reference: Biobehavioral Effects of Chronic Drug Use 40. Which factor does not cause tolerance? a. Conditioning b. Increased activity of liver enzymes c. Down-regulation of receptors d. Decreased kidney function Answer: d Textbook Reference: Biobehavioral Effects of Chronic Drug Use 41. Sensitization is most often seen with which class of drugs? a. Barbiturates b. Psychomotor stimulants c. Opiates d. Hallucinogens Answer: b Textbook Reference: Biobehavioral Effects of Chronic Drug Use 42. tolerance occurs as a result of cellular adaptation to the presence of a specific drug. a. Cross b. Drug disposition c. Pharmacodynamic d. Behavioral Answer: c Textbook Reference: Biobehavioral Effects of Chronic Drug Use WWW.THENURSINGMASTERY.COM Page 9 of 247 43. Which of the following is not a goal of pharmacogenetics? a. Assessing addiction potential b. Selecting the best drug for a given individual c. Predicting therapeutic outcome d. Minimizing serious toxic reactions Answer: a Textbook Reference: Pharmacogenetics and Personalized Medicine in Psychiatry Short Answer/Essay 44. Write a coherent and informative paragraph using the following terms: nonspecific drug effects, double-blind experiment, placebo, subject expectation. Answer: In contrast to specific drug effects that are dependent on the chemical activity of a drug–receptor interaction, nonspecific drug effects are determined by characteristics of the individual such as present mood or drug-taking experience. Placebo effects are an example of nonspecific effects because placebos have no chemical activity but depend on the expectations of the individual. Placebos are an important control in double-blind experiments because neither the patient nor the observer knows if the patient has received the active drug or placebo in order to avoid expectation of results or prejudice. Textbook Reference: Pharmacology: The Science of Drug Action 45. List the factors that can influence biotransformation, and briefly explain how they can lead to individual differences in drug response. Answer: Biotransformation can be influenced by enzyme induction, enzyme inhibition, drug competition, and individual differences in age, gender, and genetics. The increase in metabolizing enzymes (induction) increases the rate of biotransformation, causing tolerance. Inhibition of an enzyme by a drug increases the blood level of other drugs metabolized by that enzyme, causing toxicity. When two drugs compete for the limited number of enzyme molecules, higher blood levels of one or both may occur. Both young and older individuals have reduced metabolic capacity; men and women vary in enzyme activity, and genetic polymorphisms alter the rate of biotransformation. Textbook Reference: Pharmacokinetic Factors Determining Drug Action 46. Explain why absorption of aspirin is slower from the intestine than from the stomach. Answer: Because aspirin is a weak acid, it will remain in a non-ionized (lipid soluble) form in the acidic stomach and hence it will pass through the cell walls of the stomach to the blood. In the intestine, where the pH is more alkaline, the aspirin molecules will ionize to a greater extent, which reduce their movement through the cell walls to the blood. Textbook Reference: Pharmacokinetic Factors Determining Drug Action 47. List and briefly describe the five major factors that determine the pharmacokinetics of drug action. WWW.THENURSINGMASTERY.COM Page 10 of 247 Answer: Routes of administration determine how quickly and how completely the drug is absorbed into the blood. Absorption of the drug through cell membranes and into the blood precedes the distribution of the drug to all the cells in the body. Binding of the drug may occur at active target sites, to inert depots such as plasma proteins, or stored in bone or fat. Biotransformation influences the intensity and duration of drug effects because the amount of drug in the body at any one time is dependent on the dynamic balance between absorption and inactivation. Excretion of the drug with urine or feces eliminates it from the body. Textbook Reference: Pharmacokinetic Factors Determining Drug Action 48. Define the therapeutic index and describe how it is calculated and why it is important. Answer: The therapeutic index is a measure of drug safety and it is calculated by comparing the dose of a drug that produces a particular drug-induced toxic effect in 50% of a given population with the dose of the drug that produces a particular therapeutic effect. (TI = TD50 / ED50) When the TD50 and ED50 are very similar the TI is low and the probability of a toxic effect is great. When the TD50 is large and the ED50 is low, many patients will benefit from the drug and few will experience the toxic effect. Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 49. Draw the dose–response curves for two drugs with the same efficacy, given that drug A is ten times as potent as drug B. Answer: See sample figure below. Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 50. Compare and contrast competitive and noncompetitive antagonists. Answer: Both types of antagonists reduce the effects of agonists, but by different means. Competitive antagonists compete with agonists binding to receptors, but can be displaced by excess agonist. Hence, although the potency of an agonist is reduced and its dose– response curve is shifted to the right, its efficacy is not changed. In contrast, WWW.THENURSINGMASTERY.COM Page 11 of 247 noncompetitive antagonists reduce the effects of agonists in ways other than receptor competition, such as disturbing the receptor’s cell membrane environment. In these cases the dose–response curve is distorted rather than shifted and the same maximum (efficacy) is not achieved. Textbook Reference: Pharmacodynamics: Drug–Receptor Interactions 51. Define and explain receptor up-regulation and down-regulation. Answer: Receptor up-regulation is an increase in receptor number that represents a compensatory change in the cell after prolonged absence of receptor agonists. Receptor down-regulation is a decrease in receptor number and reflects a compensatory change after chronic activation of the receptor. These changes are responsible for pharmacodynamic tolerance and also explain the rebound withdrawal syndrome that is characteristic of physical dependence. Textbook Reference: Biobehavioral Effects of Chronic Drug Use 52. Describe briefly the four types of tolerance. Answer: Acute tolerance occurs when a individual experiences greater effects of a drug as her blood level rises than when her blood level has fallen to the same point during the same episode. Metabolic tolerance occurs when repeated use of a drug increases its own rate of metabolism. Pharmacodynamic tolerance occurs when compensatory cellular adjustments occur in response to the prolonged presence of the drug. Behavioral tolerance is dependent on several types of learning (classical conditioning and operant conditioning) and the environment in which the drug is administered. Textbook Reference: Biobehavioral Effects of Chronic Drug Use 53. What is state-dependent learning? Why does it occur? Answer: State-dependent learning refers to the concept that tasks learned under the influence of a psychoactive drug will subsequently be performed better in the drugged state than in the nondrugged state. Likewise, tasks learned in the nondrugged state will be performed better in the nondrugged state than in the drugged state. This occurs because drug-induced internal cues become part of the environmental ―set‖ and when any aspect of the environment, such as the experimental apparatus, changes, performance deteriorates. Textbook Reference: Biobehavioral Effects of Chronic Drug Use 54. Explain how pharmacogenetic approaches could lead to better pharmacological treatment. Answer: Pharmacogenetics investigates the genetic basis for variability in drug response among individuals. Variability can be explained by genetic differences in both pharmacokinetic and pharmacodynamic factors. However, the most studied are genetic differences in drug-metabolizing enzymes because variations in biotransformation lead to large differences in bioavailability responsible for variations in effectiveness and side effects. Knowing the inherited level of function of metabolizing enzymes could predict the correct dose for an individual to maximize benefits and avoid adverse drug effects. Textbook Reference: Pharmacogenetics and Personalized Medicine in Psychiatry WWW.THENURSINGMASTERY.COM Page 12 of 247 Test Bank to accompany Psychopharmacology, Third Edition Meyer • Quenzer Chapter 2: Structure and Function of the Nervous System Multiple Choice 1. Neurons rely on for protection, metabolic support, and insulation. a. mitochondria b. glial cells c. axoplasm d. dendritic spines Answer: b Textbook Reference: Cells of the Nervous System 2. Neurons responsible for converting environmental stimuli into neural signals are known as a. sensory neurons. b. interneurons. c. motor neurons. d. pyramidal cells. Answer: a Textbook Reference: Cells of the Nervous System 3. Neurons can be categorized by all of the following except by a. which neurotransmitters they release. b. their function (e.g., sensory versus motor). c. the size of the action potentials they generate. d. their morphology. Answer: c Textbook Reference: Cells of the Nervous System 4. The of the neuronal cell is/are found in the soma, while the may be found throughout the cell. a. mitochondria; dendrites b. dendrites; axon c. nucleus; mitochondria d. nucleus; dendrites Answer: c Textbook Reference: Cells of the Nervous System 5. Mitochondria are responsible for generating for the cell in the form of . WWW.THENURSINGMASTERY.COM Page 13 of 247 a. energy; ATP b. energy; glucose c. cytoplasm; ATP d. cytoplasm; glucose Answer: a Textbook Reference: Cells of the Nervous System 6. Neurons exchange information primarily via a. somas. b. dendrites. c. axons. d. axon collaterals. Answer: b Textbook Reference: Cells of the Nervous System 7. Dendritic spines serve to a. increase the surface area of the dendrite. b. insulate the axons. c. insulate the dendrites. d. protect the dendrites from degrading enzymes in the extracellular fluid. Answer: a Textbook Reference: Cells of the Nervous System 8. The function of the axon is to transmit the , generated at the , to the terminals. a. axoplasm; soma b. action potential; axon hillock c. action potential; dendrites d. synaptic vesicles; axon hillock Answer: b Textbook Reference: Cells of the Nervous System 9. In a myelinated axon, action potentials are regenerated a. at the terminal buttons. b. all along the axon. c. at gaps in the myelin known as nodes of Ranvier. d. at the axon hillock. Answer: c Textbook Reference: Cells of the Nervous System 10. Which statement about the myelin sheath is false? a. It is produced by glial cells. b. It increases the speed of signal conduction along the axon. c. It saves energy. d. It is found on all neurons. Answer: d WWW.THENURSINGMASTERY.COM Page 14 of 247 Textbook Reference: Cells of the Nervous System 11. are long strands of DNA divided into smaller portions called _ , which code for specific proteins. a. Chromosomes; genes b. Genes; chromosomes c. Transcription factors; genes d. Genes; ribosomes Answer: a Textbook Reference: Cells of the Nervous System 12. Which statement about the process of transcription is true? a. It is driven by ribosomes. b. It occurs in the cytoplasm. c. The nucleotide sequence of DNA is replicated by mRNA. d. It results in the production of proteins. Answer: c Textbook Reference: Cells of the Nervous System 13. Proteins, such as receptors and enzymes, are synthesized in the cytoplasm of the soma in a process called a. translation. b. regulation. c. transcription. d. transport. Answer: a Textbook Reference: Cells of the Nervous System 14. Which of the following most accurately describes the process involved in protein synthesis? a. Transcription factors activate promoter region → translation by ribosomes → transcription by mRNA b. Transcription factors activate promoter region → transcription by mRNA → translation by ribosomes c. Translation by ribosomes → transcription factors activate promoter region → transcription by mRNA d. Transcription by mRNA → transcription factors activate promoter region → translation by ribosomes Answer: b Textbook Reference: Cells of the Nervous System 15. Epigenetic changes affect gene expression by and by . a. blocking translation; DNA methylation b. breaking down chromatin; blocking transcription c. DNA methylation; chromatin remodeling d. remodeling transcription factors; blocking translation WWW.THENURSINGMASTERY.COM Page 15 of 247 Answer: c Textbook Reference: Cells of the Nervous System 16. Axonal transport of proteins occurs along a track formed by a. microtubules. b. neurofilaments. c. anterograde cytoskeleton. d. retrograde cytoskeleton. Answer: a Textbook Reference: Cells of the Nervous System 17. Neuronal cell membranes are associated with all of the following proteins except a. transporters. b. ion channels. c. microtubules. d. enzymes. Answer: c Textbook Reference: Cells of the Nervous System 18. Many ion channels are not normally open but must be gated or opened by some event. Which of the following is not a typical means of opening ion channels? a. Binding of neurotransmitter to external binding site b. Change in voltage across the membrane c. Phosphorylation by an intracellular second messenger d. Enzymatic reactions Answer: d Textbook Reference: Cells of the Nervous System 19. With regard to glial cells, form the myelin sheath in the CNS, while help maintain the ionic and chemical environment. a. Schwann cells; astrocytes b. oligodendroglia; astrocytes c. oligodendroglia; microglia d. Schwann cells; microglia Answer: b Textbook Reference: Cells of the Nervous System 20. The primary immune response in the CNS comes from the action of a. microglia. b. astrocytes. c. white blood cells. d. oligodendroglia. Answer: a Textbook Reference: Cells of the Nervous System WWW.THENURSINGMASTERY.COM Page 16 of 247 21. Neural transmission is generally within a single neuron and between neurons. a. chemical; electrical b. electrical; electrical c. electrical; chemical d. chemical; chemical Answer: c Textbook Reference: Electrical Transmission within a Neuron 22. The is best described as a result of the selective permeability of the neuronal membrane and the uneven distribution of ions inside and outside the cell. a. action potential b. threshold c. local potentials d. resting membrane potential Answer: d Textbook Reference: Electrical Transmission within a Neuron 23. The Na+ /K+ pump helps to maintain the by moving three Na+ ions in and two K+ ions out of the cell. a. action potential b. resting membrane potential c. threshold d. local potential Answer: b Textbook Reference: Electrical Transmission within a Neuron 24. The term ―hyperpolarization‖ refers to a. an excitatory postsynaptic potential. b. the opening of sodium channels. c. movement of the resting membrane potential closer to threshold. d. movement of the resting membrane potential farther from threshold. Answer: d Textbook Reference: Electrical Transmission within a Neuron 25. Postsynaptic potentials are a type of potential. a. action b. local c. resting d. equilibrium Answer: b Textbook Reference: Electrical Transmission within a Neuron 26. At the equilibrium potential, the two forces acting on ions are in balance. These forces are the and the . a. Na+ /K+ pump; threshold WWW.THENURSINGMASTERY.COM Page 17 of 247 b. Na+ /K+ pump; electrostatic gradient c. concentration gradient; action potential d. concentration gradient; electrostatic gradient Answer: d Textbook Reference: Electrical Transmission within a Neuron 27. Excitatory postsynaptic potentials are generally caused by channels opening, while inhibitory postsynaptic potentials may be caused by channels opening. a. Na+ ; Cl– b. K + ; Cl– c. Ca2+; K + d. Cl– ; K + Answer: a Textbook Reference: Electrical Transmission within a Neuron 28. Which statement about local potentials is false? a. They are generated on the dendrites and cell body. b. They occur only if threshold is reached. c. They move passively along the membrane. d. They are integrated at the axon hillock. Answer: b Textbook Reference: Electrical Transmission within a Neuron 29. Summation of local potentials can lead to a(n) at the axon hillock if the is reached. a. equilibrium potential; threshold b. local potential; equilibrium potential c. action potential; equilibrium potential d. action potential; threshold Answer: d Textbook Reference: Electrical Transmission within a Neuron 30. Action potentials are first generated at the axon hillock because this is where are located. a. non-gated K + channels b. voltage-gated Na+ channels c. transporters d. Na+ /K+ pumps Answer: b Textbook Reference: Electrical Transmission within a Neuron 31. During the period, no additional action potentials can be created. a. absolute refractory b. conduction c. integration d. relative refractory WWW.THENURSINGMASTERY.COM Page 18 of 247 Answer: a Textbook Reference: Electrical Transmission within a Neuron 32. The absolute refractory period occurs because channels cannot be opened, and the relative refractory period occurs because . a. voltage-gated Na+ ; voltage-gated K + channels cannot be opened b. voltage-gated K + ; voltage-gated Na+ channels remain open c. voltage-gated Na+ ; voltage-gated K + channels remain open d. voltage-gated Na+ ; Na+ /K+ pumps are activated Answer: c Textbook Reference: Electrical Transmission within a Neuron 33. Which statement about action potentials is false? a. They are considered all-or-none. b. Extreme excitation will result in a very large action potential. c. They can move via saltatory conduction in myelinated axons. d. They are generated at the axon hillock. Answer: b Textbook Reference: Electrical Transmission within a Neuron 34. Local anesthetics, such as lidocaine, have their effects by a. blocking the Na+ /K+ pump. b. preventing the generation of EPSPs and IPSPs. c. blocking voltage-gated Ca2+ channels. d. blocking voltage-gated Na+ channels. Answer: d Textbook Reference: Electrical Transmission within a Neuron 35. The and nervous system are components of the peripheral nervous system and relay information about the internal and external environment, respectively. a. cranial nerves; somatic b. autonomic nervous system; sympathetic c. sympathetic nervous system; parasympathetic d. autonomic nervous system; somatic Answer: d Textbook Reference: Organization of the Nervous System 36. Which of the following is not part of the peripheral nervous system? a. Sympathetic nervous system b. Parasympathetic nervous system c. Spinal cord d. Cranial nerves Answer: c Textbook Reference: Organization of the Nervous System 37. A section of the brain is cut parallel to the face. WWW.THENURSINGMASTERY.COM Page 19 of 247 a. sagittal b. coronal c. horizontal d. caudal Answer: b Textbook Reference: Organization of the Nervous System 38. What kind of information is carried by the ventral roots of the spinal cord? a. Sensory information from muscles and skin b. Proprioceptive information from joints and muscles c. Motor information to muscles d. Motor and sensory information Answer: c Textbook Reference: Organization of the Nervous System 39. The sympathetic nervous system is responsible for functions and uses as its neurotransmitter(s). a. energy conservation; acetylcholine b. energy conservation; acetylcholine and norepinephrine c. fight-or-flight; acetylcholine d. fight-or-flight; acetylcholine and norepinephrine Answer: d Textbook Reference: Organization of the Nervous System 40. Clusters of cell bodies in the CNS are called _ , and their associated bundles of axons are called . a. nuclei; tracts b. ganglia; tracts c. nuclei; nerves d. ganglia; nerves Answer: a Textbook Reference: Organization of the Nervous System Matching 41. Match each numbered description with a lettered term below. 1. Releases acetylcholine at ganglia and target 2. Fluid-filled cavities in the brain 3. Brain structure that regulates respiration and heart rate 4. Part of diencephalon involved in regulating homeostasis 5. Neural network that regulates motivation and emotion 6. Brain structure that connects right and left hemispheres 7. Originates in thoracic and lumbar spinal cord 8. Part of brain that process and relays sensory information to cortex WWW.THENURSINGMASTERY.COM Page 20 of 247 a. Limbic system b. Corpus callosum c. Hypothalamus d. Parasympathetic division e. Thalamus f. Sympathetic division g. Cerebral ventricles h. Medulla Answer: 1. d; 2. g; 3. h; 4. c; 5. a; 6. b; 7. f; 8. e Textbook Reference: Organization of the Nervous System Short Answer/Essay 42. Write a coherent and informative paragraph using the following terms: transcription factor, promoter region, transcription, translation. Answer: Changes in synaptic activity increase or decrease the production of particular proteins by activating transcription factors in the nucleus. Transcription factors are nuclear proteins that direct protein production. Transcription factors such as CREB bind to the promoter region of the gene adjacent to the coding region, modifying its rate of transcription. Transcription occurs in the nucleus, where messenger RNA (mRNA) makes a complementary copy of the active gene. After moving from the nucleus to the cytoplasm, mRNA attaches to organelles called ribosomes, which decode the ―recipe‖ and link the appropriate amino acids together to form the protein. This process is called translation. Textbook Reference: Cells of the Nervous System 43. Briefly describe the role of chromatin remodeling in the epigenetic modification of gene expression. Answer: Chromatin is a complex of DNA, histone proteins, and nonhistone proteins. When histone tails are acetylated, charges open up the chromatin, creating an active state that allows transcription factors to bind to the promoter region of a gene to enhance transcription. The inactive state of chromatin is caused by methylation of histone tails, which pulls the chromatin tighter and prevents the binding of transcription factors, reducing transcription of the gene. Textbook Reference: Cells of the Nervous System 44. Name four types of glial cells and give at least one function of each type. Answer: Schwann cells and oligodendroglia produce myelin sheath on peripheral and central nervous system neurons, respectively. Astrocytes regulate the extracellular environment of the neurons, regulate CNS blood flow, and provide physical support and nutritional assistance. Microglia act as phagocytes to remove cellular debris and provide immune function. Textbook Reference: Cells of the Nervous System 45. How are local potentials and action potentials similar, and how are they different? WWW.THENURSINGMASTERY.COM Page 21 of 247 Answer: Similarities: Both involve Na+ and K + channels. Differences: Local potentials are graded, decremental, produced by opening of ligand-gated ion channels, involve depolarization or hyperpolarization, and spatial and temporal summation. Action potentials are ―all-or-none,‖ nondecremental, produced by opening of voltage-gated channels, involve depolarization only, and the intensity of stimulus is coded by rate of firing. Textbook Reference: Electrical Transmission within a Neuron 46. Give a detailed, step-by-step description of the stages of an action potential, including a description of and explanation for the refractory periods. Answer: The summation of all EPSPs and IPSPs occurring at any single moment in time occurs at the axon hillock. If the threshold is reached (usually approximately a change from –70 mV to –50 mV), voltage-gated Na+ channels open, allowing large amounts of Na+ to enter the axon to produce the massive depolarization known as the action potential. At the peak of the action potential (+40 mV), voltage-gated Na+ channels close and cannot be opened until they reset at the resting potential, so no action potential can occur during this time (this is called the absolute refractory period). As the cell becomes more positive inside, voltage-gated K + channels open and K + exits from the cell, bringing the membrane potential back toward resting levels. The overshoot by K+ causes the cell to be more polarized than normal, so it is more difficult (although still possible) to reach the threshold to generate another action potential relative refractory period). The action potential moves down the length of the axon by sequential opening of voltage-gated Na+ channels. Textbook Reference: Electrical Transmission within a Neuron 47. Compare and contrast the sympathetic and parasympathetic divisions of the autonomic nervous system. Answer: The sympathetic nervous system predominates when energy expenditure is necessary, such as during times of stress, excitement, and exertion. This system increases heart rate and blood pressure, stimulates secretion of adrenaline, and increases blood flow to skeletal muscles, among other effects. The parasympathetic division predominates at times when energy reserves can be conserved and stored for later use; this system increases salivation, digestion, and storage of glucose and other nutrients and also slows heart rate and decreases respiration. Textbook Reference: Organization of the Nervous System 48. Discuss the anatomical differences between the sympathetic and parasympathetic divisions of the autonomic nervous system, including their points of origin in the central nervous system. Answer: The cell bodies of sympathetic neurons are in the ventral horn at the thoracic and lumbar regions. Their axons project for a relatively short distance before they synapse with a cluster of cell bodies called sympathetic ganglia. The preganglionic fibers release acetylcholine onto cell bodies in the ganglia. The postganglionic cells project their axons for a relatively long distance to the target tissues and release norepinephrine. The cell bodies of the parasympathetic neurons are located either in the brain (cranial nerves) or in the ventral horn of the spinal cord at the sacral region. Preganglionic neurons travel long WWW.THENURSINGMASTERY.COM Page 22 of 247 distances to synapse on cells in the parasympathetic ganglia are close to target organs and both preganglionic and postganglionic fibers release acetylcholine. Textbook Reference: Organization of the Nervous System 49. Describe the HPA axis and the neuroendocrine stress response, including the idea of negative feedback. Answer: Stress causes the secretion of corticotropin-releasing factor (CRF) by the paraventricular nucleus of the hypothalamus into the blood vessels ending in the anterior pituitary. The binding of CRF in that gland causes the release of adrenocorticotropic hormone (ACTH) into the general blood circulation. ACTH subsequently binds to the adrenal cortex to increase the secretion of cortisol and other glucocorticoids, all of which contribute to the mobilization of energy to cope with stress or exertion. Cortisol feeds back to the hypothalamus (and hippocampus) to shut down HPA activation and return cortisol levels to normal. Textbook Reference: Organization of the Nervous System 50. Name and briefly describe the functions of the four lobes of the cerebral cortex. Answer: The frontal lobe is responsible for movement and executive function. The other three lobes are sensory in function: parietal (somatosensory—touch, temperature, pain); occipital (vision); and temporal (audition). Textbook Reference: Organization of the Nervous System WWW.THENURSINGMASTERY.COM Page 23 of 247 Test Bank to accompany Psychopharmacology, Third Edition Meyer • Quenzer Chapter 3: Chemical Signaling by Neurotransmitters and Hormones Multiple Choice 1. Otto Loewi’s experiment with frog hearts was important because it demonstrated that a. the idea of chemical neurotransmission is correct. b. electrical impulses are responsible for neural transmission. c. the frog heart can be kept alive when removed from the frog. d. the neuron doctrine is correct. Answer: a Textbook Reference: Introduction 2. The most common type of synapse in the brain is the synapse. a. axoaxonic b. axodendritic c. axosomatic d. presynaptic inhibition Answer: b Textbook Reference: Chemical Signaling between Nerve Cells 3. Though he could not see it, Sir Charles Sherrington correctly surmised that neurons do not actually touch one another. This idea has been verified with the use of a. the electron microscope. b. the light microscope. c. frog heart experiments first done by Loewi. d. electrophysiological recordings. Answer: a Textbook Reference: Chemical Signaling between Nerve Cells 4. The sac-like structures in the presynaptic terminal are called and are filled with . a. mitochondria; neurotransmitter molecules b. synaptic vesicles; mitochondria c. synaptic vesicles; neurotransmitter molecules d. mitochondria; ATP Answer: c Textbook Reference: Chemical Signaling between Nerve Cells WWW.THENURSINGMASTERY.COM Page 24 of 247 5. Which of the following is not one of the criteria a substance must meet to be considered a neurotransmitter? a. A synthetic mechanism is present in the presynaptic cell. b. Vesicles containing the substance move down the axon with the action potentials when the neuron is stimulated. c. Receptors for the proposed substance are present on the postsynaptic cell. d. There is a means for inactivating the substance. Answer: b Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 6. If a substance is a neurotransmitter, stimulation of the presynaptic cell should have the same effect as a. direct application of the proposed substance to the postsynaptic cell. b. stimulation of the postsynaptic cell. c. blocking receptors on the postsynaptic cell. d. inactivating the substance. Answer: a Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 7. Activity at an axoaxonic synapse can directly increase the amount of neurotransmitter released from the postsynaptic cell. This is known as a. presynaptic inhibition. b. neuromodulation. c. axosomatic activation. d. presynaptic facilitation. Answer: d Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 8. The classical neurotransmitters do not include a. acetylcholine. b. amino acids. c. neuropeptides. d. monoamines. Answer: c Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 9. If one neuron contains both a neuropeptide and a classical neurotransmitter, a. all vesicles in the neuron will contain both substances. b. stimulation of the neuron will result in release of only one of these. c. some vesicles will contain only the neuropeptide and other vesicles will contain both substances. d. some vesicles will contain only the classical neurotransmitter and other vesicles will contain both substances. Answer: d Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation WWW.THENURSINGMASTERY.COM Page 25 of 247 10. Which statement about neuropeptides is false? a. Neuropeptide replenishment after neural activity occurs more slowly than replenishment of classical neurotransmitters. b. Neuropeptides must be synthesized in the cell body. c. Necessary enzymes are packed into the vesicle with the protein precursor. d. Transport of the vesicles down the axon depends on action potential propagation. Answer: d Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 11. The direct effect of depolarization of the presynaptic nerve terminal by the action potential is the a. docking of vesicles at the active zones. b. opening of voltage-gated Ca2+ channels. c. packaging of neurotransmitter into vesicles. d. activation of autoreceptors. Answer: b Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 12. The process of releasing neurotransmitter molecules from the vesicles is known as and occurs as a result of an influx of . a. exocytosis; Ca2+ b. endocytosis; Ca2+ c. exocytosis; Na+ d. docking; K + Answer: a Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 13. Prior to neurotransmitter release, vesicles are transported to specialized regions of the presynaptic terminal called zones, where they bind to the terminal in a process known as . a. priming; docking b. active; docking c. active; endocytosis d. priming; exocytosis Answer: b Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 14. Which statement about vesicular recycling is false? a. It occurs through a process known as endocytosis. b. Without it, the neuron would grow progressively larger as vesicular membrane is added to the terminal. c. New vesicles for classical neurotransmitters and neuropeptides are re-formed and filled in the terminal. d. The processes of endocytosis and exocytosis constitute vesicle recycling. Answer: d Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation WWW.THENURSINGMASTERY.COM Page 26 of 247 15. When activated, somatodendritic autoreceptors a. increase neurotransmitter release. b. increase the rate of cell firing. c. reduce the rate of cell firing. d. reduce neurotransmitter release. Answer: c Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 16. Selective blockade of terminal autoreceptors for DA would lead to a(n) a. increase in neurotransmitter release. b. decrease in neurotransmitter release. c. decrease in cell firing. d. increase in cell firing. Answer: a Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 17. Inactivation of neurotransmitters cannot be accomplished by a. enzymatic breakdown in the synaptic cleft. b. transport back into the presynaptic cell. c. transport into the postsynaptic cell. d. transport into nearby glial cells. Answer: c Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 18. Cocaine increases the amount of DA, 5-HT, and NE in the synaptic cleft by a. preventing metabolism. b. blocking transporters. c. blocking autoreceptors. d. increasing synthesis. Answer: b Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 19. The specific effect of a particular neurotransmitter at a particular synapse is largely determined by a. the receptor subtype(s) present on the postsynaptic cell. b. the rate of firing of the presynaptic cell. c. reuptake and metabolism of the neurotransmitter. d. the presence of antagonists at the synapse. Answer: a Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 20. Which statement about ionotropic receptors is true? a. They rapidly cause intracellular effects. b. G proteins are activated upon binding of neurotransmitter. c. They are composed of only one subunit. WWW.THENURSINGMASTERY.COM Page 27 of 247 d. Binding of an agonist induces long-lasting responses in the cell. Answer: a Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 21. Ionotropic receptors may let in , which can then act as a(n) . a. Na+ ; second messenger b. Ca2+; kinase c. Ca2+; second messenger d. Cl– ; effector enzyme Answer: c Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 22. Ligand-gated ion channels are ; G protein–coupled receptors are . a. slow/ionotropic; fast/metabotropic b. fast/ionotropic; slow/metabotropic c. slow/metabotropic; fast/ionotropic d. fast/metabotropic; slow/ionotropic Answer: b Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 23. Which statement regarding metabotropic receptors is false? a. The receptor itself is an ion channel that opens upon ligand binding. b. The receptor has one subunit with seven transmembrane domains. c. They are coupled to intracellular G proteins. d. When activated they can stimulate effector enzymes. Answer: a Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 24. Synaptic inhibition may be produced by ACh acting through metabotropic receptors. This inhibition results from the activation of channels by the G protein. a. Na+ b. Cl– c. K + d. Ca2+ Answer: c Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 25. Activating a metabotropic receptor cannot result in a. opening of a G protein–gated ion channel. b. changes in the levels of a second messenger. c. opening of an ion channel within the receptor. d. changes in gene expression. Answer: c Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems WWW.THENURSINGMASTERY.COM Page 28 of 247 26. Which of the following best describes the sequence of steps following the activation of a metabotropic receptor? a. Activation of G protein → change in activity of effector enzyme → activation of protein kinase → change in second messenger levels b. Activation of G protein → change in second messenger levels → change in activity of effector enzyme → activation of protein kinase c. Change in second messenger levels → change in activity of effector enzyme → activation of protein kinase → activation of G protein d. Activation of G protein → change in activity of effector enzyme → change in second messenger levels → activation of protein kinase Answer: d Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 27. receptors mediate the effects of neurotrophic factors. a. Calcium/calmodulin kinase b. Tyrosine kinase c. Protein kinase A d. Protein kinase C Answer: b Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 28. In contrast to the classical neurotransmitters and the neuropeptides, nitric oxide does not ―behave‖ like a typical neurotransmitter. Which statement regarding nitric oxide signaling is false? a. It may be released from the postsynaptic cell. b. It is not released from synaptic vesicles via exocytosis. c. It remains in the synaptic cleft until it is inactivated. d. It may travel some distance before it reaches target cells. Answer: d Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 29. The relaxing effects of on smooth muscle and the resulting dilation of the arteries are due to an increase in the second messenger . a. protein kinase G; cGMP b. protein kinase A; cAMP c. nitric oxide; cGMP d. nitric oxide; calcium Answer: c Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 30. Neurotrophic factors are generally involved in regulating a. long term changes, such as gene expression. b. the rate of cell firing. c. rapid synaptic events. d. opening of ion channels. Answer: a WWW.THENURSINGMASTERY.COM Page 29 of 247 Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 31. Binding of neurotrophic factors to their respective trk receptors results in the a. activation of G proteins. b. reciprocal phosphorylation of the two receptor molecules. c. opening of ion channels. d. activation of second messenger systems. Answer: b Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 32. The primary treatment for Parkinson’s disease is the administration of L-DOPA because this drug a. stimulates the release of dopamine. b. inhibits the synthesis of dopamine. c. directly stimulates postsynaptic dopamine receptors. d. is the synthetic precursor to dopamine. Answer: d Textbook Reference: Pharmacology of Synaptic Transmission 33. Environmental stimuli, sensory stimuli, and psychoactive drugs can trigger longlasting changes in neuronal connectivity. Collectively, these changes are termed a. synaptic plasticity. b. dendritic spine plasticity. c. synaptic density. d. sensitization. Answer: a Textbook Reference: Synaptic Plasticity 34. Neurotransmitters are released into the , whereas hormones are released into the . a. synaptic cleft; brain b. bloodstream; synaptic cleft c. synaptic cleft; bloodstream d. vesicles; bloodstream Answer: c Textbook Reference: The Endocrine System 35. is an example of a substance that can act as both a neurotransmitter and a hormone. a. Acetylcholine b. Norepinephrine c. Nitric oxide d. Cortisol Answer: b Textbook Reference: The Endocrine System WWW.THENURSINGMASTERY.COM Page 30 of 247 36. In response to stressors, the adrenal cortex secretes and the adrenal medulla secretes . a. epinephrine; norepinephrine b. epinephrine; glucocorticoids c. glucocorticoids; chromaffin cells d. glucocorticoids; epinephrine Answer: d Textbook Reference: The Endocrine System 37. Secretory neurons from the hypothalamus release and _ into the bloodstream from the pituitary. a. prolactin; vasopressin; anterior b. vasopressin; oxytocin; posterior c. oxytocin; prolactin; posterior d. releasing hormones; tropic; anterior Answer: b Textbook Reference: The Endocrine System 38. Releasing hormones from the enter the bloodstream in the median eminence and act on the , causing the release of various hormones. a. anterior pituitary; thyroid b. posterior pituitary; hypothalamus c. hypothalamus; anterior pituitary d. hypothalamus; posterior pituitary Answer: c Textbook Reference: The Endocrine System 39. Which statement regarding hormones and neuropharmacology is false? a. Hormones can alter behavioral responses to drugs. b. Hormone secretion can be altered by psychoactive drugs. c. Some hormones have psychoactive effects on their own. d. The effects of hormones on the brain are simple and easy to measure. Answer: d Textbook Reference: The Endocrine System 40. Steroid hormones bind to receptors, which act as when activated, and regulate gene expression. a. metabotropic; G proteins b. intracellular; transcription factors c. tyrosine kinase; transcription factors d. membrane-bound; G proteins Answer: b Textbook Reference: The Endocrine System Matching WWW.THENURSINGMASTERY.COM Page 31 of 247 41. Match each numbered description with a lettered term below. 1. May occur at axoaxonic synapses 2. Provide(s) feedback to decrease neurotransmitter release 3. Release(s) norepinephrine and epinephrine 4. Amplifies chemical signal with second messengers 5. Move(s) neurotransmitter into terminal 6. The ―master gland‖ 7. Associated with cyclic AMP a. Metabotropic receptors b. Protein kinase A c. Pituitary d. Presynaptic inhibition e. Autoreceptors f. Transporters g. Chromaffin cells Answer: 1. d; 2. e; 3. g; 4. a; 5. f; 6. c; 7. b Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation Short Answer/Essay 42. Describe three factors that regulate neurotransmitter release. Answer: Any three of the following: (Answers may vary.)  The rate of cell firing—the more rapid the firing, the greater the NT release.  The probability of neurotransmitter release—synapses in different parts of the brain vary in the probability that even a single vesicle will undergo exocytosis in response to an action potential.  The presence of autoreceptors on axon terminals or cell bodies and dendrites— terminal autoreceptors, located on axon terminals, typically inhibit further transmitter release; somatodendritic autoreceptors, on the cell body or dendrites, slow the rate of cell firing, resulting in less neurotransmitter release because fewer action potentials reach the axon terminal to stimulate NT release.  Agonist or antagonist drugs—stimulate or block autoreceptors.  Heteroreceptors—respond to transmitters other than the main NT for that synapse and may enhance or reduce the amount of transmitter released from axon terminal. Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 43. List the criteria for classifying a substance as a neurotransmitter. Answer: Any or all of the following: (Answers may vary.)  The presynaptic cell should contain the proposed substance along with a mechanism for manufacturing it.  A mechanism for inactivating the substance should also be present.  The substance should be released from the axon terminal upon stimulation of the neuron. WWW.THENURSINGMASTERY.COM Page 32 of 247  Receptors for the proposed substance should be present on the postsynaptic cell.  Direct application of the proposed substance or of an agonist drug that acts on its receptors should have the same effect on the postsynaptic cell as stimulating the presynaptic neuron does.  Applying an antagonist drug that blocks the receptors should inhibit both the action of the applied substance and the effect of stimulating the presynaptic neuron. Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 44. Describe three types of symptoms typically associated with narcolepsy. Answer: Cataplexy—sudden loss of muscle tone; hypnagogic hallucinations—vivid dream like sensations; sleep paralysis—loss of muscle tone leading to a sense of paralysis. Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 45. What role might orexin play in narcolepsy? Briefly explain evidence that supports this role. Answer: Orexin may play a role in arousal and maintaining wakeful behavior. Wakefulness can be stimulated in mice by activating orexin neurons. Dogs with narcolepsy have a mutation in a particular orexin gene, causing production of an abnormal OX2R protein and loss of normal postsynaptic responsiveness to orexin. In humans that have narcolepsy there appears to be a complete loss of orexin neurons throughout the hypothalamic area, suggesting that there is little to no orexin input to their sleep–waking circuits. Textbook Reference: Neurotransmitter Synthesis, Release, and Inactivation 46. Compare and contrast metabotropic and ionotropic receptors. Answer: Ionotropic receptors have 4–5 subunits that are assembled and then inserted into the cell membrane, whereas metabotropic receptors have just one subunit. Ionotropic receptors contain an intrinsic ion channel that opens in response to neurotransmitter or drug binding, whereas metabotropic receptors activate G proteins in response to neurotransmitter or drug binding. Ionotropic receptors are not coupled to second messengers but metabotropic receptors are. Ionotropic receptors are fast but metabotropic receptors are slower. Textbook Reference: Neurotransmitter Receptors and Second-Messenger Systems 47. Briefly summarize five mechanisms by which drugs can alter synaptic transmission, and provide an example of a drug that acts in each manner. Answer: Any five of the following: (Answers may vary.)  Increase the rate of NT synthesis. Example: L-DOPA is the precursor to dopamine—increases synthesis of dopamine; used to treat Parkinson’s disease.  Decrease the levels of neurotransmitter synthesized, such as by inhibiting enzymes needed for NT synthesis. Example: AMPT (alpha-methyl-para-tyrosine) inhibits the enzyme tyrosine hydroxylase, so synthesis of DA and NE is reduced. WWW.THENURSINGMASTERY.COM Page 33 of 247  Enhance the activity of a neurotransmitter by blocking the enzyme that breaks the NT down. Example: Physostigmine blocks the enzyme acetylcholinesterase, which breaks down ACh, so more ACh remains in the synapse.  Enhance the activity of a neurotransmitter (if it uses transporters for reuptake) by blocking the transporter that moves NT from the synapse back into the presynaptic terminal, thus increasing action in the synapse. Example: Cocaine blocks the transporter for DA, NE, and 5-HT.  Increase release of certain neurotransmitters from cytoplasm in axon terminal. Example: Amphetamine stimulates the release of DA and NE.  Drugs that act on postsynaptic receptors for a specific neurotransmitter. Agonists mimic the neurotransmitter. Example: Opiates like heroin bind to opiate receptors and act like endogenous opiates. Antagonists block the neurotransmitter action in some way. Example: Caffeine blocks the action of adenosine at its receptors (without stimulating them). Textbook Reference: Pharmacology of Synaptic Transmission 48. Write a coherent and informative paragraph using the following terms: hypothalamus; posterior pituitary; median eminence; releasing hormones. Answer: The pituitary stalk, connecting the hypothalamus with the pituitary gland, contains blood vessels that carry special hypothalamic releasing hormones. These hormones are mainly neuropeptides manufactured by various groups of neurons in the hypothalamus. Instead of forming normal synapses, these neurons release peptides into blood capillaries in a region called the median eminence. These blood vessels carry the hormones to the hormone secreting regions of the anterior pituitary gland. The pituitary stalk also contains the axons of secretory neurons of the hypothalamus that synthesize the peptide hormones vasopressin and oxytocin. When these axons reach the posterior pituitary, they release these hormones into the bloodstream. Textbook Reference: The Endocrine System 49. Describe how drugs that block the D2 dopamine receptor alter prolactin levels and release. Answer: Release of the hormone prolactin is inhibited by the neurotransmitter DA (via its action on D2 receptors in the pituitary gland). Several drugs that are used to treat psychiatric disorders, particularly schizophrenia, are D2 receptor antagonists. One consequence of these drugs, therefore, is that the inhibitory effect of DA is removed, which results in a rise in blood prolactin levels. Textbook Reference: The Endocrine System 50. Describe the evidence supporting the role of sex hormones in sensitivity to cocaine. Answer: There is some evidence that sex hormone levels affect the intensity or subjective response to cocaine in women. Women who were tested during the midfollicular phase (6–10 days after the beginning of menstruation) and the midluteal phase (7–12 days following the LH surge) of their cycle reported lower intensity responses during their luteal phase than during their follicular phase. Men tested under the same conditions showed a response similar to that of women in their follicular phase. Textbook Reference: The Endocrine System WWW.THENURSINGMASTERY.COM Page 34 of 247 Test Bank to accompany Psychopharmacology, Third Edition Meyer • Quenzer Chapter 4: Methods of Research in Psychopharmacology Multiple Choice 1. Which statement about methods of research in neurobehavioral pharmacology is false? a. Use of scientific method and critical reading of literature are necessary skills. b. Methods focus only on the molecular level, not the whole organism. c. Researchers must be able to quantify changes in behavior, mood, and thinking. d. Many studies require images of neurotransmitters and receptors in the living brain. Answer: b Textbook Reference: Research Methods for Evaluating the Brain and Behavior 2. Which statement about the importance of behavioral measures in psychopharmacology is false? a. Behavioral measures use observational measures, which are the most reliable and valid approaches. b. Behavioral measures are used for developing animal models of psychiatric disorders. c. Behavioral measures are used for screening newly-developed drug molecules in preclinical trials. d. Behavioral measures aid in understanding the neurochemical basis of behavior. Answer: a Textbook Reference: Evaluating Animal Behavior 3. Which of the following is not an advantage of animal studies in psychopharmacology? a. They allow for precise control of living conditions not possible with humans. b. Assessing emotional and psychological changes in response to experimental manipulations is relatively straightforward in nonhuman subjects. c. The past histories of animal subjects are known to the investigator. d. Invasive procedures that would be unethical on humans can be used. Answer: b Textbook Reference: Evaluating Animal Behavior 4. What are the limitations to studying fetal alcohol syndrome (FAS) in human subjects? a. There are not enough cases to study. b. The studies are correlational only; one cannot assert that alcohol causes any particular effect. c. There is very little evidence for FAS in children born to women in the United States. d. It is impossible to obtain permission to conduct this type of research. Answer: b Textbook Reference: Evaluating Animal Behavior WWW.THENURSINGMASTERY.COM Page 35 of 247 5. Which of the following is not a guideline of the Health Extension Act of 1985? a. Researchers should be trained in basic veterin