Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
Stahl's Essential Psychopharmacology
6 6
Neuroscientific6Basis6and6Practical6Applications6 5th6Edition6Testbank/Study6Guide
Chapter616Chemical6neurotransmission
MULTIPLE6CHOICE
1. A6patient6with6depression6mentions6to6the6nurse,6My6mother6says6depression6is6a6c
hemical6disorder.6What6does6she6mean?6The6nurses6response6is6based6on6the6theory6th
at6depression6primarily6involves6which6of6the6following6neurotransmitters?
a. Cortisol6and6GABA
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,Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
b. COMT6and6glutamate
c. Monamine6and6glycine
d. Serotonin6and6norepinephrine
ANS:6D
One6possible6cause6of6depression6is6thought6to6involve6one6or6more6neurotransmitters.6
Serotonin6and6norepinephrine6have6been6found6to6be6important6in6the6regulation6of6dep
ression.6There6is6no6research6to6support6that6the6other6options6play6a6significant6role6in6
the6development6of6depression.
2. A6patient6has6experienced6a6stroke6(cerebral6vascular6accident)6that6has6resulted6in6
damage6to6the6Broca6area.6Which6evaluation6does6the6nurse6conduct6to6reinforce6this6d
iagnosis?
a. Observing6the6patient6pick6up6a6spoon
b. Asking6the6patient6to6recite6the6alphabet
c. Monitoring6the6patients6blood6pressure
d. Comparing6the6patients6grip6strength6in6both6hands
ANS:6B
Accidents6or6strokes6that6damage6Brocas6area6may6result6in6the6inability6to6speak6(i.e.,6
motor6aphasia).6Fine6motor6skills,6blood6pressure6control,6and6muscle6strength6are6not6c
ontrolled6by6the6Broca6area6of6the6left6frontal6lobe.
3. The6patient6diagnosed6with6schizophrenia6asks6why6psychotropic6medications6are6a
lways6prescribed6by6the6doctor.6The6nurses6answer6will6be6based6on6information6that6th
e6therapeutic6action6of6psychotropic6drugs6is6the6result6of6their6effect6on:
a. The6temporal6lobe;6especially6Wernickes6area
b. Dendrites6and6their6ability6to6transmit6electrical6impulses
c. The6regulation6of6neurotransmitters6especially6dopamine
d. The6peripheral6nervous6system6sensitivity6to6the6psychotropic6medications
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,Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
ANS:6C
Medications6used6to6treat6psychiatric6disorders6operate6in6and6around6the6synaptic6cleft6
and6have6action6at6the6neurotransmitter6level,6especially6in6the6case6of6schizophrenia,6o
n6dopamine.6The6Wernickes6area,6dendrite6function,6or6the6sensitivity6of6the6peripheral6
nervous6system6are6not6relevant6to6either6schizophrenia6or6psychotropic6medications.
4. A6student6nurse6mutters6that6it6seems6entirely6unnecessary6to6have6to6struggle6with6
understanding6the6anatomy6and6physiology6of6the6neurologic6system.6The6mentor6wo
uld6base6a6response6on6the6understanding6that6it6is:
Necessary6but6generally6for6psychiatric6nurses6who6focus6primarily6on6
a. behavioral6interventions
A6complex6undertaking6that6advance6practice6psychiatric6nurses6frequently6use6i
b. n6their6practice
Important6primarily6for6the6nursing6assessment6of6patients6with6brain6t
c. raumacaused6cognitive6symptoms
Necessary6for6planning6psychiatric6care6for6all6patients6especially6those6
d. experiencing6psychiatric6disorders
ANS:6D
Nurses6must6understand6that6many6symptoms6of6psychiatric6disorders6have6a6neurolo
gic6basis,6although6the6symptoms6are6manifested6behaviorally.6This6understanding6fa
cilitates6effective6care6planning.6The6foundation6of6knowledge6is6not6used6exclusively6
by6advanced6practice6psychiatric6nurses6nor6is6it6relevant6for6only6behavior6therapies6
or6brain6trauma6since6dealing6with6the6results6of6normal6and6abnormal6brain6function6i
s6a6responsibility6of6all6nurses6providing6all6types6of6care6to6the6psychiatric6patient.
5. A6patient6asks6the6nurse,6My6wife6has6breast6cancer.6Could6it6be6caused6by6her6
chronic6depression?6Which6response6is6supported6by6research6data?
a. Too6much6stress6has6been6proven6to6cause6all6kinds6of6cancer.
b. There6have6been6no6research6studies6done6on6stress6and6disease6yet.
c. Stress6does6cause6the6release6of6factors6that6suppress6the6immune6system.
d. There6appears6to6be6little6connection6between6stress6and6diseases6of6the6body
ANS:6C
Research6indicates6that6stress6causes6a6release6of6corticotropin-
releasing6factors6that6suppress6the6immune6system.6Studies6indicate6that6psychiatric6dis
orders6such6as6mood6disorders6are6sometimes6associated6with6decreased6functioning6of6
the6immune6system.6Research6does6not6support6a6connection6between6many6cancers6an
d6stress.6There6is6a6significant6amount6of6research6about6stress6and6the6body.6Research6
has6shown6that6there6are6some6connections6between6stress6and6physical6disease.
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, Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
6. A6patient6who6has6a6parietal6lobe6injury6is6being6evaluated6for6psychiatric6rehabilitat
ion6needs.6Of6the6aspects6of6functioning6listed,6which6will6the6nurse6identify6as6a6focus6
of6nursing6intervention?
a. Expression6of6emotion
b. Detecting6auditory6stimuli
c. Receiving6visual6images
d. Processing6associations
ANS:6D
The6parietal6lobe6is6responsible6for6associating6and6processing6sensory6information6tha
t6allows6for6functions6such6as6following6directions6on6a6map,6reading6a6clock,6dressing6
self,6keeping6appointments,6and6distinguishing6right6from6left.6Emotional6expression6is
6associated6with6frontal6lobe6function.6Detecting6auditory6stimuli6is6a6temporal6lobe6fu
nction.6Receiving6visual6images6is6related6to6occipital6lobe6function.
7. At6admission,6the6nurse6learns6that6some6time6ago6the6patient6had6an6infarct6in6the6r
ight6cerebral6cortex.6During6assessment,6the6nurse6would6expect6to6find6that6the6patie
nt:
a. Demonstrates6major6deficiencies6in6speech
b. Is6unable6to6effectively6hold6a6spoon6in6the6left6hand
c. Has6difficulty6explaining6how6to6go6about6using6the6telephone
d. Cannot6use6his6right6hand6to6shave6himself6or6comb6his6own6hair
ANS:6B
The6cerebral6hemispheres6are6responsible6for6functions6such6as6control6of6muscles.6Th
e6right6hemisphere6mainly6controls6the6motor6and6sensory6functions6on6the6left6side6of6t
he6body.6Damage6to6the6right6side6would6result6in6impaired6function6on6the6left6side6of6
the6body.6The6motor6cortex6controls6voluntary6motor6activity.6Brocas6area6controls6mo
tor6speech.6Cognitive6functions6are6attributed6to6the6association6cortex.
The6right6side6of6the6bodys6motor6activity6is6controlled6by6the6left6cerebral6cortex.
8. A6patient6with6chronic6schizophrenia6had6a6stroke6involving6the6hippocampus.6The6
patient6will6be6discharged6on6low6doses6of6haloperidol.6The6nurse6will6need6to6individ
ualize6the6patients6medication6teaching6by:
a. Including6the6patients6caregiver6in6the6education
b. Being6careful6to6stress6the6importance6of6taking6the6medication6as6prescribed
Providing6the6education6at6a6time6when6the6patient6is6emotionally6calm6and6r
c. elaxed
Encouraging6the6patient6to6crush6or6dissolve6the6medication6to6help6with6
d. swallowing
ANS:6A
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6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
Stahl's Essential Psychopharmacology
6 6
Neuroscientific6Basis6and6Practical6Applications6 5th6Edition6Testbank/Study6Guide
Chapter616Chemical6neurotransmission
MULTIPLE6CHOICE
1. A6patient6with6depression6mentions6to6the6nurse,6My6mother6says6depression6is6a6c
hemical6disorder.6What6does6she6mean?6The6nurses6response6is6based6on6the6theory6th
at6depression6primarily6involves6which6of6the6following6neurotransmitters?
a. Cortisol6and6GABA
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,Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
b. COMT6and6glutamate
c. Monamine6and6glycine
d. Serotonin6and6norepinephrine
ANS:6D
One6possible6cause6of6depression6is6thought6to6involve6one6or6more6neurotransmitters.6
Serotonin6and6norepinephrine6have6been6found6to6be6important6in6the6regulation6of6dep
ression.6There6is6no6research6to6support6that6the6other6options6play6a6significant6role6in6
the6development6of6depression.
2. A6patient6has6experienced6a6stroke6(cerebral6vascular6accident)6that6has6resulted6in6
damage6to6the6Broca6area.6Which6evaluation6does6the6nurse6conduct6to6reinforce6this6d
iagnosis?
a. Observing6the6patient6pick6up6a6spoon
b. Asking6the6patient6to6recite6the6alphabet
c. Monitoring6the6patients6blood6pressure
d. Comparing6the6patients6grip6strength6in6both6hands
ANS:6B
Accidents6or6strokes6that6damage6Brocas6area6may6result6in6the6inability6to6speak6(i.e.,6
motor6aphasia).6Fine6motor6skills,6blood6pressure6control,6and6muscle6strength6are6not6c
ontrolled6by6the6Broca6area6of6the6left6frontal6lobe.
3. The6patient6diagnosed6with6schizophrenia6asks6why6psychotropic6medications6are6a
lways6prescribed6by6the6doctor.6The6nurses6answer6will6be6based6on6information6that6th
e6therapeutic6action6of6psychotropic6drugs6is6the6result6of6their6effect6on:
a. The6temporal6lobe;6especially6Wernickes6area
b. Dendrites6and6their6ability6to6transmit6electrical6impulses
c. The6regulation6of6neurotransmitters6especially6dopamine
d. The6peripheral6nervous6system6sensitivity6to6the6psychotropic6medications
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,Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
ANS:6C
Medications6used6to6treat6psychiatric6disorders6operate6in6and6around6the6synaptic6cleft6
and6have6action6at6the6neurotransmitter6level,6especially6in6the6case6of6schizophrenia,6o
n6dopamine.6The6Wernickes6area,6dendrite6function,6or6the6sensitivity6of6the6peripheral6
nervous6system6are6not6relevant6to6either6schizophrenia6or6psychotropic6medications.
4. A6student6nurse6mutters6that6it6seems6entirely6unnecessary6to6have6to6struggle6with6
understanding6the6anatomy6and6physiology6of6the6neurologic6system.6The6mentor6wo
uld6base6a6response6on6the6understanding6that6it6is:
Necessary6but6generally6for6psychiatric6nurses6who6focus6primarily6on6
a. behavioral6interventions
A6complex6undertaking6that6advance6practice6psychiatric6nurses6frequently6use6i
b. n6their6practice
Important6primarily6for6the6nursing6assessment6of6patients6with6brain6t
c. raumacaused6cognitive6symptoms
Necessary6for6planning6psychiatric6care6for6all6patients6especially6those6
d. experiencing6psychiatric6disorders
ANS:6D
Nurses6must6understand6that6many6symptoms6of6psychiatric6disorders6have6a6neurolo
gic6basis,6although6the6symptoms6are6manifested6behaviorally.6This6understanding6fa
cilitates6effective6care6planning.6The6foundation6of6knowledge6is6not6used6exclusively6
by6advanced6practice6psychiatric6nurses6nor6is6it6relevant6for6only6behavior6therapies6
or6brain6trauma6since6dealing6with6the6results6of6normal6and6abnormal6brain6function6i
s6a6responsibility6of6all6nurses6providing6all6types6of6care6to6the6psychiatric6patient.
5. A6patient6asks6the6nurse,6My6wife6has6breast6cancer.6Could6it6be6caused6by6her6
chronic6depression?6Which6response6is6supported6by6research6data?
a. Too6much6stress6has6been6proven6to6cause6all6kinds6of6cancer.
b. There6have6been6no6research6studies6done6on6stress6and6disease6yet.
c. Stress6does6cause6the6release6of6factors6that6suppress6the6immune6system.
d. There6appears6to6be6little6connection6between6stress6and6diseases6of6the6body
ANS:6C
Research6indicates6that6stress6causes6a6release6of6corticotropin-
releasing6factors6that6suppress6the6immune6system.6Studies6indicate6that6psychiatric6dis
orders6such6as6mood6disorders6are6sometimes6associated6with6decreased6functioning6of6
the6immune6system.6Research6does6not6support6a6connection6between6many6cancers6an
d6stress.6There6is6a6significant6amount6of6research6about6stress6and6the6body.6Research6
has6shown6that6there6are6some6connections6between6stress6and6physical6disease.
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, Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical
6 6 6 6 6 6 6
Applications 8th Edition Testbank/Study Guide
6 6 6 6
6. A6patient6who6has6a6parietal6lobe6injury6is6being6evaluated6for6psychiatric6rehabilitat
ion6needs.6Of6the6aspects6of6functioning6listed,6which6will6the6nurse6identify6as6a6focus6
of6nursing6intervention?
a. Expression6of6emotion
b. Detecting6auditory6stimuli
c. Receiving6visual6images
d. Processing6associations
ANS:6D
The6parietal6lobe6is6responsible6for6associating6and6processing6sensory6information6tha
t6allows6for6functions6such6as6following6directions6on6a6map,6reading6a6clock,6dressing6
self,6keeping6appointments,6and6distinguishing6right6from6left.6Emotional6expression6is
6associated6with6frontal6lobe6function.6Detecting6auditory6stimuli6is6a6temporal6lobe6fu
nction.6Receiving6visual6images6is6related6to6occipital6lobe6function.
7. At6admission,6the6nurse6learns6that6some6time6ago6the6patient6had6an6infarct6in6the6r
ight6cerebral6cortex.6During6assessment,6the6nurse6would6expect6to6find6that6the6patie
nt:
a. Demonstrates6major6deficiencies6in6speech
b. Is6unable6to6effectively6hold6a6spoon6in6the6left6hand
c. Has6difficulty6explaining6how6to6go6about6using6the6telephone
d. Cannot6use6his6right6hand6to6shave6himself6or6comb6his6own6hair
ANS:6B
The6cerebral6hemispheres6are6responsible6for6functions6such6as6control6of6muscles.6Th
e6right6hemisphere6mainly6controls6the6motor6and6sensory6functions6on6the6left6side6of6t
he6body.6Damage6to6the6right6side6would6result6in6impaired6function6on6the6left6side6of6
the6body.6The6motor6cortex6controls6voluntary6motor6activity.6Brocas6area6controls6mo
tor6speech.6Cognitive6functions6are6attributed6to6the6association6cortex.
The6right6side6of6the6bodys6motor6activity6is6controlled6by6the6left6cerebral6cortex.
8. A6patient6with6chronic6schizophrenia6had6a6stroke6involving6the6hippocampus.6The6
patient6will6be6discharged6on6low6doses6of6haloperidol.6The6nurse6will6need6to6individ
ualize6the6patients6medication6teaching6by:
a. Including6the6patients6caregiver6in6the6education
b. Being6careful6to6stress6the6importance6of6taking6the6medication6as6prescribed
Providing6the6education6at6a6time6when6the6patient6is6emotionally6calm6and6r
c. elaxed
Encouraging6the6patient6to6crush6or6dissolve6the6medication6to6help6with6
d. swallowing
ANS:6A
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