NCLEX Psychopharmacology Chapter 4 Exam 2025

B (“Neurotransmitters are chemicals that pass messages between brain cells.") (Stating that neurotransmitters are chemicals that pass messages between brain cells gives the most accurate information. Neurotransmitters are messengers in the central nervous system. They are released from the axon terminal, diffuse across the synapse, and attach to specialized receptors on the postsynaptic neuron. The incorrect responses do not answer the patient's question, are demeaning, and provide untrue and misleading information.) - -A patient asks a nurse, "What are neurotransmitters? My doctor says mine are out of balance." The best reply would be: a. "You must feel relieved to know that your problem has a physical basis." b. "Neurotransmitters are chemicals that pass messages between brain cells." c. "It is a high-level concept to explain. You should ask the doctor to tell you more." d. "Neurotransmitters are substances we eat daily that influence memory and mood." D ( "PET is a special scan that shows blood flow and activity in the brain.") (The parent is seeking information about PET scans. It is important to use terms the parent can understand. The correct option is the only reply that provides information relevant to PET scans. The incorrect responses describe magnetic resonance imaging (MRI), computed tomographic (CT) scans, and electroencephalography (EEG).) - -The parent of an adolescent with schizophrenia asks a nurse, "My child's doctor ordered a positron-emission tomography (PET) scan. What is that?" Select the nurse's best reply. a. "PET uses a magnetic field and gamma waves to identify problems areas in the brain. Does your teenager have any metal implants?" b. "It's a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred." c. "PET is a scan that passes an electrical current through the brain and shows brain wave activity. PET can help diagnose seizures." d. "PET is a special scan that shows blood flow and activity in the brain." A (Computed tomography (CT) scan) (A CT scan shows the presence or absence of structural changes, including cortical atrophy, ventricular enlargement, and areas of infarction—information that will be helpful to the health care provider. The other tests focus on brain activity and are more expensive; they may be ordered later.) - -A patient has dementia. The health care provider wants to make a differential diagnosis between Alzheimer disease and multiple Psychopharmacology Psychopharmacology infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first? a. Computed tomography (CT) scan b. Positron emission tomography (PET) scan c. Functional magnetic resonance imaging (fMRI) d. Single-photon-emission computed tomography (SPECT) scan B (Computed tomography (CT) scan or magnetic resonance imaging (MRI)) (A CT scan and an MRI visualize neoplasms and other structural abnormalities. A PET scan, SPECT scan, and fMRI, which give information about brain function, are not indicated. An arteriogram would not be appropriate.) - -A patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient? a. Cerebral arteriogram b. Computed tomography (CT) scan or magnetic resonance imaging (MRI) c. Positron emission tomography (PET) or single photon emission computed tomography (SPECT) d. Functional magnetic resonance imaging (fMRI) C ("What are your worst and best times of day?") (Mood changes throughout the day are related to circadian rhythms. Questions about sleep pattern would also be relevant to circadian rhythms. The question about seeing or hearing things is relevant to the assessment for illusions and hallucinations. The question about thinking is relevant to the assessment of thought processes. The other question is relevant to assessment of memory.) - -The nurse wants to assess for disturbances in circadian rhythms in a patient admitted for depression. Which question best implements this assessment? a. "Do you ever see or hear things that others do not?" b. "Do you have problems with short-term memory?" c. "What are your worst and best times of day?" d. "How would you describe your thinking?" A (Reduced anxiety) (Increased levels of GABA reduce anxiety, thus any potentiation of GABA action should result in anxiety reduction. Memory enhancement is associated with acetylcholine and substance P. Thought disorganization is associated with dopamine. GABA is not associated with sensory perceptual alterations.) - -A nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which finding would be expected? Psychopharmacology Psychopharmacology a. Reduced anxiety b. Improved memory c. More organized thinking d. Fewer sensory perceptual alterations D (prevent destruction of acetylcholine.) (Increased acetylcholine plays a role in learning and memory. Preventing the destruction of acetylcholine by acetylcholinesterase results in higher levels of acetylcholine with the potential for improved memory. GABA is known to affect anxiety level rather than memory. Increased dopamine causes symptoms associated with schizophrenia or mania rather than improves memory. Decreasing dopamine at receptor sites is associated with Parkinson disease rather than improving memory.) - On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to: a. inhibit GABA production. b. increase dopamine sensitivity. c. decrease dopamine at receptor sites. d. prevent destruction of acetylcholine. D (Prefrontal cortex) (The prefrontal cortex is responsible for intellectual functioning. The temporal lobe is responsible for the sensation of hearing. The cerebellum regulates skeletal muscle coordination and equilibrium. The brainstem regulates internal organs.) - -A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain? a. Brainstem b. Cerebellum c. Temporal lobe d. Prefrontal cortex A (parasympathetic nervous system) (Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic nervous system. When acetylcholine action is inhibited by anticholinergic drugs, parasympathetic symptoms such as blurred vision, dry mouth, constipation, and urinary retention appear. The functions of the sympathetic nervous system, the reticular activating system, and the medulla oblongata are not affected by anticholinergic medications.) - -A nurse should assess a patient taking a medication with anticholinergic properties for inhibited function of the: Psychopharmacology Psychopharmacology a. parasympathetic nervous system b. sympathetic nervous system c. reticular activating system d. medulla oblongata A (increased concentration of neurotransmitters in the synaptic gap) (If the reuptake of a substance is inhibited, then it accumulates in the synaptic gap and its concentration increases, permitting the ease of the transmission of impulses across the synaptic gap. Normal transmission of impulses across synaptic gaps is consistent with a normal rather than a depressed mood. The other options are not associated with blocking neurotransmitter reuptake.) - -The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing: a. increased concentration of neurotransmitters in the synaptic gap b. decreased concentration of neurotransmitters in serum c. destruction of receptor sites d. limbic system stimulation B (Dopamine-blocking effects) (Medications that block dopamine often produce disturbances of movement such as akathisia because dopamine affects neurons involved in both the thought processes and movement regulation. Anticholinergic effects include dry mouth, blurred vision, urinary retention, and constipation. Akathisia is not caused by endocrine stimulation or spinal nerve stimulation.) - -A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. A nurse can correctly analyze that these symptoms are related to which drug action? a. Anticholinergic effects b. Dopamine-blocking effects c. Endocrine-stimulating effects d. Ability to stimulate spinal nerves D (Norepinephrine) Norepinephrine is the neurotransmitter associated with sympathetic nervous system stimulation, preparing the individual for "fight or flight" response. GABA is a mediator of anxiety level. A high concentration of histamine is associated with an inflammatory response. A high concentration of acetylcholine is associated with parasympathetic nervous system stimulation. - -A patient ha