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Applications 5th Edition Testbank/Study Guide
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,Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
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Applications 5th Edition Testbank/Study Guide sr sr sr sr
Stahl'sEssentialPsychopharmacology n n
NeuroscientificnBasisnandnPracticalnApplicationsn 5thnEditionnTestbank/StudynGuide
Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE n
1. A patient with depression mentions to the nurse, My mother says depression is a c h
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emical disorder. What does she mean? The nurses response is based on the theoryth at
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depression primarily involves which of the following neurotransmitters?
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a. Cortisol and GABA n n
b. COMT and glutamate n n
c. Monamine and glycine n n
d. Serotonin and norepinephrine n n n
ANS: D n
One possible cause of depression is thought to involve one or more neurotransmitters.
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Serotonin and norepinephrine have been found to be important in the regulation of dep re
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ssion. There is no research to support that the other options play a significant role in t he d
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evelopment of depression. n n
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in d
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amage to the Broca area. Which evaluation does the nurse conduct to reinforce this d iag
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nosis?
a. Observing the patient pick up a spoon n n n n n n
b. Asking the patient to recite the alphabet
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c. Monitoring the patients blood pressure n n n n
d. Comparing the patients grip strength in both hands n n n n n n n n
ANS: B n
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
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motor aphasia). Fine motor skills, blood pressure control, and muscle strength are notc o
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ntrolled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are a l
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ways prescribed by the doctor. The nurses answer will be based on information that th e t
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herapeutic action of psychotropic drugs is the result of their effect on:
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a. The temporal lobe; especially Wernickes area
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b. Dendrites and their ability to transmit electrical impulses
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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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Applications 5th Edition Testbank/Study Guide sr sr sr sr
ANS: C n
Medications used to treat psychiatric disorders operate in and around the synaptic cleft a n
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d have action at the neurotransmitter level, especially in the case of schizophrenia, on do
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pamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral ne rvo
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us system are not relevant to either schizophrenia or psychotropic medications.
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4. A student nurse mutters that it seems entirely unnecessary to have to struggle with u n
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derstanding the anatomy and physiology of the neurologic system. The mentor woul d b
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ase a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily on n n n n n n n n sr sr
a. behavioral interventions n
A complex undertaking that advance practice psychiatric nurses frequently use i n
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b. their practice n
Important primarily for the nursing assessment of patients with brain t raumacause
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c. d cognitive symptoms
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Necessary for planning psychiatric care for all patients especially those experienc n n n n n n sr n n n
d. ing psychiatric disorders n n
ANS: D n
Nurses must understand that many symptoms of psychiatric disorders have a neurolo gi
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c basis, although the symptoms are manifested behaviorally. This understanding fac ilita
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tes effective care planning. The foundation of knowledge is not used exclusively b y adv
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anced practice psychiatric nurses nor is it relevant for only behavior therapies or brain tr
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auma since dealing with the results of normal and abnormal brain function is a responsib
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ility of all nurses providing all types of care tothe psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herc hr
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onic 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 n
Research indicates that stress causes a release of corticotropin-
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releasing factors that suppress the immune system. Studies indicate that psychiatric dis o
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rders such as mooddisorders are sometimes associated with decreased functioning of t he
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immune system.Research does not support a connection between many cancers and stre
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ss. There is a significant amount of research about stress and the body. Research ha s sho
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wn that there are some connections between stress and physical disease.
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Applications 5th Edition Testbank/Study Guide sr sr sr sr
6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitat io
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n needs. Of the aspects of functioning listed, which will the nurse identifyas a focus of n
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ursing intervention? n
a. Expression of emotion n n
b. Detecting auditory stimuli n n
c. Receiving visual images n n
d. Processing associations n n
ANS: D n
The parietal lobe is responsible for associating and processing sensory information tha
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t allows for functions such as following directions on a map, reading a clock, dressing sel
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f, keeping appointments, and distinguishing right from left. Emotional expression is asso
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ciated with frontal lobe function. Detecting auditory stimuli is a temporal lobe fun ction.
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Receiving visual images is related to occipital lobe function.
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7. At admission, the nurse learns that some time ago the patient had an infarct in ther ig
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ht cerebral cortex. During assessment, the nurse would expect to find that the patie nt:
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a. Demonstrates major deficiencies in speech n n n n
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 n n n n n sr sr n n n n n n
ANS: B n
The cerebral hemispheres are responsible for functions such as control of muscles. The
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right hemisphere mainly controls the motor and sensory functions on the left side of th e
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body. Damage to the right side would result in impaired function on the left side of th e bo
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dy. The motor cortex controls voluntary motor activity. Brocas area controls moto r spe
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ech. Cognitive functions are attributed to the 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. The p a
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tient will be discharged on low doses of haloperidol. The nurse will need to individu ali
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ze the patients medication teaching by:
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a. Including the patients caregiver in the education n n n n n n
b. Being careful to stress the importance of taking the medication as prescribed P
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roviding the education at a time when the patient is emotionally calm and r
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c. elaxed
Encouraging the patient to crush or dissolve the medication to help withs wallo
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d. wing
ANS: A n
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