Test Bank For Prescriber's Guide Stahl's Essential Psychopharmacology 7th Edition by Stephen M. Stahl Complete Guide Questions And Answers Revised Edition Latest Update

,TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY:
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NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 7TH EDITION
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Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE i



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
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theorythat depression primarily involves which of the following
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neurotransmitters?
a. Cortisol and GABA i i




b. COMT and glutamate i i




c. Monamine and glycine i i



d. Serotonin and norepinephrine i i



ANS: D i



One possible cause of depression is thought to involve one or more
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neurotransmitters.Serotonin and norepinephrine have been found to be important in
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the regulation of depression. There is no research to support that the other options
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play a significant role in the development of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has
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resulted indamage to the Broca area. Which evaluation does the nurse conduct to
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reinforce thisdiagnosis?
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a. Observing the patient pick up a spoon i i i i i i




b. Asking the patient to recite the alphabet i i i i i i




c. Monitoring the patients blood pressure i i i i



d. Comparing the patients grip strength in both hands i i i i i i i




ANS: B i



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
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notcontrolled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications
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are always prescribed by the doctor. The nurses answer will be based on
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information thatthe therapeutic action of psychotropic drugs is the result of their
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effect on:
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a. The temporal lobe; especially Wernickes area i i i i i




b. Dendrites and their ability to transmit electrical impulses i i i i i i i




c. The regulation of neurotransmitters especially dopamine i i i i i



d. The peripheral nervous system sensitivity to the psychotropic medications
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,ANS: C i



Medications used to treat psychiatric disorders operate in and around the synaptic
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cleftand have action at the neurotransmitter level, especially in the case of
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schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
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sensitivity of the peripheral nervous system are not relevant to either schizophrenia or
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psychotropic medications.
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4. A student nurse mutters that it seems entirely unnecessary to have to struggle
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withunderstanding the anatomy and physiology of the neurologic system. The
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mentor would base a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily onbehavioral i i i i i i i i i


a. interventions i




A complex undertaking that advance practice psychiatric nurses frequently usein
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b. their practice i i




Important primarily for the nursing assessment of patients with i i i i i i i i


c. braintraumacaused cognitive symptoms
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Necessary for planning psychiatric care for all patients especially i i i i i i i i


d. thoseexperiencing psychiatric disorders
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ANS: D i



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
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notused exclusively by advanced practice psychiatric nurses nor is it relevant for
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only 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
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tothe psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
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herchronic 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. i i i i i i i i i i i




b. There have been no research studies done on stress and disease yet. i i i i i i i i i i i




c. Stress does cause the release of factors that suppress the immune system. i i i i i i i i i i i



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



ANS: C i



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
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mooddisorders are sometimes associated with decreased functioning of the
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immune system.Research does not support a connection between many cancers and
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stress. There is a significant amount of research about stress and the body.
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Research has shown that there are some connections between stress and physical
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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
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identifyas a focus of nursing intervention?
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a. Expression of emotion i i




b. Detecting auditory stimuli i i




c. Receiving visual images i i



d. Processing associations i




ANS: D i



The parietal lobe is responsible for associating and processing sensory information
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that allows for functions such as following directions on a map, reading a clock,
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dressing self, keeping appointments, and distinguishing right from left. Emotional
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expression is associated with frontal lobe function. Detecting auditory stimuli is a
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temporal lobe 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
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theright 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 i i i i




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 i i i i i i i i i



d. Cannot use his right hand to shave himself or comb his own hair i i i i i i i i i i i i



ANS: B i



The cerebral hemispheres are responsible for functions such as control of muscles.
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The right hemisphere mainly controls the motor and sensory functions on the left
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sideof the body. Damage to the right side would result in impaired function on the left
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side of the body. The motor cortex controls voluntary motor activity. Brocas area
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controls motor 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.
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Thepatient 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 i i i i i i




b. Being careful to stress the importance of taking the medication as prescribed i i i i i i i i i i i




Providing the education at a time when the patient is emotionally calm andrelaxed i i i i i i i i i i i i


c.
Encouraging the patient to crush or dissolve the medication to help i i i i i i i i i i


d. withswallowing
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ANS: A i