NR 546 Midterm Exam Advanced
Pathophysiology Questions and Answers
1. What should the PMHNP consider when prescribing chemical
restraints?: -allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical restraint
-state regulations regarding chemical restrains must be reviewed
2. Are the PMHNP and other staff liable if the client has an allergic
reaction or adverse side effects to the drugs used for chemical
restraint?: No.
The client has been court-ordered to take the prescribed medications and the standing order for chemical
restraints is approved. The PMHNP and other staff are not liable if the patient has an allergic reaction or
adverse side effects.
3. How does reviewing the genetic makeup of a client help guide the
PMHNP in
selecting medication for clients?: -Genetic testing can assist by providing more information
on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications based on the
cytochrome P450 system.
4. Tanrıkulu and Erbaş (2020) investigated identical twins to determine
, the
presence of an inherited link for schizophrenia and why one twin may
develop schizophrenia when the other does not. When two people
have 100% identical DNA, why don't both persons develop the exact
illnesses? Studies of identical Danish twins found that if one twin had
schizophrenia, the other twin had a 50% lifetime risk of developing
schizophrenia (Lemvigh et al., 2020). Why is there only half the risk?: Both
environmental and psychosocial stressors can impact mental health. Although twins may have
identical genes, their gene expression may be different.
There may be an environmental exposure that turned a gene "on" that should have been "off" for one
twin to develop schizophrenia and not the other.
5. central sulcus: separates the frontal lobe from the parietal lobe
6. frontal lobe: associated with movement, intelligence, abstract thinking
7. broca's area: speech production
8. temporal lobe: involves object identification and auditory signals
9. cerebellum: coordination
10. wernicke's area: speech comprehension
,11. occipital lobe: primary visual area
12. parietal lobe: keeps us alert to what is going on around us
13. sensory cortex: pain, heat, and other sensations
14. motor cortex: movement
15. hippocampus: involved in both memory and anxiety
16. nucleus accumbens: involved in the reward process
17. thalamus: involved in sensory organ and motor command processing
18. striatum: involved in complex motor actions, also links cognition to motor actions
19. limbic system: includes circuits that are associated with pleasure and reward
20. basal ganglia: group of structures involved in voluntary motor movements
21. amygdala: involved in emotional regulation and perception of odors
, 22. corpus callosum: controls the communication between the two brain hemispheres
23. white matter: contains nerve fibers that connect neurons from different regions into
functional circuits
24. grey matter: contains nerve cells and dendrites
25. brain tissue: made up of grey matter and white matter
26. dorsal striatum: involved in complex motor actions and linkage of cognition to motor
actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
27. The field of epigenetics is rapidly growing and can help explain
how gene expression is:: influenced by environmental factors and how epigenetics
contributes to the manifestation of mental illness
28. How does epigenetics impact a person's mental health?: internal or
external factors activate portions of the genome that result in the manifestation of mental health
symptoms
-activation is often a result of a stressful event, which, when combined with the genetic risk, results in the
disease
-genes being on or ott
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of normal genes being
"on" when they should be "ott."
Pathophysiology Questions and Answers
1. What should the PMHNP consider when prescribing chemical
restraints?: -allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical restraint
-state regulations regarding chemical restrains must be reviewed
2. Are the PMHNP and other staff liable if the client has an allergic
reaction or adverse side effects to the drugs used for chemical
restraint?: No.
The client has been court-ordered to take the prescribed medications and the standing order for chemical
restraints is approved. The PMHNP and other staff are not liable if the patient has an allergic reaction or
adverse side effects.
3. How does reviewing the genetic makeup of a client help guide the
PMHNP in
selecting medication for clients?: -Genetic testing can assist by providing more information
on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications based on the
cytochrome P450 system.
4. Tanrıkulu and Erbaş (2020) investigated identical twins to determine
, the
presence of an inherited link for schizophrenia and why one twin may
develop schizophrenia when the other does not. When two people
have 100% identical DNA, why don't both persons develop the exact
illnesses? Studies of identical Danish twins found that if one twin had
schizophrenia, the other twin had a 50% lifetime risk of developing
schizophrenia (Lemvigh et al., 2020). Why is there only half the risk?: Both
environmental and psychosocial stressors can impact mental health. Although twins may have
identical genes, their gene expression may be different.
There may be an environmental exposure that turned a gene "on" that should have been "off" for one
twin to develop schizophrenia and not the other.
5. central sulcus: separates the frontal lobe from the parietal lobe
6. frontal lobe: associated with movement, intelligence, abstract thinking
7. broca's area: speech production
8. temporal lobe: involves object identification and auditory signals
9. cerebellum: coordination
10. wernicke's area: speech comprehension
,11. occipital lobe: primary visual area
12. parietal lobe: keeps us alert to what is going on around us
13. sensory cortex: pain, heat, and other sensations
14. motor cortex: movement
15. hippocampus: involved in both memory and anxiety
16. nucleus accumbens: involved in the reward process
17. thalamus: involved in sensory organ and motor command processing
18. striatum: involved in complex motor actions, also links cognition to motor actions
19. limbic system: includes circuits that are associated with pleasure and reward
20. basal ganglia: group of structures involved in voluntary motor movements
21. amygdala: involved in emotional regulation and perception of odors
, 22. corpus callosum: controls the communication between the two brain hemispheres
23. white matter: contains nerve fibers that connect neurons from different regions into
functional circuits
24. grey matter: contains nerve cells and dendrites
25. brain tissue: made up of grey matter and white matter
26. dorsal striatum: involved in complex motor actions and linkage of cognition to motor
actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
27. The field of epigenetics is rapidly growing and can help explain
how gene expression is:: influenced by environmental factors and how epigenetics
contributes to the manifestation of mental illness
28. How does epigenetics impact a person's mental health?: internal or
external factors activate portions of the genome that result in the manifestation of mental health
symptoms
-activation is often a result of a stressful event, which, when combined with the genetic risk, results in the
disease
-genes being on or ott
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of normal genes being
"on" when they should be "ott."
