,Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE w
1. A patient with depression mentions to the nurse, My mother says depression is
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a chemical disorder. What does she mean? The nurses response is based on the
w w w w w w w w w w w w w w
theorythat depression primarily involves which of the following
w w w w w w w w
neurotransmitters?
a. Cortisol and GABA w w
b. COMT and glutamate w w
c. Monamine and glycine w w
d. Serotonin and norepinephrine w w
ANS: D w
One possible cause of depression is thought to involve one or more
w w w w w w w w w w w
neurotransmitters.Serotonin and norepinephrine have been found to be important
w w w w w w w w w
in the regulation of depression. There is no research to support that the other
w w w w w w w w w w w w w w
options play a significant role in the development of depression.
w w w w w w w w w w
2. A patient has experienced a stroke (cerebral vascular accident) that
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whas resulted in damage to the Broca area. Which evaluation does the nurse conduct
w w w w w w w w w w w w w
to reinforce thisdiagnosis?
w w w
a. Observing the patient pick up a spoon w w w w w w
b. Asking the patient to recite the alphabet w w w w w w
c. Monitoring the patients blood pressure w w w w
d. Comparing the patients grip strength in both hands w w w w w w w
ANS: B w
Accidents or strokes that damage Brocas area may result in the inability to speak
w w w w w w w w w w w w w
(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle
w w w w w w w w w w w
strength are notcontrolled by the Broca area of the left frontal lobe.
w w w w w w w w w w w w
3. The patient diagnosed with schizophrenia asks why psychotropic medications
w w w w w w w w
are always prescribed by the doctor. The nurses answer will be based on
w w w w w w w w w w w w w
information thatthe therapeutic action of psychotropic drugs is the result of
w w w w w w w w w w w
their effect on:
w w w
a. The temporal lobe; especially Wernickes area
w w w w w
b. Dendrites and their ability to transmit electrical impulses w w w w w w w
c. The regulation of neurotransmitters especially dopamine
w w w w w
d. The peripheral nervous system sensitivity to the psychotropic medications
w w w w w w w w
,ANS: C w
Medications used to treat psychiatric disorders operate in and around the synaptic
w w w w w w w w w w w
cleftand have action at the neurotransmitter level, especially in the case of
w w w w w w w w w w w w
schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
w w w w w w w w w w
sensitivity of the peripheral nervous system are not relevant to either
w w w w w w w w w w w
schizophrenia or psychotropic medications.
w w w w
4. A student nurse mutters that it seems entirely unnecessary to have to struggle
w w w w w w w w w w w w
withunderstanding the anatomy and physiology of the neurologic system. The
w w w w w w w w w w
mentor would base a response on the understanding that it is:
w w w w w w w w w w w
Necessary but generally for psychiatric nurses who focus primarily w w w w w w w w
a. onbehavioral interventions
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A complex undertaking that advance practice psychiatric nurses frequently
w w w w w w w w
b. usein their practice
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Important primarily for the nursing assessment of patients with w w w w w w w w
c. braintraumacaused cognitive symptoms
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Necessary for planning psychiatric care for all patients especially w w w w w w w w
d. thoseexperiencing psychiatric disorders
w w w
ANS: D w
Nurses must understand that many symptoms of psychiatric disorders have a
w w w w w w w w w w
neurologic basis, although the symptoms are manifested behaviorally. This
w w w w w w w w w
understanding facilitates effective care planning. The foundation of knowledge
w w w w w w w w w
is notused exclusively by advanced practice psychiatric nurses nor is it relevant
w w w w w w w w w w w w
for only behavior therapies or brain trauma since dealing with the results of
w w w w w w w w w w w w w
normal and abnormal brain function is a responsibility of all nurses providing all
w w w w w w w w w w w w w
types of care tothe psychiatric patient.
w w w w w w
5. A patient asks the nurse, My wife has breast cancer. Could it be caused
w w w w w w w w w w w w w
by herchronic depression? Which response is supported by research data?
w w w w w w w w w w
a. Too much stress has been proven to cause all kinds of cancer.
w w w w w w w w w w w
b. There have been no research studies done on stress and disease yet.
w w w w w w w w w w w
c. Stress does cause the release of factors that suppress the immune system.
w w w w w w w w w w w
d. There appears to be little connection between stress and diseases of the body
w w w w w w w w w w w w
ANS: C w
Research indicates that stress causes a release of corticotropin-releasing factors
w w w w w w w w w
that suppress the immune system. Studies indicate that psychiatric disorders such
w w w w w w w w w w w
as mooddisorders are sometimes associated with decreased functioning of the
w w w w w w w w w w
immune system.Research does not support a connection between many cancers
w w w w w w w w w w
and stress. There is a significant amount of research about stress and the body.
w w w w w w w w w w w w w w
Research has shown that there are some connections between stress and physical
w w w w w w w w w w w
disease.
w
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
w w w w w w w w w w w w
rehabilitation needs. Of the aspects of functioning listed, which will the
w w w w w w w w w w w
nurse identifyas a focus of nursing intervention?
w w w w w w w
a. Expression of emotion w w
b. Detecting auditory stimuli w w
c. Receiving visual images w w
d. Processing associations w
ANS: D w
The parietal lobe is responsible for associating and processing sensory information
w w w w w w w w w w
that allows for functions such as following directions on a map, reading a clock,
w w w w w w w w w w w w w w
dressing self, keeping appointments, and distinguishing right from left. Emotional
w w w w w w w w w w
expression is associated with frontal lobe function. Detecting auditory stimuli is a
w w w w w w w w w w w w
temporal lobe function. Receiving visual images is related to occipital lobe
w w w w w w w w w w w
function.
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7. At admission, the nurse learns that some time ago the patient had an infarct
w w w w w w w w w w w w w
in theright cerebral cortex. During assessment, the nurse would expect to find
w w w w w w w w w w w w
that the patient:
w w w
a. Demonstrates major deficiencies in speech w w w w
b. Is unable to effectively hold a spoon in the left hand
w w w w w w w w w w
c. Has difficulty explaining how to go about using the telephone
w w w w w w w w w
d. Cannot use his right hand to shave himself or comb his own hair w w w w w w w w w w w w
ANS: B w
The cerebral hemispheres are responsible for functions such as control of muscles.
w w w w w w w w w w w
The right hemisphere mainly controls the motor and sensory functions on the left
w w w w w w w w w w w w w
sideof the body. Damage to the right side would result in impaired function on
w w w w w w w w w w w w w w
the left side of the body. The motor cortex controls voluntary motor activity.
w w w w w w w w w w w w w
Brocas area controls motor speech. Cognitive functions are attributed to the
w w w w w w w w w w w
association cortex.
w w
The right side of the bodys motor activity is controlled by the left cerebral cortex.
w w w w w w w w w w w w w w
8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
w w w w w w w w w w
Thepatient will be discharged on low doses of haloperidol. The nurse will need
w w w w w w w w w w w w w
to individualize the patients medication teaching by:
w w w w w w w
a. Including the patients caregiver in the education w w w w w w
b. Being careful to stress the importance of taking the medication as prescribed
w w w w w w w w w w w
Providing the education at a time when the patient is emotionally calm
w w w w w w w w w w w
c. andrelaxed
w
Encouraging the patient to crush or dissolve the medication to help w w w w w w w w w w
d. withswallowing
w
ANS: A w
w w w
MULTIPLE CHOICE w
1. A patient with depression mentions to the nurse, My mother says depression is
w w w w w w w w w w w w
a chemical disorder. What does she mean? The nurses response is based on the
w w w w w w w w w w w w w w
theorythat depression primarily involves which of the following
w w w w w w w w
neurotransmitters?
a. Cortisol and GABA w w
b. COMT and glutamate w w
c. Monamine and glycine w w
d. Serotonin and norepinephrine w w
ANS: D w
One possible cause of depression is thought to involve one or more
w w w w w w w w w w w
neurotransmitters.Serotonin and norepinephrine have been found to be important
w w w w w w w w w
in the regulation of depression. There is no research to support that the other
w w w w w w w w w w w w w w
options play a significant role in the development of depression.
w w w w w w w w w w
2. A patient has experienced a stroke (cerebral vascular accident) that
w w w w w w w w w
whas resulted in damage to the Broca area. Which evaluation does the nurse conduct
w w w w w w w w w w w w w
to reinforce thisdiagnosis?
w w w
a. Observing the patient pick up a spoon w w w w w w
b. Asking the patient to recite the alphabet w w w w w w
c. Monitoring the patients blood pressure w w w w
d. Comparing the patients grip strength in both hands w w w w w w w
ANS: B w
Accidents or strokes that damage Brocas area may result in the inability to speak
w w w w w w w w w w w w w
(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle
w w w w w w w w w w w
strength are notcontrolled by the Broca area of the left frontal lobe.
w w w w w w w w w w w w
3. The patient diagnosed with schizophrenia asks why psychotropic medications
w w w w w w w w
are always prescribed by the doctor. The nurses answer will be based on
w w w w w w w w w w w w w
information thatthe therapeutic action of psychotropic drugs is the result of
w w w w w w w w w w w
their effect on:
w w w
a. The temporal lobe; especially Wernickes area
w w w w w
b. Dendrites and their ability to transmit electrical impulses w w w w w w w
c. The regulation of neurotransmitters especially dopamine
w w w w w
d. The peripheral nervous system sensitivity to the psychotropic medications
w w w w w w w w
,ANS: C w
Medications used to treat psychiatric disorders operate in and around the synaptic
w w w w w w w w w w w
cleftand have action at the neurotransmitter level, especially in the case of
w w w w w w w w w w w w
schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
w w w w w w w w w w
sensitivity of the peripheral nervous system are not relevant to either
w w w w w w w w w w w
schizophrenia or psychotropic medications.
w w w w
4. A student nurse mutters that it seems entirely unnecessary to have to struggle
w w w w w w w w w w w w
withunderstanding the anatomy and physiology of the neurologic system. The
w w w w w w w w w w
mentor would base a response on the understanding that it is:
w w w w w w w w w w w
Necessary but generally for psychiatric nurses who focus primarily w w w w w w w w
a. onbehavioral interventions
w w
A complex undertaking that advance practice psychiatric nurses frequently
w w w w w w w w
b. usein their practice
w w w
Important primarily for the nursing assessment of patients with w w w w w w w w
c. braintraumacaused cognitive symptoms
w w w
Necessary for planning psychiatric care for all patients especially w w w w w w w w
d. thoseexperiencing psychiatric disorders
w w w
ANS: D w
Nurses must understand that many symptoms of psychiatric disorders have a
w w w w w w w w w w
neurologic basis, although the symptoms are manifested behaviorally. This
w w w w w w w w w
understanding facilitates effective care planning. The foundation of knowledge
w w w w w w w w w
is notused exclusively by advanced practice psychiatric nurses nor is it relevant
w w w w w w w w w w w w
for only behavior therapies or brain trauma since dealing with the results of
w w w w w w w w w w w w w
normal and abnormal brain function is a responsibility of all nurses providing all
w w w w w w w w w w w w w
types of care tothe psychiatric patient.
w w w w w w
5. A patient asks the nurse, My wife has breast cancer. Could it be caused
w w w w w w w w w w w w w
by herchronic depression? Which response is supported by research data?
w w w w w w w w w w
a. Too much stress has been proven to cause all kinds of cancer.
w w w w w w w w w w w
b. There have been no research studies done on stress and disease yet.
w w w w w w w w w w w
c. Stress does cause the release of factors that suppress the immune system.
w w w w w w w w w w w
d. There appears to be little connection between stress and diseases of the body
w w w w w w w w w w w w
ANS: C w
Research indicates that stress causes a release of corticotropin-releasing factors
w w w w w w w w w
that suppress the immune system. Studies indicate that psychiatric disorders such
w w w w w w w w w w w
as mooddisorders are sometimes associated with decreased functioning of the
w w w w w w w w w w
immune system.Research does not support a connection between many cancers
w w w w w w w w w w
and stress. There is a significant amount of research about stress and the body.
w w w w w w w w w w w w w w
Research has shown that there are some connections between stress and physical
w w w w w w w w w w w
disease.
w
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
w w w w w w w w w w w w
rehabilitation needs. Of the aspects of functioning listed, which will the
w w w w w w w w w w w
nurse identifyas a focus of nursing intervention?
w w w w w w w
a. Expression of emotion w w
b. Detecting auditory stimuli w w
c. Receiving visual images w w
d. Processing associations w
ANS: D w
The parietal lobe is responsible for associating and processing sensory information
w w w w w w w w w w
that allows for functions such as following directions on a map, reading a clock,
w w w w w w w w w w w w w w
dressing self, keeping appointments, and distinguishing right from left. Emotional
w w w w w w w w w w
expression is associated with frontal lobe function. Detecting auditory stimuli is a
w w w w w w w w w w w w
temporal lobe function. Receiving visual images is related to occipital lobe
w w w w w w w w w w w
function.
w
7. At admission, the nurse learns that some time ago the patient had an infarct
w w w w w w w w w w w w w
in theright cerebral cortex. During assessment, the nurse would expect to find
w w w w w w w w w w w w
that the patient:
w w w
a. Demonstrates major deficiencies in speech w w w w
b. Is unable to effectively hold a spoon in the left hand
w w w w w w w w w w
c. Has difficulty explaining how to go about using the telephone
w w w w w w w w w
d. Cannot use his right hand to shave himself or comb his own hair w w w w w w w w w w w w
ANS: B w
The cerebral hemispheres are responsible for functions such as control of muscles.
w w w w w w w w w w w
The right hemisphere mainly controls the motor and sensory functions on the left
w w w w w w w w w w w w w
sideof the body. Damage to the right side would result in impaired function on
w w w w w w w w w w w w w w
the left side of the body. The motor cortex controls voluntary motor activity.
w w w w w w w w w w w w w
Brocas area controls motor speech. Cognitive functions are attributed to the
w w w w w w w w w w w
association cortex.
w w
The right side of the bodys motor activity is controlled by the left cerebral cortex.
w w w w w w w w w w w w w w
8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
w w w w w w w w w w
Thepatient will be discharged on low doses of haloperidol. The nurse will need
w w w w w w w w w w w w w
to individualize the patients medication teaching by:
w w w w w w w
a. Including the patients caregiver in the education w w w w w w
b. Being careful to stress the importance of taking the medication as prescribed
w w w w w w w w w w w
Providing the education at a time when the patient is emotionally calm
w w w w w w w w w w w
c. andrelaxed
w
Encouraging the patient to crush or dissolve the medication to help w w w w w w w w w w
d. withswallowing
w
ANS: A w
