STAHL'S ESSENTIAL PSYC t t
HOPHARMACOLOGY
NEUROSCIENTIFICtBASIStANDtPRACTICALtAPPLICATIONStTESTBANK/STUDYt
GUIDE
Chapter 1 Chemical neurotransmission t t t
MULTIPLE CHOICE t
1. A patient with depression mentions to the nurse, My mother says depression is a chem
t t t t t t t t t t t t t t
ical disorder. What does she mean? The nurses response is based on the theory
t t t t t t t t t t t t t
that depression primarily involves which of the following neurotransmitters?
t t t t t t t t
a. Cortisol and GABA t t
b. COMT and glutamate t t
c. Monamine and glycine t t
d. Serotonin and norepinephrine t t t
ANS: D t
One possible cause of depression is thought to involve one or more neurotransmitters.
t t t t t t t t t t t t
Serotonin and norepinephrine have been found to be important in the regulation ofdep
t t t t t t t t t t t t t
ression. There is no research to support that the other options play a significantrole in th
t t t t t t t t t t t t t t t t
e development of depression.
t t t
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage t
t t t t t t t t t t t t t t
o the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?
t t t t t t t t t t t t t
a. Observing the patient pick up a spoon t t t t t t
b. Asking the patient to recite the alphabet t t t t t t
c. Monitoring the patients blood pressure t t t t
d. Comparing the patients grip strength in both handsA t t t t t t t t
NS: B t
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
t t t t t t t t t t t t t t
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are notcontrolle
t t t t t t t t t t t t t
d by the Broca area of the left frontal lobe.
t t t t t t t t t
3. The patient diagnosed with schizophrenia asks why psychotropic medications are alw
t t t t t t t t t t
ays prescribed by the doctor. The nurses answer will be based on information that
t t t t t t t t t t t t t
the therapeutic action of psychotropic drugs is the result of their effect on:
t t t t t t t t t t t t
a. The temporal lobe; especially Wernickes area t t t t t
b. Dendrites and their ability to transmit electrical impulses t t t t t t t
c. The regulation of neurotransmitters especially dopamine
t t t t t
d. The peripheral nervous system sensitivity to the psychotropic medications
t t t t t t t t
,ANS: C t
Medications used to treat psychiatric disorders operate in and around the synaptic cleftand t t t t t t t t t t t t t t
have action at the neurotransmitter level, especially in the case of schizophrenia, on dopam
t t t t t t t t t t t t t
ine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nervous syst
t t t t t t t t t t t t t
em are not relevant to either schizophrenia or psychotropic medications.
t t t t t t t t t
4. A student nurse mutters that it seems entirely unnecessary to have to struggle withunde
t t t t t t t t t t t t t t
rstanding the anatomy and physiology of the neurologic system. The mentor would base
t t t t t t t t t t t t t
a response on the understanding that it is:
t t t t t t t
Necessary but generally for psychiatric nurses who focus primarily on t t t t t t t t t
a. behavioral interventions t
A complex undertaking that advance practice psychiatric nurses frequently usein th
t t t t t t t t t t t
b. eir practice t
Important primarily for the nursing assessment of patients with braintraumacaused t t t t t t t t t t t
c. cognitive symptoms t
Necessary for planning psychiatric care for all patients especially thoseexperiencing p t t t t t t t t t t t
d. sychiatric disorders t
ANS: D t
Nurses must understand that many symptoms of psychiatric disorders have a neurologic ba
t t t t t t t t t t t t
sis, although the symptoms are manifested behaviorally. This understanding facilitates eff
t t t t t t t t t t
ective care planning. The foundation of knowledge is notused exclusively by advanced pra
t t t t t t t t t t t t t
ctice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma since d
t t t t t t t t t t t t t t t
ealing with the results of normal and abnormal brain function is a responsibility of all nurse
t t t t t t t t t t t t t t t
s providing all types of care tothe psychiatric patient.
t t t t t t t t t
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herchro
t t t t t t t t t t t t t t t t
nic depression? Which response is supported by research data?
t t t t t t t t
a. Too much stress has been proven to cause all kinds of cancer. t t t t t t t t t t t
b. There have been no research studies done on stress and disease yet. t t t t t t t t t t t
c. Stress does cause the release of factors that suppress the immune system. t t t t t t t t t t t
d. There appears to be little connection between stress and diseases of the bodyAN t t t t t t t t t t t t t
S: C t
Research indicates that stress causes a release of corticotropin-releasing factors that
t t t t t t t t t t
suppress the immune system. Studies indicate that psychiatric disorders such as mooddiso
t t t t t t t t t t t t
rders are sometimes associated with decreased functioning of the immune system.Researc
t t t t t t t t t t t
h does not support a connection between many cancers and stress. There is a significant am
t t t t t t t t t t t t t t t
ount of research about stress and the body. Research has shown that there are some connec
t t t t t t t t t t t t t t t
tions between stress and physical disease.
t t t t t
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation
t t t t t t t t t t t t t t
needs. Of the aspects of functioning listed, which will the nurse identifyas a focus of nursin
t t t t t t t t t t t t t t t t
g intervention?
t
a. Expression of emotion t t
b. Detecting auditory stimuli t t
c. Receiving visual images t t
d. Processing associations t t
ANS: D t
The parietal lobe is responsible for associating and processing sensory information
t t t t t t t t t t
that allows for functions such as following directions on a map, reading a clock, dressing se
t t t t t t t t t t t t t t t
lf, keeping appointments, and distinguishing right from left. Emotional expression is assoc
t t t t t t t t t t t
iated with frontal lobe function. Detecting auditory stimuli is a temporal lobe function. Rec
t t t t t t t t t t t t t
eiving visual images is related to occipital lobe function.
t t t t t t t t
7. At admission, the nurse learns that some time ago the patient had an infarct in theright
t t t t t t t t t t t t t t t t t
cerebral cortex. During assessment, the nurse would expect to find that the patient:
t t t t t t t t t t t t
a. Demonstrates major deficiencies in speech t t t t
b. Is unable to effectively hold a spoon in the left hand
t t t t t t t t t t
c. Has difficulty explaining how to go about using the telephone t t t t t t t t t
d. Cannot use his right hand to shave himself or comb his own hairAN t t t t t t t t t t t t t
S: B t
The cerebral hemispheres are responsible for functions such as control of muscles.
t t t t t t t t t t t
The right hemisphere mainly controls the motor and sensory functions on the left sideof th
t t t t t t t t t t t t t t t
e body. Damage to the right side would result in impaired function on the left side of the bo
t t t t t t t t t t t t t t t t t t
dy. The motor cortex controls voluntary motor activity. Brocas area controls motor speec
t t t t t t t t t t t t
h. Cognitive functions are attributed to the association cortex.
t t t t t t t t
The right side of the bodys motor activity is controlled by the left cerebral cortex.
t t t t t t t t t t t t t t
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. Thepati
t t t t t t t t t t t t
ent will be discharged on low doses of haloperidol. The nurse will need to individualize th
t t t t t t t t t t t t t t t
e patients medication teaching by:
t t t t
a. Including the patients caregiver in the education t t t t t t
b. Being careful to stress the importance of taking the medication as prescribedPro
t t t t t t t t t t t t
viding the education at a time when the patient is emotionally calm and
t t t t t t t t t t t t
c. relaxed
Encouraging the patient to crush or dissolve the medication to help withswallowing t t t t t t t t t t t t
d.
ANS: A t
, The hippocampus plays a major role in short-
t t t t t t t
term memory and, hence, in learning. Taking the medication as prescribed and providing t
t t t t t t t t t t t t t
he education at a time when the patient is calm and relaxed is information or considerations
t t t t t t t t t t t t t t t t
that all patients should begiven. The medication does not necessarily need to be crushed or
t t t t t t t t t t t t t t t t
dissolved since the stroke would not have caused difficulty with swallowing.
t t t t t t t t t t
9. The physician tells the nurse, The medication Im prescribing for the patient enha
t t t t t t t t t t t t
nces the g- t t
aminobutyric acid (GABA) system. Which patient behavior willprovide evidence t t t t t t t t t t t
hat the medication therapy is successful?
t t t t t
a. The patient is actively involved in playing cards with other patients. t t t t t t t t t t
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
t t t t t t t t t t t t t t t t
c. The patient reports that both auditory and visual hallucinations have decreased.
t t t t t t t t t t
d. The patient says that, I am much happier than before I came to the hospital.ANS
t t t t t t t t t t t t t t t
:B t
GABA is the principle inhibitory neurotransmitter. The medication should provide an
t t t t t t t t t t
antianxiety effect. Alertness, psychotic behaviors, and mood elevation are notge
t t t t t t t t t t
nerally affected by g-aminobutyric acid. t t t t
10. The patients family asks whether a diagnosis of Parkinsons disease creates anincr
t t t t t t t t t t t t
eased risk for any mental health issues. What question would the nurse ask toassess fo
t t t t t t t t t t t t t t t
r such a comorbid condition?
t t t t
a. Has your father exhibited any signs of depression? t t t t t t t
b. Does your father seem to experience mood swings? t t t t t t t
c. Have you noticed your father talking about seeing things you cant see? t t t t t t t t t t t
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?ANS
t t t t t t t t t t t t t t
:A t
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the
t t t t t t t t t t
neurotransmitters that are most widely involved in various forms of depression. Mostresea t t t t t t t t t t t t
rchers agree that the immediate cause of parkinsonism is a deficiency of dopamine and so a
t t t t t t t t t t t t t t t
patient with Parkinsons disease should be monitored for depression, The other mental hea
t t t t t t t t t t t t t
lth disorders (bipolar disorder, hallucinations, and obsessive compulsive disorder) have n
t t t t t t t t t t
ot been connected to Parkinsons disease.
t t t t t
11. Which explanation for the prescription of donepezil (Aricept) would the nursepro
t t t t t t t t t t t
vide for a patient in the early stage of Alzheimers disease?
t t t t t t t t t t
a. It will increase the metabolism of excess GABA. t t t t t t t
b. Excess dopamine will be prevented from attaching to receptor sites. t t t t t t t t t
c. Serotonin deficiency will be managed through a prolonged reuptake period. t t t t t t t t t
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.A
t t t t t t t t t
NS: D t
HOPHARMACOLOGY
NEUROSCIENTIFICtBASIStANDtPRACTICALtAPPLICATIONStTESTBANK/STUDYt
GUIDE
Chapter 1 Chemical neurotransmission t t t
MULTIPLE CHOICE t
1. A patient with depression mentions to the nurse, My mother says depression is a chem
t t t t t t t t t t t t t t
ical disorder. What does she mean? The nurses response is based on the theory
t t t t t t t t t t t t t
that depression primarily involves which of the following neurotransmitters?
t t t t t t t t
a. Cortisol and GABA t t
b. COMT and glutamate t t
c. Monamine and glycine t t
d. Serotonin and norepinephrine t t t
ANS: D t
One possible cause of depression is thought to involve one or more neurotransmitters.
t t t t t t t t t t t t
Serotonin and norepinephrine have been found to be important in the regulation ofdep
t t t t t t t t t t t t t
ression. There is no research to support that the other options play a significantrole in th
t t t t t t t t t t t t t t t t
e development of depression.
t t t
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage t
t t t t t t t t t t t t t t
o the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?
t t t t t t t t t t t t t
a. Observing the patient pick up a spoon t t t t t t
b. Asking the patient to recite the alphabet t t t t t t
c. Monitoring the patients blood pressure t t t t
d. Comparing the patients grip strength in both handsA t t t t t t t t
NS: B t
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
t t t t t t t t t t t t t t
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are notcontrolle
t t t t t t t t t t t t t
d by the Broca area of the left frontal lobe.
t t t t t t t t t
3. The patient diagnosed with schizophrenia asks why psychotropic medications are alw
t t t t t t t t t t
ays prescribed by the doctor. The nurses answer will be based on information that
t t t t t t t t t t t t t
the therapeutic action of psychotropic drugs is the result of their effect on:
t t t t t t t t t t t t
a. The temporal lobe; especially Wernickes area t t t t t
b. Dendrites and their ability to transmit electrical impulses t t t t t t t
c. The regulation of neurotransmitters especially dopamine
t t t t t
d. The peripheral nervous system sensitivity to the psychotropic medications
t t t t t t t t
,ANS: C t
Medications used to treat psychiatric disorders operate in and around the synaptic cleftand t t t t t t t t t t t t t t
have action at the neurotransmitter level, especially in the case of schizophrenia, on dopam
t t t t t t t t t t t t t
ine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nervous syst
t t t t t t t t t t t t t
em are not relevant to either schizophrenia or psychotropic medications.
t t t t t t t t t
4. A student nurse mutters that it seems entirely unnecessary to have to struggle withunde
t t t t t t t t t t t t t t
rstanding the anatomy and physiology of the neurologic system. The mentor would base
t t t t t t t t t t t t t
a response on the understanding that it is:
t t t t t t t
Necessary but generally for psychiatric nurses who focus primarily on t t t t t t t t t
a. behavioral interventions t
A complex undertaking that advance practice psychiatric nurses frequently usein th
t t t t t t t t t t t
b. eir practice t
Important primarily for the nursing assessment of patients with braintraumacaused t t t t t t t t t t t
c. cognitive symptoms t
Necessary for planning psychiatric care for all patients especially thoseexperiencing p t t t t t t t t t t t
d. sychiatric disorders t
ANS: D t
Nurses must understand that many symptoms of psychiatric disorders have a neurologic ba
t t t t t t t t t t t t
sis, although the symptoms are manifested behaviorally. This understanding facilitates eff
t t t t t t t t t t
ective care planning. The foundation of knowledge is notused exclusively by advanced pra
t t t t t t t t t t t t t
ctice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma since d
t t t t t t t t t t t t t t t
ealing with the results of normal and abnormal brain function is a responsibility of all nurse
t t t t t t t t t t t t t t t
s providing all types of care tothe psychiatric patient.
t t t t t t t t t
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herchro
t t t t t t t t t t t t t t t t
nic depression? Which response is supported by research data?
t t t t t t t t
a. Too much stress has been proven to cause all kinds of cancer. t t t t t t t t t t t
b. There have been no research studies done on stress and disease yet. t t t t t t t t t t t
c. Stress does cause the release of factors that suppress the immune system. t t t t t t t t t t t
d. There appears to be little connection between stress and diseases of the bodyAN t t t t t t t t t t t t t
S: C t
Research indicates that stress causes a release of corticotropin-releasing factors that
t t t t t t t t t t
suppress the immune system. Studies indicate that psychiatric disorders such as mooddiso
t t t t t t t t t t t t
rders are sometimes associated with decreased functioning of the immune system.Researc
t t t t t t t t t t t
h does not support a connection between many cancers and stress. There is a significant am
t t t t t t t t t t t t t t t
ount of research about stress and the body. Research has shown that there are some connec
t t t t t t t t t t t t t t t
tions between stress and physical disease.
t t t t t
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation
t t t t t t t t t t t t t t
needs. Of the aspects of functioning listed, which will the nurse identifyas a focus of nursin
t t t t t t t t t t t t t t t t
g intervention?
t
a. Expression of emotion t t
b. Detecting auditory stimuli t t
c. Receiving visual images t t
d. Processing associations t t
ANS: D t
The parietal lobe is responsible for associating and processing sensory information
t t t t t t t t t t
that allows for functions such as following directions on a map, reading a clock, dressing se
t t t t t t t t t t t t t t t
lf, keeping appointments, and distinguishing right from left. Emotional expression is assoc
t t t t t t t t t t t
iated with frontal lobe function. Detecting auditory stimuli is a temporal lobe function. Rec
t t t t t t t t t t t t t
eiving visual images is related to occipital lobe function.
t t t t t t t t
7. At admission, the nurse learns that some time ago the patient had an infarct in theright
t t t t t t t t t t t t t t t t t
cerebral cortex. During assessment, the nurse would expect to find that the patient:
t t t t t t t t t t t t
a. Demonstrates major deficiencies in speech t t t t
b. Is unable to effectively hold a spoon in the left hand
t t t t t t t t t t
c. Has difficulty explaining how to go about using the telephone t t t t t t t t t
d. Cannot use his right hand to shave himself or comb his own hairAN t t t t t t t t t t t t t
S: B t
The cerebral hemispheres are responsible for functions such as control of muscles.
t t t t t t t t t t t
The right hemisphere mainly controls the motor and sensory functions on the left sideof th
t t t t t t t t t t t t t t t
e body. Damage to the right side would result in impaired function on the left side of the bo
t t t t t t t t t t t t t t t t t t
dy. The motor cortex controls voluntary motor activity. Brocas area controls motor speec
t t t t t t t t t t t t
h. Cognitive functions are attributed to the association cortex.
t t t t t t t t
The right side of the bodys motor activity is controlled by the left cerebral cortex.
t t t t t t t t t t t t t t
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. Thepati
t t t t t t t t t t t t
ent will be discharged on low doses of haloperidol. The nurse will need to individualize th
t t t t t t t t t t t t t t t
e patients medication teaching by:
t t t t
a. Including the patients caregiver in the education t t t t t t
b. Being careful to stress the importance of taking the medication as prescribedPro
t t t t t t t t t t t t
viding the education at a time when the patient is emotionally calm and
t t t t t t t t t t t t
c. relaxed
Encouraging the patient to crush or dissolve the medication to help withswallowing t t t t t t t t t t t t
d.
ANS: A t
, The hippocampus plays a major role in short-
t t t t t t t
term memory and, hence, in learning. Taking the medication as prescribed and providing t
t t t t t t t t t t t t t
he education at a time when the patient is calm and relaxed is information or considerations
t t t t t t t t t t t t t t t t
that all patients should begiven. The medication does not necessarily need to be crushed or
t t t t t t t t t t t t t t t t
dissolved since the stroke would not have caused difficulty with swallowing.
t t t t t t t t t t
9. The physician tells the nurse, The medication Im prescribing for the patient enha
t t t t t t t t t t t t
nces the g- t t
aminobutyric acid (GABA) system. Which patient behavior willprovide evidence t t t t t t t t t t t
hat the medication therapy is successful?
t t t t t
a. The patient is actively involved in playing cards with other patients. t t t t t t t t t t
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
t t t t t t t t t t t t t t t t
c. The patient reports that both auditory and visual hallucinations have decreased.
t t t t t t t t t t
d. The patient says that, I am much happier than before I came to the hospital.ANS
t t t t t t t t t t t t t t t
:B t
GABA is the principle inhibitory neurotransmitter. The medication should provide an
t t t t t t t t t t
antianxiety effect. Alertness, psychotic behaviors, and mood elevation are notge
t t t t t t t t t t
nerally affected by g-aminobutyric acid. t t t t
10. The patients family asks whether a diagnosis of Parkinsons disease creates anincr
t t t t t t t t t t t t
eased risk for any mental health issues. What question would the nurse ask toassess fo
t t t t t t t t t t t t t t t
r such a comorbid condition?
t t t t
a. Has your father exhibited any signs of depression? t t t t t t t
b. Does your father seem to experience mood swings? t t t t t t t
c. Have you noticed your father talking about seeing things you cant see? t t t t t t t t t t t
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?ANS
t t t t t t t t t t t t t t
:A t
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the
t t t t t t t t t t
neurotransmitters that are most widely involved in various forms of depression. Mostresea t t t t t t t t t t t t
rchers agree that the immediate cause of parkinsonism is a deficiency of dopamine and so a
t t t t t t t t t t t t t t t
patient with Parkinsons disease should be monitored for depression, The other mental hea
t t t t t t t t t t t t t
lth disorders (bipolar disorder, hallucinations, and obsessive compulsive disorder) have n
t t t t t t t t t t
ot been connected to Parkinsons disease.
t t t t t
11. Which explanation for the prescription of donepezil (Aricept) would the nursepro
t t t t t t t t t t t
vide for a patient in the early stage of Alzheimers disease?
t t t t t t t t t t
a. It will increase the metabolism of excess GABA. t t t t t t t
b. Excess dopamine will be prevented from attaching to receptor sites. t t t t t t t t t
c. Serotonin deficiency will be managed through a prolonged reuptake period. t t t t t t t t t
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.A
t t t t t t t t t
NS: D t
