FULL TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY
NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 5th EDITION FULL
CHAPTERS
,Contents
Chapter 1 Chemical neurotransmission .................................................................................................... 3
Chapter 2 Transporters, receptors, and enzymes as targets of psychopharmacological drug
action .............................................................................................................................. 13
Chapter 3 Ion channels as targets of psychopharmacological drug action .......................... 19
Chapter 4 Psychosis and schizophrenia ............................................................................. 26
Chapter 5 Antipsychotic agents ........................................................................................ 43
Chapter 6 Mood disorders ................................................................................................ 51
Chapter 7: Antidepressants/Depressive Disorders Answer Section ................................... 70
Chapter 8 Mood stabilizers ............................................................................................... 73
Chapter 9 Anxiety disorders and anxiolytics ..................................................................... 92
Chapter 10 Chronic pain and its treatment ..................................................................... 100
Chapter 11 Disorders of sleep and wakefulness and their ............................................... 109
Chapter 12 Attention deficit hyperactivity disorder and its treatment ............................ 117
Chapter 13 Dementia and its treatment ......................................................................... 128
Chapter 14 Impulsivity, compulsivity, and addiction ....................................................... 142
,Chapter 1 Chemical neurotransmission
MULTIPLE CHOICE
1. A patient with depression mentions to the nurse, my mother says depression is a chemical
disorder. What does she mean? The nurse’s response is based on the theory
that depression primarily involves which of the following neurotransmitters?
a. Cortisol and GABA
b. COMT and glutamate
c. Monoamine and glycine
d. Serotonin and norepinephrine
ANS:D
One possible cause of depression is thought to involve one or more neurotransmitters.
Serotonin and norepinephrine have been found to be important in the regulation of depression. There is
no research to support that the other options play a significant role in the development of depression.
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage to
the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?
a. Observing the patient pick up a spoon
b. Asking the patient to recite the alphabet
c. Monitoring the patients blood pressure
d. Comparing the patients grip strength in both hands
ANS:B
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not controlled by the
Broca area of the left frontal lobe.
3. The patient diagnosed with schizophrenia asks why psychotropic medications are always
prescribed by the doctor. The nurses answer will be based on information that
the therapeutic action of psychotropic drugs is the result of their effect on:
a. The temporal lobe; especially Wernicke’s area
b. Dendrites and their ability to transmit electrical impulses
,c. The regulation of neurotransmitters especially dopamine
d. The peripheral nervous system sensitivity to the psychotropic medications
m
ANS:C
Medications used to treat psychiatric disorders operate in and around the synaptic cleft and have action
at the neurotransmitter level, especially in the case of schizophrenia, on dopamine. The Wernickes area,
dendrite function, or the sensitivity of the peripheral nervous system are not relevant to either
schizophrenia or psychotropic medications.
4. A student nurse mutters that it seems entirely unnecessary to have to struggle with
understanding the anatomy and physiology of the neurologic system. The mentor would base a
response on the understanding that it is:
Necessary but generally for psychiatric nurses who focus primarily on
a. behavioral interventions
b. A complex undertaking that advance practice psychiatric nurses frequently use in their practice
c. Important primarily for the nursing assessment of patients with brain traumacaused cognitive
symptoms
d. Necessary for planning psychiatric care for all patients especially those experiencing psychiatric
disorders
ANS:D
Nurses must understand that many symptoms of psychiatric disorders have a neurologic basis, although
the symptoms are manifested behaviorally. This understanding facilitates effective care planning. The
foundation of knowledge is not used exclusively by advanced practice psychiatric nurses nor is it
relevant for only behavior therapies or brain trauma since dealing with the results of normal and
abnormal brain function is a responsibility of all nurses providing all types of care to the psychiatric
patient.
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her chronic
depression? Which response is supported by research data?
,a. Too much stress has been proven to cause all kinds of cancer.
b. There have been no research studies done on stress and disease yet.
c. Stress does cause the release of factors that suppress the immune system.
d. There appears to be little connection between stress and diseases of the body
ANS:C
Research indicates that stress causes a release of corticotropin-releasing factors that
suppress the immune system. Studies indicate that psychiatric disorders such as mood disorders are
sometimes associated with decreased functioning of the immune system. Research does not support a
connection between many cancers and stress. There is a significant amount of research about stress and
the body. Research has shown that there are some connections between stress and physical disease.
6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs.
Of the aspects of functioning listed, which will the nurse identify as a focus of nursing intervention?
a. Expression of emotion
b. Detecting auditory stimuli
c. Receiving visual images
d. Processing associations
ANS:D
The parietal lobe is responsible for associating and processing sensory information
that allows for functions such as following directions on a map, reading a clock, dressing self, keeping
appointments, and distinguishing right from left. Emotional expression is associated with frontal lobe
function. Detecting auditory stimuli is a temporal lobe function. Receiving visual images is related to
occipital lobe function.
7. At admission, the nurse learns that some time ago the patient had an infarct in the right
cerebral cortex. During assessment, the nurse would expect to find that the patient:
a. Demonstrates major deficiencies in speech
b. Is unable to effectively hold a spoon in the left hand
c. Has difficulty explaining how to go about using the telephone
, d. Cannot use his right hand to shave himself or comb his own hair
ANS:B
The cerebral hemispheres are responsible for functions such as control of muscles.
The right hemisphere mainly controls the motor and sensory functions on the left side of the body.
Damage to the right side would result in impaired function on the left side of the body. The motor
cortex controls voluntary motor activity. Brocas area controls motor speech. Cognitive functions are
attributed to the association cortex.
The right side of the bodys motor activity is controlled by the left cerebral cortex.
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The patient will be
discharged on low doses of haloperidol. The nurse will need to individualize the patients medication
teaching by:
a. Including the patients caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed Providing the
education at a time when the patient is emotionally calm and
c.
d.
ANS:A
relaxed
Encouraging the patient to crush or dissolve the medication to help with swallowing
The hippocampus plays a major role in short-term memory and, hence, in learning. Taking the
medication as prescribed and providing the education at a time when the patient is calm and relaxed is
information or considerations that all patients should be given. The medication does not necessarily
need to be crushed or dissolved since the stroke would not have caused difficulty with swallowing.
9. The physician tells the nurse, The medication Im prescribing for the patient enhances the g-
aminobutyric acid (GABA) system. Which patient behavior will provide evidence that the medication
therapy is successful?
a. The patient is actively involved in playing cards with other patients.
NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 5th EDITION FULL
CHAPTERS
,Contents
Chapter 1 Chemical neurotransmission .................................................................................................... 3
Chapter 2 Transporters, receptors, and enzymes as targets of psychopharmacological drug
action .............................................................................................................................. 13
Chapter 3 Ion channels as targets of psychopharmacological drug action .......................... 19
Chapter 4 Psychosis and schizophrenia ............................................................................. 26
Chapter 5 Antipsychotic agents ........................................................................................ 43
Chapter 6 Mood disorders ................................................................................................ 51
Chapter 7: Antidepressants/Depressive Disorders Answer Section ................................... 70
Chapter 8 Mood stabilizers ............................................................................................... 73
Chapter 9 Anxiety disorders and anxiolytics ..................................................................... 92
Chapter 10 Chronic pain and its treatment ..................................................................... 100
Chapter 11 Disorders of sleep and wakefulness and their ............................................... 109
Chapter 12 Attention deficit hyperactivity disorder and its treatment ............................ 117
Chapter 13 Dementia and its treatment ......................................................................... 128
Chapter 14 Impulsivity, compulsivity, and addiction ....................................................... 142
,Chapter 1 Chemical neurotransmission
MULTIPLE CHOICE
1. A patient with depression mentions to the nurse, my mother says depression is a chemical
disorder. What does she mean? The nurse’s response is based on the theory
that depression primarily involves which of the following neurotransmitters?
a. Cortisol and GABA
b. COMT and glutamate
c. Monoamine and glycine
d. Serotonin and norepinephrine
ANS:D
One possible cause of depression is thought to involve one or more neurotransmitters.
Serotonin and norepinephrine have been found to be important in the regulation of depression. There is
no research to support that the other options play a significant role in the development of depression.
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage to
the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?
a. Observing the patient pick up a spoon
b. Asking the patient to recite the alphabet
c. Monitoring the patients blood pressure
d. Comparing the patients grip strength in both hands
ANS:B
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not controlled by the
Broca area of the left frontal lobe.
3. The patient diagnosed with schizophrenia asks why psychotropic medications are always
prescribed by the doctor. The nurses answer will be based on information that
the therapeutic action of psychotropic drugs is the result of their effect on:
a. The temporal lobe; especially Wernicke’s area
b. Dendrites and their ability to transmit electrical impulses
,c. The regulation of neurotransmitters especially dopamine
d. The peripheral nervous system sensitivity to the psychotropic medications
m
ANS:C
Medications used to treat psychiatric disorders operate in and around the synaptic cleft and have action
at the neurotransmitter level, especially in the case of schizophrenia, on dopamine. The Wernickes area,
dendrite function, or the sensitivity of the peripheral nervous system are not relevant to either
schizophrenia or psychotropic medications.
4. A student nurse mutters that it seems entirely unnecessary to have to struggle with
understanding the anatomy and physiology of the neurologic system. The mentor would base a
response on the understanding that it is:
Necessary but generally for psychiatric nurses who focus primarily on
a. behavioral interventions
b. A complex undertaking that advance practice psychiatric nurses frequently use in their practice
c. Important primarily for the nursing assessment of patients with brain traumacaused cognitive
symptoms
d. Necessary for planning psychiatric care for all patients especially those experiencing psychiatric
disorders
ANS:D
Nurses must understand that many symptoms of psychiatric disorders have a neurologic basis, although
the symptoms are manifested behaviorally. This understanding facilitates effective care planning. The
foundation of knowledge is not used exclusively by advanced practice psychiatric nurses nor is it
relevant for only behavior therapies or brain trauma since dealing with the results of normal and
abnormal brain function is a responsibility of all nurses providing all types of care to the psychiatric
patient.
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her chronic
depression? Which response is supported by research data?
,a. Too much stress has been proven to cause all kinds of cancer.
b. There have been no research studies done on stress and disease yet.
c. Stress does cause the release of factors that suppress the immune system.
d. There appears to be little connection between stress and diseases of the body
ANS:C
Research indicates that stress causes a release of corticotropin-releasing factors that
suppress the immune system. Studies indicate that psychiatric disorders such as mood disorders are
sometimes associated with decreased functioning of the immune system. Research does not support a
connection between many cancers and stress. There is a significant amount of research about stress and
the body. Research has shown that there are some connections between stress and physical disease.
6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs.
Of the aspects of functioning listed, which will the nurse identify as a focus of nursing intervention?
a. Expression of emotion
b. Detecting auditory stimuli
c. Receiving visual images
d. Processing associations
ANS:D
The parietal lobe is responsible for associating and processing sensory information
that allows for functions such as following directions on a map, reading a clock, dressing self, keeping
appointments, and distinguishing right from left. Emotional expression is associated with frontal lobe
function. Detecting auditory stimuli is a temporal lobe function. Receiving visual images is related to
occipital lobe function.
7. At admission, the nurse learns that some time ago the patient had an infarct in the right
cerebral cortex. During assessment, the nurse would expect to find that the patient:
a. Demonstrates major deficiencies in speech
b. Is unable to effectively hold a spoon in the left hand
c. Has difficulty explaining how to go about using the telephone
, d. Cannot use his right hand to shave himself or comb his own hair
ANS:B
The cerebral hemispheres are responsible for functions such as control of muscles.
The right hemisphere mainly controls the motor and sensory functions on the left side of the body.
Damage to the right side would result in impaired function on the left side of the body. The motor
cortex controls voluntary motor activity. Brocas area controls motor speech. Cognitive functions are
attributed to the association cortex.
The right side of the bodys motor activity is controlled by the left cerebral cortex.
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The patient will be
discharged on low doses of haloperidol. The nurse will need to individualize the patients medication
teaching by:
a. Including the patients caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed Providing the
education at a time when the patient is emotionally calm and
c.
d.
ANS:A
relaxed
Encouraging the patient to crush or dissolve the medication to help with swallowing
The hippocampus plays a major role in short-term memory and, hence, in learning. Taking the
medication as prescribed and providing the education at a time when the patient is calm and relaxed is
information or considerations that all patients should be given. The medication does not necessarily
need to be crushed or dissolved since the stroke would not have caused difficulty with swallowing.
9. The physician tells the nurse, The medication Im prescribing for the patient enhances the g-
aminobutyric acid (GABA) system. Which patient behavior will provide evidence that the medication
therapy is successful?
a. The patient is actively involved in playing cards with other patients.
