Stahl’s Essential Psychopharmacology – Test Bank, 4th Edition | Neuroscientific Basis and Practical Applications | Nursing & Psychiatry Exam Questions

Stahl's Essential Psychopharmacology: j j



Neuroscientific Basis and Practical Applications
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4th Edition
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Stahl's Essential Psychopharmacology j j



Neuroscientific jBasis jand jPractical jApplications jTESTBANK/STUDY jGUIDE

Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE j


1. A patient with depression mentions to the nurse, My mother says depression is a
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chemical disorder. What does she mean? The nurses response is based on the theory
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that depression 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


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
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depression. There is no research to support that the other options play a significant role
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in the development of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in
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damage to the Broca area. Which evaluation does the nurse conduct to reinforce this
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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 j j j j j j j


ANS: 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
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controlled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are
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always prescribed by the doctor. The nurses answer will be based on information that
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the 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 j


Medications used to treat psychiatric disorders operate in and around the synaptic cleft
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and have action at the neurotransmitter level, especially in the case of schizophrenia, on
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dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral
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nervous 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 strugglewith
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understanding the anatomy and physiology of the neurologic system. The mentor
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would base 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 j



A complex undertaking that advance practice psychiatric nurses frequently use
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b. in their practice
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Important primarily for the nursing assessment of patients with brain traumacaused j j j j j j j j j j


c. cognitive symptoms
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Necessary for planning psychiatric care for all patients especially those j j j j j j j j j


d. experiencing psychiatric disorders
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ANS: D j


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


d. There appears to be little connection between stress and diseases of the body j j j j j j j j j j j j


ANS: 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
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disorders are sometimes associated with decreased functioning of the immune system.
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Research does not support a connection between many cancers and stress. There is a
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significant amount of research about stress and the body. Research has shown that
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there are some connections between stress and physical disease.
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, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
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rehabilitation 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 j j



b. Detecting auditory stimuli j j



c. Receiving visual images j j


d. Processing associations j


ANS: D j


The parietal lobe is responsible for associating and processing sensory information that
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allows for functions such as following directions on a map, reading a clock, dressing
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self, keeping appointments, and distinguishing right from left. Emotional expression is
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associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe
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function. 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 the
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right cerebral cortex. During assessment, the nurse would expect to find that the
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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 j j j j j j j j j j j j


ANS: B j


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 the
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body. Damage to the right side would result in impaired function on the left side of the
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body. The motor cortex controls voluntary motor activity. Brocas area controls motor
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speech. 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
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patient will be discharged on low doses of haloperidol. The nurse will need to
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individualize the 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
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Providing the education at a time when the patient is emotionally calm and j j j j j j j j j j j j


c. relaxed
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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