Test Bank - Stahl's Essential Psychopharmacology 5th Edition Neuroscientific Basis and Practical Applications (Stephen M. Stahl, 2021), All Chapters 1-13

Stahl's Essential Psychopharmacology mn mn




Neuroscientific Basis and Practical Applications 5th Edition Testbank/Study Guide
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Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE mn


1. A patient with depression mentions to the nurse, My mother says depression i
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s a chemical disorder. What does she mean? The nurses response is based on th
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e theorythat depression primarily involves which of the following neurotransmitt
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ers?
a. Cortisol and GABA mn mn




b. COMT and glutamate
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c. Monamine and glycine mn mn




d. Serotonin and norepinephrine mn mn



ANS: D mn


One possible cause of depression is thought to involve one or more neurotransmit
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ters.Serotonin and norepinephrine have been found to be important in the regulati
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on of depression. There is no research to support that the other options play a sig
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nificant role in the development of depression.
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,2. A patient has experienced a stroke (cerebral vascular accident) that has resulte
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d indamage to the Broca area. Which evaluation does the nurse conduct to reinf
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orce thisdiagnosis?
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a. Observing the patient pick up a spoon mn mn mn mn mn mn




b. Asking the patient to recite the alphabet
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c. Monitoring the patients blood pressure mn mn mn mn




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



ANS: B mn


Accidents or strokes that damage Brocas area may result in the inability to speak
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(i.e.,motor aphasia). Fine motor skills, blood pressure control, and muscle strength
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are notcontrolled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications a
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re always prescribed by the doctor. The nurses answer will be based on informati
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on thatthe therapeutic 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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,ANS: C mn


Medications used to treat psychiatric disorders operate in and around the synaptic
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cleftand have action at the neurotransmitter level, especially in the case of schizop
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hrenia, on dopamine. The Wernickes area, dendrite function, or the sensitivity of t
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he peripheral nervous system are not relevant to either schizophrenia or psychotrop
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ic medications.
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4. A student nurse mutters that it seems entirely unnecessary to have to struggle
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withunderstanding the anatomy and physiology of the neurologic system. The m
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entor would base a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily
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a. onbehavioral interventions
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A complex undertaking that advance practice psychiatric nurses frequently
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b. usein their practice
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Important primarily for the nursing assessment of patients with br
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c. aintraumacaused cognitive symptoms
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Necessary for planning psychiatric care for all patients especially th
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d. oseexperiencing psychiatric disorders
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ANS: D mn


Nurses must understand that many symptoms of psychiatric disorders have a neu
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rologic basis, although the symptoms are manifested behaviorally. This understan
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ding facilitates effective care planning. The foundation of knowledge is notused e
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xclusively by advanced practice psychiatric nurses nor is it relevant for only beh
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avior therapies or brain trauma since dealing with the results of normal and abno
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rmal brain function is a responsibility of all nurses providing all types of care tot
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he psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused b
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y herchronic 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 mn


Research indicates that stress causes a release of corticotropin-
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releasing factors that suppress the immune system. Studies indicate that psychiatri
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c disorders such as mooddisorders are sometimes associated with decreased functi
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oning of the immune system.Research does not support a connection between man
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y cancers and stress. There is a significant amount of research about stress and th
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e body. Research has shown that there are some connections between stress and p
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hysical disease. mn

, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric reha
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bilitation needs. Of the aspects of functioning listed, which will the nurse identify
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as a focus of nursing intervention?
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a. Expression of emotion mn mn




b. Detecting auditory stimuli mn mn




c. Receiving visual images mn mn




d. Processing associations mn



ANS: D mn


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




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 mn mn mn mn mn mn mn mn mn mn mn mn



ANS: B mn



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




b. Being careful to stress the importance of taking the medication as prescribed
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Providing the education at a time when the patient is emotionally calm
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c. andrelaxed
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Encouraging the patient to crush or dissolve the medication to help
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d. withswallowing m
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ANS: A mn