test bank for stahls essential psychopharmacology 4th edition

, Stahl's Essential Psychopharmacology j j



NeuroscientificjBasisjandjPracticaljApplicationsjTESTBANK/STUDYjGUIDE

Chapter 1 Chemical neurotransmission j j j


MULTIPLE CHOICE j


1. A patient with depression mentions to the nurse, My mother says depression is a chem
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ical disorder. What does she mean? The nurses response is based on the theory that depre
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ssion primarily involves which of the following neurotransmitters?
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a. Cortisol and GABA j j



b. COMT and glutamate j j



c. Monamine and glycine j j



d. Serotonin and norepinephrine j j j


ANS: D j


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 depr
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ession. There is no research to support that the other options play a significant role in th
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e development of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in dam
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age to the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis
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?
a. Observing the patient pick up a spoon j j j j j j



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



c. Monitoring the patients blood pressure j j j j



d. Comparing the patients grip strength in both hands A j j j j j j j j


NS: B j


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 not controlle
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d by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are alw
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ays prescribed by the doctor. The nurses answer will be based on information that the thera
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peutic action of psychotropic drugs is the result of their effect on:
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a. The temporal lobe; especially Wernickes area j j j j j



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



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 j


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


have action at the neurotransmitter level, especially in the case of schizophrenia, on dopam
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ine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nervous syst
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em 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 unde
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rstanding the anatomy and physiology of the neurologic system. The mentor would base
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a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily on j j j j j j j j j


a. behavioral interventions j



A complex undertaking that advance practice psychiatric nurses frequently use in th
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b. eir practice j



Important primarily for the nursing assessment of patients with brain traumacaused c j j j j j j j j j j j


c. ognitive symptoms j



Necessary for planning psychiatric care for all patients especially those experiencing j j j j j j j j j j j


d. psychiatric disorders j


ANS: D j


Nurses must understand that many symptoms of psychiatric disorders have a neurologic ba
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sis, although the symptoms are manifested behaviorally. This understanding facilitates eff
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ective care planning. The foundation of knowledge is not used exclusively by advanced pra
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ctice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma since d
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ealing with the results of normal and abnormal brain function is a responsibility of all nurse
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s providing all types of care to the psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her chron
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ic 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. j j j j j j j j j j j



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 AN j j j j j j j j j j j j j


S: C j


Research indicates that stress causes a release of corticotropin-releasing factors that
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suppress the immune system. Studies indicate that psychiatric disorders such as mood diso
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rders are sometimes associated with decreased functioning of the immune system. Researc
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h does not support a connection between many cancers and stress. There is a significant am
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ount of research about stress and the body. Research has shown that there are some connecti
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ons 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. Of the aspects of functioning listed, which will the nurse identify as a focus of nursin
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g intervention?
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a. Expression of emotion j j



b. Detecting auditory stimuli j j



c. Receiving visual images j j



d. Processing associations j j


ANS: D j


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, dressing se
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lf, keeping appointments, and distinguishing right from left. Emotional expression is assoc
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iated with frontal lobe function. Detecting auditory stimuli is a temporal lobe function. Rec
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eiving 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 the right
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cerebral cortex. During assessment, the nurse would expect to find that the patient:
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a. Demonstrates major deficiencies in speech j j j j



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 AN j j j j j j j j j j j j j


S: B j


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 left side of th
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e body. Damage to the right side would result in impaired function on the left side of the bo
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dy. The motor cortex controls voluntary motor activity. Brocas area controls motor speec
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h. 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 pati
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ent will be discharged on low doses of haloperidol. The nurse will need to individualize th
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e patients medication teaching by:
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a. Including the patients caregiver in the education j j j j j j



b. Being careful to stress the importance of taking the medication as prescribed Pro
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viding the education at a time when the patient is emotionally calm and
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c. relaxed
Encouraging the patient to crush or dissolve the medication to help with swallowing j j j j j j j j j j j j


d.
ANS: A j




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