Stahl's Essential Psychopharmacology h h
NeuroscientifichBasishandhPracticalhApplicationsh 5thhEditionhTestbank/StudyhGuide
Chapter 1 Chemical neurotransmission
h h h
MULTIPLE CHOICE h
1. A patient with depression mentions to the nurse, My mother says depression is a ch
h h h h h h h h h h h h h h
emical disorder. What does she mean? The nurses response is based on the theorythat
h h h h h h h h h h h h h h h
depression primarily involves which of the following neurotransmitters?
h h h h h h h
a. Cortisol and GABA h h
b. COMT and glutamate h h
c. Monamine and glycine h h
d. Serotonin and norepinephrine h h
ANS: D h
One possible cause of depression is thought to involve one or more neurotransmitters.S
h h h h h h h h h h h h h
erotonin and norepinephrine have been found to be important in the regulation of depre
h h h h h h h h h h h h h
ssion. There is no research to support that the other options play a significant role in the
h h h h h h h h h h h h h h h h h
development of depression. h h
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted ind
h h h h h h h h h h h h h
amage to the Broca area. Which evaluation does the nurse conduct to reinforce thisdia
h h h h h h h h h h h h h h
gnosis?
a. Observing the patient pick up a spoon h h h h h h
b. Asking the patient to recite the alphabet
h h h h h h
c. Monitoring the patients blood pressure h h h h
d. Comparing the patients grip strength in both hands h h h h h h h
ANS: B h
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,m
h h h h h h h h h h h h h h h
otor aphasia). Fine motor skills, blood pressure control, and muscle strength are notcont
h h h h h h h h h h h h h
rolled by the Broca area of the left frontal lobe.
h h h h h h h h h
3. The patient diagnosed with schizophrenia asks why psychotropic medications are al
h h h h h h h h h h
ways prescribed by the doctor. The nurses answer will be based on information thatthe
h h h h h h h h h h h h h h h
therapeutic action of psychotropic drugs is the result of their effect on:
h h h h h h h h h h h
a. The temporal lobe; especially Wernickes area
h h h h h
b. Dendrites and their ability to transmit electrical impulses
h h h h h h h
c. The regulation of neurotransmitters especially dopamine
h h h h h
d. The peripheral nervous system sensitivity to the psychotropic medications
h h h h h h h h
WWW.TESTBANKTANK.COM
,ANS: C h
Medications used to treat psychiatric disorders operate in and around the synaptic clefta
h h h h h h h h h h h h h
nd have action at the neurotransmitter level, especially in the case of schizophrenia, on d
h h h h h h h h h h h h h h
opamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nerv
h h h h h h h h h h h h
ous system are not relevant to either schizophrenia or psychotropic medications.
h h h h h h h h h h
4. A student nurse mutters that it seems entirely unnecessary to have to struggle withu
h h h h h h h h h h h h h h
nderstanding the anatomy and physiology of the neurologic system. The mentor woul
h h h h h h h h h h h
d base a response on the understanding that it is:
h h h h h h h h h
Necessary but generally for psychiatric nurses who focus primarily onb h h h h h h h h h h
a. ehavioral interventions h
A complex undertaking that advance practice psychiatric nurses frequently usei
h h h h h h h h h h
b. n their practice
h h
Important primarily for the nursing assessment of patients with braintr
h h h h h h h h h h
c. aumacaused cognitive symptoms h h
Necessary for planning psychiatric care for all patients especially thosee
h h h h h h h h h h
d. xperiencing psychiatric disorders h h
ANS: D h
Nurses must understand that many symptoms of psychiatric disorders have a neurologi
h h h h h h h h h h h
c basis, although the symptoms are manifested behaviorally. This understanding facilit
h h h h h h h h h h
ates effective care planning. The foundation of knowledge is notused exclusively by ad
h h h h h h h h h h h h h
vanced practice psychiatric nurses nor is it relevant for only behavior therapies or brain
h h h h h h h h h h h h h
htrauma since dealing with the results of normal and abnormal brain function is a respo
h h h h h h h h h h h h h h
nsibility of all nurses providing all types of care tothe psychiatric patient.
h h h h h h h h h h h h
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herch
h h h h h h h h h h h h h h h h
ronic depression? Which response is supported by research data?
h h h h h h h h
a. Too much stress has been proven to cause all kinds of cancer.
h h h h h h h h h h h
b. There have been no research studies done on stress and disease yet.
h h h h h h h h h h h
c. Stress does cause the release of factors that suppress the immune system.
h h h h h h h h h h h
d. There appears to be little connection between stress and diseases of the body
h h h h h h h h h h h h
ANS: C h
Research indicates that stress causes a release of corticotropin-
h h h h h h h h
releasing factors that suppress the immune system. Studies indicate that psychiatric dis
h h h h h h h h h h h
orders such as mooddisorders are sometimes associated with decreased functioning of t
h h h h h h h h h h h h
he immune system.Research does not support a connection between many cancers and s
h h h h h h h h h h h h h
tress. There is a significant amount of research about stress and the body. Research has s
h h h h h h h h h h h h h h h
hown that there are some connections between stress and physical disease.
h h h h h h h h h h
WWW.TESTBANKTANK.COM
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitati
h h h h h h h h h h h h h
on needs. Of the aspects of functioning listed, which will the nurse identifyas a focus of
h h h h h h h h h h h h h h h h h
nursing intervention? h
a. Expression of emotion h h
b. Detecting auditory stimuli h h
c. Receiving visual images h h
d. Processing associations h
ANS: D h
The parietal lobe is responsible for associating and processing sensory information that
h h h h h h h h h h h h
allows for functions such as following directions on a map, reading a clock, dressing sel
h h h h h h h h h h h h h h
f, keeping appointments, and distinguishing right from left. Emotional expression is ass
h h h h h h h h h h h
ociated with frontal lobe function. Detecting auditory stimuli is a temporal lobe functio
h h h h h h h h h h h h
n. Receiving visual images is related to occipital lobe function.
h h h h h h h h h
7. At admission, the nurse learns that some time ago the patient had an infarct in theri
h h h h h h h h h h h h h h h h
ght cerebral cortex. During assessment, the nurse would expect to find that the patient
h h h h h h h h h h h h h
:
a. Demonstrates major deficiencies in speech h h h h
b. Is unable to effectively hold a spoon in the left hand
h h h h h h h h h h
c. Has difficulty explaining how to go about using the telephone
h h h h h h h h h
d. Cannot use his right hand to shave himself or comb his own hair h h h h h h h h h h h h
ANS: B h
The cerebral hemispheres are responsible for functions such as control of muscles. The
h h h h h h h h h h h h h
right hemisphere mainly controls the motor and sensory functions on the left sideof the
h h h h h h h h h h h h h h h
body. Damage to the right side would result in impaired function on the left side of the b
h h h h h h h h h h h h h h h h h
ody. The motor cortex controls voluntary motor activity. Brocas area controls motor sp
h h h h h h h h h h h h
eech. Cognitive functions are attributed to the association cortex.
h h h h h h h h
The right side of the bodys motor activity is controlled by the left cerebral cortex.
h h h h h h h h h h h h h h
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. Thep
h h h h h h h h h h h h
atient will be discharged on low doses of haloperidol. The nurse will need to individual
h h h h h h h h h h h h h h
ize the patients medication teaching by:
h h h h h
a. Including the patients caregiver in the education h h h h h h
b. Being careful to stress the importance of taking the medication as prescribed
h h h h h h h h h h h
Providing the education at a time when the patient is emotionally calm andre
h h h h h h h h h h h h h
c. laxed
Encouraging the patient to crush or dissolve the medication to help withs
h h h h h h h h h h h h
d. wallowing
ANS: A h
WWW.TESTBANKTANK.COM
, The hippocampus plays a major role in short-
h h h h h h h
term memory and, hence, in learning. Taking the medication as prescribed and providi
h h h h h h h h h h h h
ng the education at a time when the patient is calm and relaxed is information or consid
h h h h h h h h h h h h h h h h
erations that all patients should begiven. The medication does not necessarily need to b
h h h h h h h h h h h h h h
e crushed or dissolved since the stroke would not have caused difficulty with swallowi
h h h h h h h h h h h h h
ng.
9. The physician tells the nurse, The medication Im prescribing for the patient en
h h h h h h h h h h h h
hances the g- h h
aminobutyric acid (GABA) system. Which patient behavior willprovide evidenc
h h h h h h h h h
e that the medication therapy is successful?
h h h h h h
a. The patient is actively involved in playing cards with other patients.
h h h h h h h h h h
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
h h h h h h h h h h h h h h h h
c. The patient reports that both auditory and visual hallucinations have decreased.
h h h h h h h h h h
d. The patient says that, I am much happier than before I came to the hospital.
h h h h h h h h h h h h h h
ANS: B h
GABA is the principle inhibitory neurotransmitter. The medication should provide ana
h h h h h h h h h h h
ntianxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally
h h h h h h h h h h h
affected by g-aminobutyric acid. h h h
10. The patients family asks whether a diagnosis of Parkinsons disease creates ani
h h h h h h h h h h h h
ncreased risk for any mental health issues. What question would the nurse ask toas
h h h h h h h h h h h h h h
sess for such a comorbid condition?
h h h h h
a. Has your father exhibited any signs of depression? h h h h h h h
b. Does your father seem to experience mood swings?
h h h h h h h
c. Have you noticed your father talking about seeing things you cant see?
h h h h h h h h h h h
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
h h h h h h h h h h h h h
ANS: A h
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the neuro
h h h h h h h h h h h
transmitters that are most widely involved in various forms of depression. Mostresearc
h h h h h h h h h h h h
hers agree that the immediate cause of parkinsonism is a deficiency of dopamine and s
h h h h h h h h h h h h h h
o a patient with Parkinsons disease should be monitored for depression, The other ment
h h h h h h h h h h h h h
al health disorders (bipolar disorder, hallucinations, and obsessive compulsive disorde
h h h h h h h h h
r) have not been connected to Parkinsons disease.
h h h h h h h
11. Which explanation for the prescription of donepezil (Aricept) would the nursep
h h h h h h h h h h h
rovide for a patient in the early stage of Alzheimers disease?
h h h h h h h h h h
a. It will increase the metabolism of excess GABA.
h h h h h h h
b. Excess dopamine will be prevented from attaching to receptor sites.
h h h h h h h h h
c. Serotonin deficiency will be managed through a prolonged reuptake period. h h h h h h h h h
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
h h h h h h h h
ANS: D h
WWW.TESTBANKTANK.COM
NeuroscientifichBasishandhPracticalhApplicationsh 5thhEditionhTestbank/StudyhGuide
Chapter 1 Chemical neurotransmission
h h h
MULTIPLE CHOICE h
1. A patient with depression mentions to the nurse, My mother says depression is a ch
h h h h h h h h h h h h h h
emical disorder. What does she mean? The nurses response is based on the theorythat
h h h h h h h h h h h h h h h
depression primarily involves which of the following neurotransmitters?
h h h h h h h
a. Cortisol and GABA h h
b. COMT and glutamate h h
c. Monamine and glycine h h
d. Serotonin and norepinephrine h h
ANS: D h
One possible cause of depression is thought to involve one or more neurotransmitters.S
h h h h h h h h h h h h h
erotonin and norepinephrine have been found to be important in the regulation of depre
h h h h h h h h h h h h h
ssion. There is no research to support that the other options play a significant role in the
h h h h h h h h h h h h h h h h h
development of depression. h h
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted ind
h h h h h h h h h h h h h
amage to the Broca area. Which evaluation does the nurse conduct to reinforce thisdia
h h h h h h h h h h h h h h
gnosis?
a. Observing the patient pick up a spoon h h h h h h
b. Asking the patient to recite the alphabet
h h h h h h
c. Monitoring the patients blood pressure h h h h
d. Comparing the patients grip strength in both hands h h h h h h h
ANS: B h
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,m
h h h h h h h h h h h h h h h
otor aphasia). Fine motor skills, blood pressure control, and muscle strength are notcont
h h h h h h h h h h h h h
rolled by the Broca area of the left frontal lobe.
h h h h h h h h h
3. The patient diagnosed with schizophrenia asks why psychotropic medications are al
h h h h h h h h h h
ways prescribed by the doctor. The nurses answer will be based on information thatthe
h h h h h h h h h h h h h h h
therapeutic action of psychotropic drugs is the result of their effect on:
h h h h h h h h h h h
a. The temporal lobe; especially Wernickes area
h h h h h
b. Dendrites and their ability to transmit electrical impulses
h h h h h h h
c. The regulation of neurotransmitters especially dopamine
h h h h h
d. The peripheral nervous system sensitivity to the psychotropic medications
h h h h h h h h
WWW.TESTBANKTANK.COM
,ANS: C h
Medications used to treat psychiatric disorders operate in and around the synaptic clefta
h h h h h h h h h h h h h
nd have action at the neurotransmitter level, especially in the case of schizophrenia, on d
h h h h h h h h h h h h h h
opamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nerv
h h h h h h h h h h h h
ous system are not relevant to either schizophrenia or psychotropic medications.
h h h h h h h h h h
4. A student nurse mutters that it seems entirely unnecessary to have to struggle withu
h h h h h h h h h h h h h h
nderstanding the anatomy and physiology of the neurologic system. The mentor woul
h h h h h h h h h h h
d base a response on the understanding that it is:
h h h h h h h h h
Necessary but generally for psychiatric nurses who focus primarily onb h h h h h h h h h h
a. ehavioral interventions h
A complex undertaking that advance practice psychiatric nurses frequently usei
h h h h h h h h h h
b. n their practice
h h
Important primarily for the nursing assessment of patients with braintr
h h h h h h h h h h
c. aumacaused cognitive symptoms h h
Necessary for planning psychiatric care for all patients especially thosee
h h h h h h h h h h
d. xperiencing psychiatric disorders h h
ANS: D h
Nurses must understand that many symptoms of psychiatric disorders have a neurologi
h h h h h h h h h h h
c basis, although the symptoms are manifested behaviorally. This understanding facilit
h h h h h h h h h h
ates effective care planning. The foundation of knowledge is notused exclusively by ad
h h h h h h h h h h h h h
vanced practice psychiatric nurses nor is it relevant for only behavior therapies or brain
h h h h h h h h h h h h h
htrauma since dealing with the results of normal and abnormal brain function is a respo
h h h h h h h h h h h h h h
nsibility of all nurses providing all types of care tothe psychiatric patient.
h h h h h h h h h h h h
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herch
h h h h h h h h h h h h h h h h
ronic depression? Which response is supported by research data?
h h h h h h h h
a. Too much stress has been proven to cause all kinds of cancer.
h h h h h h h h h h h
b. There have been no research studies done on stress and disease yet.
h h h h h h h h h h h
c. Stress does cause the release of factors that suppress the immune system.
h h h h h h h h h h h
d. There appears to be little connection between stress and diseases of the body
h h h h h h h h h h h h
ANS: C h
Research indicates that stress causes a release of corticotropin-
h h h h h h h h
releasing factors that suppress the immune system. Studies indicate that psychiatric dis
h h h h h h h h h h h
orders such as mooddisorders are sometimes associated with decreased functioning of t
h h h h h h h h h h h h
he immune system.Research does not support a connection between many cancers and s
h h h h h h h h h h h h h
tress. There is a significant amount of research about stress and the body. Research has s
h h h h h h h h h h h h h h h
hown that there are some connections between stress and physical disease.
h h h h h h h h h h
WWW.TESTBANKTANK.COM
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitati
h h h h h h h h h h h h h
on needs. Of the aspects of functioning listed, which will the nurse identifyas a focus of
h h h h h h h h h h h h h h h h h
nursing intervention? h
a. Expression of emotion h h
b. Detecting auditory stimuli h h
c. Receiving visual images h h
d. Processing associations h
ANS: D h
The parietal lobe is responsible for associating and processing sensory information that
h h h h h h h h h h h h
allows for functions such as following directions on a map, reading a clock, dressing sel
h h h h h h h h h h h h h h
f, keeping appointments, and distinguishing right from left. Emotional expression is ass
h h h h h h h h h h h
ociated with frontal lobe function. Detecting auditory stimuli is a temporal lobe functio
h h h h h h h h h h h h
n. Receiving visual images is related to occipital lobe function.
h h h h h h h h h
7. At admission, the nurse learns that some time ago the patient had an infarct in theri
h h h h h h h h h h h h h h h h
ght cerebral cortex. During assessment, the nurse would expect to find that the patient
h h h h h h h h h h h h h
:
a. Demonstrates major deficiencies in speech h h h h
b. Is unable to effectively hold a spoon in the left hand
h h h h h h h h h h
c. Has difficulty explaining how to go about using the telephone
h h h h h h h h h
d. Cannot use his right hand to shave himself or comb his own hair h h h h h h h h h h h h
ANS: B h
The cerebral hemispheres are responsible for functions such as control of muscles. The
h h h h h h h h h h h h h
right hemisphere mainly controls the motor and sensory functions on the left sideof the
h h h h h h h h h h h h h h h
body. Damage to the right side would result in impaired function on the left side of the b
h h h h h h h h h h h h h h h h h
ody. The motor cortex controls voluntary motor activity. Brocas area controls motor sp
h h h h h h h h h h h h
eech. Cognitive functions are attributed to the association cortex.
h h h h h h h h
The right side of the bodys motor activity is controlled by the left cerebral cortex.
h h h h h h h h h h h h h h
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. Thep
h h h h h h h h h h h h
atient will be discharged on low doses of haloperidol. The nurse will need to individual
h h h h h h h h h h h h h h
ize the patients medication teaching by:
h h h h h
a. Including the patients caregiver in the education h h h h h h
b. Being careful to stress the importance of taking the medication as prescribed
h h h h h h h h h h h
Providing the education at a time when the patient is emotionally calm andre
h h h h h h h h h h h h h
c. laxed
Encouraging the patient to crush or dissolve the medication to help withs
h h h h h h h h h h h h
d. wallowing
ANS: A h
WWW.TESTBANKTANK.COM
, The hippocampus plays a major role in short-
h h h h h h h
term memory and, hence, in learning. Taking the medication as prescribed and providi
h h h h h h h h h h h h
ng the education at a time when the patient is calm and relaxed is information or consid
h h h h h h h h h h h h h h h h
erations that all patients should begiven. The medication does not necessarily need to b
h h h h h h h h h h h h h h
e crushed or dissolved since the stroke would not have caused difficulty with swallowi
h h h h h h h h h h h h h
ng.
9. The physician tells the nurse, The medication Im prescribing for the patient en
h h h h h h h h h h h h
hances the g- h h
aminobutyric acid (GABA) system. Which patient behavior willprovide evidenc
h h h h h h h h h
e that the medication therapy is successful?
h h h h h h
a. The patient is actively involved in playing cards with other patients.
h h h h h h h h h h
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
h h h h h h h h h h h h h h h h
c. The patient reports that both auditory and visual hallucinations have decreased.
h h h h h h h h h h
d. The patient says that, I am much happier than before I came to the hospital.
h h h h h h h h h h h h h h
ANS: B h
GABA is the principle inhibitory neurotransmitter. The medication should provide ana
h h h h h h h h h h h
ntianxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally
h h h h h h h h h h h
affected by g-aminobutyric acid. h h h
10. The patients family asks whether a diagnosis of Parkinsons disease creates ani
h h h h h h h h h h h h
ncreased risk for any mental health issues. What question would the nurse ask toas
h h h h h h h h h h h h h h
sess for such a comorbid condition?
h h h h h
a. Has your father exhibited any signs of depression? h h h h h h h
b. Does your father seem to experience mood swings?
h h h h h h h
c. Have you noticed your father talking about seeing things you cant see?
h h h h h h h h h h h
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
h h h h h h h h h h h h h
ANS: A h
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the neuro
h h h h h h h h h h h
transmitters that are most widely involved in various forms of depression. Mostresearc
h h h h h h h h h h h h
hers agree that the immediate cause of parkinsonism is a deficiency of dopamine and s
h h h h h h h h h h h h h h
o a patient with Parkinsons disease should be monitored for depression, The other ment
h h h h h h h h h h h h h
al health disorders (bipolar disorder, hallucinations, and obsessive compulsive disorde
h h h h h h h h h
r) have not been connected to Parkinsons disease.
h h h h h h h
11. Which explanation for the prescription of donepezil (Aricept) would the nursep
h h h h h h h h h h h
rovide for a patient in the early stage of Alzheimers disease?
h h h h h h h h h h
a. It will increase the metabolism of excess GABA.
h h h h h h h
b. Excess dopamine will be prevented from attaching to receptor sites.
h h h h h h h h h
c. Serotonin deficiency will be managed through a prolonged reuptake period. h h h h h h h h h
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
h h h h h h h h
ANS: D h
WWW.TESTBANKTANK.COM
