FULL TEST BANK Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications 5th Edition by Stephen M. Stahl (Author) With 100% Verified Questions And Answers Graded A+.

Stahl's Essential Psychopharmacology Neuroscientific Basis and Practical Ap
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plications 5th Edition Testbank/Study Guide t t t t




Stahl's Essential Psychopharmacology t t



NeuroscientifictBasistandtPracticaltApplicationst 5thtEditiontTestbank/StudytGuide

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
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ical disorder. What does she mean? The nurses response is based on the theorythat depre
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ssion primarily involves which of the following neurotransmitters?
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a. Cortisol and GABA t t



b. COMT and glutamate t t



c. Monamine and glycine t t



d. Serotonin and norepinephrine t t


ANS: D t


One possible cause of depression is thought to involve one or more neurotransmitters.Sero
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tonin and norepinephrine have been found to be important in the regulation of depression.
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There is no research to support that the other options play a significant role in the developm
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ent of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has resulted indam
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age to the Broca area. Which evaluation does the nurse conduct to reinforce thisdiagnosis
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?
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 hands t t t t t t t


ANS: B t


Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,moto
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r aphasia). Fine motor skills, blood pressure control, and muscle strength are notcontrolle
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d by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are alw
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ays prescribed by the doctor. The nurses answer will be based on information thatthe thera
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peutic action of psychotropic drugs is the result of their effect on:
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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
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d. The peripheral nervous system sensitivity to the psychotropic medications
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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
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ine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nervous syst
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em are not relevant to either schizophrenia or psychotropic medications.
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4. A student nurse mutters that it seems entirely unnecessary to have to struggle withunde
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rstanding the anatomy and physiology of the neurologic system. The mentor would base
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a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily onbe t t t t t t t t t t


a. havioral interventions t



A complex undertaking that advance practice psychiatric nurses frequently usein t
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b. heir practice t



Important primarily for the nursing assessment of patients with braintra t t t t t t t t t t


c. umacaused cognitive symptoms t t



Necessary for planning psychiatric care for all patients especially thoseex t t t t t t t t t t


d. periencing psychiatric disorders t t


ANS: D t


Nurses must understand that many symptoms of psychiatric disorders have a neurologic
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basis, although the symptoms are manifested behaviorally. This understanding facilitate
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s effective care planning. The foundation of knowledge is notused exclusively by advanc
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ed practice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma
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since dealing with the results of normal and abnormal brain function is a responsibility of
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all nurses providing all types of care tothe psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herchro
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nic 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. t t t t t t t t t t t



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


ANS: C t


Research indicates that stress causes a release of corticotropin-
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releasing factors that suppress the immune system. Studies indicate that psychiatric disord
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ers such as mooddisorders are sometimes associated with decreased functioning of the im
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mune system.Research does not support a connection between many cancers and stress. T
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here is a significant amount of research about stress and the body. Research has shown that
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there are some connections between stress and physical disease.
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6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation
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needs. Of the aspects of functioning listed, which will the nurse identifyas a focus of nursin
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g intervention?
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a. Expression of emotion t t



b. Detecting auditory stimuli t t



c. Receiving visual images t t



d. Processing associations t


ANS: D t


The parietal lobe is responsible for associating and processing sensory information that all
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ows for functions such as following directions on a map, reading a clock, dressing self, kee
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ping appointments, and distinguishing right from left. Emotional expression is associated
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with frontal lobe function. Detecting auditory stimuli is a temporal lobe function. Receivi
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ng 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 theright
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cerebral cortex. During assessment, the nurse would expect to find that the patient:
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a. Demonstrates major deficiencies in speech t t t t



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 t t t t t t t t t



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


ANS: B t


The cerebral hemispheres are responsible for functions such as control of muscles. The rig
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ht hemisphere mainly controls the motor and sensory functions on the left sideof the body.
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Damage to the right side would result in impaired function on the left side of the body. The
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motor cortex controls voluntary motor activity. Brocas area controls motor speech. Cogni
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tive 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. Thepati
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ent will be discharged on low doses of haloperidol. The nurse will need to individualize th
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e patients medication teaching by:
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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 prescribed
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Providing the education at a time when the patient is emotionally calm andrela
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c. xed
Encouraging the patient to crush or dissolve the medication to help withswa t t t t t t t t t t t t


d. llowing
ANS: A t




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The hippocampus plays a major role in short-
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term memory and, hence, in learning. Taking the medication as prescribed and providing t
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he education at a time when the patient is calm and relaxed is information or consideration
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s that all patients should begiven. The medication does not necessarily need to be crushed
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or dissolved since the stroke would not have caused difficulty with swallowing.
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9. The physician tells the nurse, The medication Im prescribing for the patient enha
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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?
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a. The patient is actively involved in playing cards with other patients.
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b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
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c. The patient reports that both auditory and visual hallucinations have decreased.
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d. The patient says that, I am much happier than before I came to the hospital.
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ANS: B t


GABA is the principle inhibitory neurotransmitter. The medication should provide ananti
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anxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally affec
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ted by g-aminobutyric acid.
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10. The patients family asks whether a diagnosis of Parkinsons disease creates anincr
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eased risk for any mental health issues. What question would the nurse ask toassess fo
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r such a comorbid condition?
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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?
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c. Have you noticed your father talking about seeing things you cant see?
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d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
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ANS: A t


Serotonin and its close chemical relatives, dopamine and norepinephrine, are the neurotr
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ansmitters that are most widely involved in various forms of depression. Mostresearchers
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agree that the immediate cause of parkinsonism is a deficiency of dopamine and so a patie
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nt with Parkinsons disease should be monitored for depression, The other mental health di
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sorders (bipolar disorder, hallucinations, and obsessive compulsive disorder) have not be
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en connected to Parkinsons disease.
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11. Which explanation for the prescription of donepezil (Aricept) would the nursepro
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vide for a patient in the early stage of Alzheimers disease?
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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.
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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.
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ANS: D t




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