TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY: NEUROS
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CIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION
w w w w w w
Stahl's Essential Psychopharmacology w w
NeuroscientificwBasiswandwPracticalwApplicationswTESTBANK/STUDYwGUIDE
Chapter 1 Chemical neurotransmission
w w w
MULTIPLE CHOICE w
1. A patient with depression mentions to the nurse, My mother says depression is
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wa 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
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 neurotransmi
w w w w w w w w w w w w
tters.Serotonin and norepinephrine have been found to be important in the regulat
w w w w w w w w w w w
ion of depression. There is no research to support that the other options play a si
w w w w w w w w w w w w w w w
gnificant role in the development of depression.
w w w w w w
2. A patient has experienced a stroke (cerebral vascular accident) that has result
w w w w w w w w w w w
ed in damage to the Broca area. Which evaluation does the nurse conduct to reinforce
w w w w w w w w w w w w w w w
thisdiagnosis?
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 w
i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle strength
w w w w w w w w w w w w
are notcontrolled by the Broca area of the left frontal lobe.
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
ware always prescribed by the doctor. The nurses answer will be based on infor
w w w w w w w w w w w w w
mation thatthe therapeutic action of psychotropic drugs is the result of their effe
w w w w w w w w w w w w
ct on:
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 w
cleftand have action at the neurotransmitter level, especially in the case of schizop
w w w w w w w w w w w w
hrenia, on dopamine. The Wernickes area, dendrite function, or the sensitivity of t
w w w w w w w w w w w w
he peripheral nervous system are not relevant to either schizophrenia or psychotro
w w w w w w w w w w w
pic medications.
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
wwithunderstanding 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
Necessary but generally for psychiatric nurses who focus primarily onbehavio
w w w w w w w w w
a. ral interventions w
A complex undertaking that advance practice psychiatric nurses frequently use
w w w w w w w w w
b. in their practice w w
Important primarily for the nursing assessment of patients with braintraumaca
w w w w w w w w w
c. used cognitive symptoms w w
Necessary for planning psychiatric care for all patients especially thoseexperie
w w w w w w w w w
d. ncing psychiatric disorders w w
ANS: D w
Nurses must understand that many symptoms of psychiatric disorders have a neu
w w w w w w w w w w w
rologic basis, although the symptoms are manifested behaviorally. This understa
w w w w w w w w w
nding facilitates effective care planning. The foundation of knowledge is notused
w w w w w w w w w w
wexclusively by advanced practice psychiatric nurses nor is it relevant for only be
w w w w w w w w w w w w
havior therapies or brain trauma since dealing with the results of normal and abn
w w w w w w w w w w w w w
ormal brain function is a responsibility of all nurses providing all types of care to
w w w w w w w w w w w w w w
the psychiatric patient.
w w
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
w w w w w w w w w w w w w w
wherchronic depression? Which response is supported by research data?
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-
w w w w w w w w
releasing factors that suppress the immune system. Studies indicate that psychiatr
w w w w w w w w w w
ic disorders such as mooddisorders are sometimes associated with decreased fun
w w w w w w w w w w
ctioning of the immune system.Research does not support a connection between
w w w w w w w w w w w
many cancers and stress. There is a significant amount of research about stress a
w w w w w w w w w w w w w
nd the body.
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 w
disease.
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric r
w w w w w w w w w w w w w
ehabilitation needs. Of the aspects of functioning listed, which will the nurse
w w w w w w w w w w w w
identifyas a focus of nursing intervention?
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
wthat allows for functions such as following directions on a map, reading a clock, d
w w w w w w w w w w w w w w
ressing self, keeping appointments, and distinguishing right from left. Emotional e
w w w w w w w w w w
xpression is associated with frontal lobe function. Detecting auditory stimuli is a t
w w w w w w w w w w w w
emporal lobe function. Receiving visual images is related to occipital lobe functio
w w w w w w w w w w w
n.
7. At admission, the nurse learns that some time ago the patient had an infarct in
w w w w w w w w w w w w w w
wtheright cerebral cortex. During assessment, the nurse would expect to find that
w w w w w w w w w w w
wthe patient:
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 w
The right hemisphere mainly controls the motor and sensory functions on the left s
w w w w w w w w w w w w w
ideof the body. Damage to the right side would result in impaired function on the l
w w w w w w w w w w w w w w w
eft side of the body. The motor cortex controls voluntary motor activity. Brocas ar
w w w w w w w w w w w w w
ea controls motor speech. Cognitive functions are attributed to the association cort
w w w w w w w w w w w
ex.
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 w
Thepatient will be discharged on low doses of haloperidol. The nurse will need to
w w w w w w w w w w w w w
windividualize the patients medication teaching by:
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 andrela
w w w w w w w w w w w w
c. xed
Encouraging the patient to crush or dissolve the medication to help withswallo
w w w w w w w w w w w
d. wing
ANS: A w
, The hippocampus plays a major role in short-
w w w w w w w
term memory and, hence, in learning. Taking the medication as prescribed and pr
w w w w w w w w w w w w
oviding the education at a time when the patient is calm and relaxed is informatio
w w w w w w w w w w w w w w
n or considerations that all patients should begiven. The medication does not nec
w w w w w w w w w w w w
essarily need to be crushed or dissolved since the stroke would not have caused d
w w w w w w w w w w w w w w
ifficulty with swallowing. w w
9. The physician tells the nurse, The medication Im prescribing for the p
w w w w w w w w w w w
atient enhances the g- w w w
aminobutyric acid (GABA) system. Which patient behavior willprovide
w w w w w w w w
evidence that the medication therapy is successful?
w w w w w w
a. The patient is actively involved in playing cards with other patients.
w w w w w w w w w w
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
w w w w w w w w w w w w w w w w
c. The patient reports that both auditory and visual hallucinations have decrea
w w w w w w w w w w
sed.
d. The patient says that, I am much happier than before I came to the hospital.
w w w w w w w w w w w w w w
ANS: B w
GABA is the principle inhibitory neurotransmitter. The medication should provide
w w w w w w w w w w
anantianxiety effect. Alertness, psychotic behaviors, and mood elevation are not g
w w w w w w w w w w
enerally affected by g-aminobutyric acid.
w w w w
10. The patients family asks whether a diagnosis of Parkinsons disease creates
w w w w w w w w w w
wan increased risk for any mental health issues. What question would the nurse
w w w w w w w w w w w w
wask toassess for such a comorbid condition?
w w w w w w
a. Has your father exhibited any signs of depression?
w w w w w w w
b. Does your father seem to experience mood swings? w w w w w w w
c. Have you noticed your father talking about seeing things you cant see?
w w w w w w w w w w w
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
w w w w w w w w w w w w w
ANS: A w
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the
w w w w w w w w w w w
neurotransmitters that are most widely involved in various forms of depression. w w w w w w w w w w w
Mostresearchers agree that the immediate cause of parkinsonism is a deficiency
w w w w w w w w w w w
of dopamine and so a patient with Parkinsons disease should be monitored for de
w w w w w w w w w w w w w
pression, The other mental health disorders (bipolar disorder, hallucinations, and
w w w w w w w w w w
obsessive compulsive disorder) have not been connected to Parkinsons disease.
w w w w w w w w w
11. Which explanation for the prescription of donepezil (Aricept) would the
w w w w w w w w w
wnurseprovide for a patient in the early stage of Alzheimers disease?
w w w w w w w w w w
a. It will increase the metabolism of excess GABA.
w w w w w w w
b. Excess dopamine will be prevented from attaching to receptor sites.
w w w w w w w w w
c. Serotonin deficiency will be managed through a prolonged reuptake period. w w w w w w w w w
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
w w w w w w w w
ANS: D w
w w w w w ww
CIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION
w w w w w w
Stahl's Essential Psychopharmacology w w
NeuroscientificwBasiswandwPracticalwApplicationswTESTBANK/STUDYwGUIDE
Chapter 1 Chemical neurotransmission
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
wa 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
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 neurotransmi
w w w w w w w w w w w w
tters.Serotonin and norepinephrine have been found to be important in the regulat
w w w w w w w w w w w
ion of depression. There is no research to support that the other options play a si
w w w w w w w w w w w w w w w
gnificant role in the development of depression.
w w w w w w
2. A patient has experienced a stroke (cerebral vascular accident) that has result
w w w w w w w w w w w
ed in damage to the Broca area. Which evaluation does the nurse conduct to reinforce
w w w w w w w w w w w w w w w
thisdiagnosis?
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 w
i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle strength
w w w w w w w w w w w w
are notcontrolled by the Broca area of the left frontal lobe.
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
ware always prescribed by the doctor. The nurses answer will be based on infor
w w w w w w w w w w w w w
mation thatthe therapeutic action of psychotropic drugs is the result of their effe
w w w w w w w w w w w w
ct on:
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 w
cleftand have action at the neurotransmitter level, especially in the case of schizop
w w w w w w w w w w w w
hrenia, on dopamine. The Wernickes area, dendrite function, or the sensitivity of t
w w w w w w w w w w w w
he peripheral nervous system are not relevant to either schizophrenia or psychotro
w w w w w w w w w w w
pic medications.
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
wwithunderstanding 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
Necessary but generally for psychiatric nurses who focus primarily onbehavio
w w w w w w w w w
a. ral interventions w
A complex undertaking that advance practice psychiatric nurses frequently use
w w w w w w w w w
b. in their practice w w
Important primarily for the nursing assessment of patients with braintraumaca
w w w w w w w w w
c. used cognitive symptoms w w
Necessary for planning psychiatric care for all patients especially thoseexperie
w w w w w w w w w
d. ncing psychiatric disorders w w
ANS: D w
Nurses must understand that many symptoms of psychiatric disorders have a neu
w w w w w w w w w w w
rologic basis, although the symptoms are manifested behaviorally. This understa
w w w w w w w w w
nding facilitates effective care planning. The foundation of knowledge is notused
w w w w w w w w w w
wexclusively by advanced practice psychiatric nurses nor is it relevant for only be
w w w w w w w w w w w w
havior therapies or brain trauma since dealing with the results of normal and abn
w w w w w w w w w w w w w
ormal brain function is a responsibility of all nurses providing all types of care to
w w w w w w w w w w w w w w
the psychiatric patient.
w w
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
w w w w w w w w w w w w w w
wherchronic depression? Which response is supported by research data?
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-
w w w w w w w w
releasing factors that suppress the immune system. Studies indicate that psychiatr
w w w w w w w w w w
ic disorders such as mooddisorders are sometimes associated with decreased fun
w w w w w w w w w w
ctioning of the immune system.Research does not support a connection between
w w w w w w w w w w w
many cancers and stress. There is a significant amount of research about stress a
w w w w w w w w w w w w w
nd the body.
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 w
disease.
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric r
w w w w w w w w w w w w w
ehabilitation needs. Of the aspects of functioning listed, which will the nurse
w w w w w w w w w w w w
identifyas a focus of nursing intervention?
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
wthat allows for functions such as following directions on a map, reading a clock, d
w w w w w w w w w w w w w w
ressing self, keeping appointments, and distinguishing right from left. Emotional e
w w w w w w w w w w
xpression is associated with frontal lobe function. Detecting auditory stimuli is a t
w w w w w w w w w w w w
emporal lobe function. Receiving visual images is related to occipital lobe functio
w w w w w w w w w w w
n.
7. At admission, the nurse learns that some time ago the patient had an infarct in
w w w w w w w w w w w w w w
wtheright cerebral cortex. During assessment, the nurse would expect to find that
w w w w w w w w w w w
wthe patient:
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 w
The right hemisphere mainly controls the motor and sensory functions on the left s
w w w w w w w w w w w w w
ideof the body. Damage to the right side would result in impaired function on the l
w w w w w w w w w w w w w w w
eft side of the body. The motor cortex controls voluntary motor activity. Brocas ar
w w w w w w w w w w w w w
ea controls motor speech. Cognitive functions are attributed to the association cort
w w w w w w w w w w w
ex.
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 w
Thepatient will be discharged on low doses of haloperidol. The nurse will need to
w w w w w w w w w w w w w
windividualize the patients medication teaching by:
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 andrela
w w w w w w w w w w w w
c. xed
Encouraging the patient to crush or dissolve the medication to help withswallo
w w w w w w w w w w w
d. wing
ANS: A w
, The hippocampus plays a major role in short-
w w w w w w w
term memory and, hence, in learning. Taking the medication as prescribed and pr
w w w w w w w w w w w w
oviding the education at a time when the patient is calm and relaxed is informatio
w w w w w w w w w w w w w w
n or considerations that all patients should begiven. The medication does not nec
w w w w w w w w w w w w
essarily need to be crushed or dissolved since the stroke would not have caused d
w w w w w w w w w w w w w w
ifficulty with swallowing. w w
9. The physician tells the nurse, The medication Im prescribing for the p
w w w w w w w w w w w
atient enhances the g- w w w
aminobutyric acid (GABA) system. Which patient behavior willprovide
w w w w w w w w
evidence that the medication therapy is successful?
w w w w w w
a. The patient is actively involved in playing cards with other patients.
w w w w w w w w w w
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
w w w w w w w w w w w w w w w w
c. The patient reports that both auditory and visual hallucinations have decrea
w w w w w w w w w w
sed.
d. The patient says that, I am much happier than before I came to the hospital.
w w w w w w w w w w w w w w
ANS: B w
GABA is the principle inhibitory neurotransmitter. The medication should provide
w w w w w w w w w w
anantianxiety effect. Alertness, psychotic behaviors, and mood elevation are not g
w w w w w w w w w w
enerally affected by g-aminobutyric acid.
w w w w
10. The patients family asks whether a diagnosis of Parkinsons disease creates
w w w w w w w w w w
wan increased risk for any mental health issues. What question would the nurse
w w w w w w w w w w w w
wask toassess for such a comorbid condition?
w w w w w w
a. Has your father exhibited any signs of depression?
w w w w w w w
b. Does your father seem to experience mood swings? w w w w w w w
c. Have you noticed your father talking about seeing things you cant see?
w w w w w w w w w w w
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
w w w w w w w w w w w w w
ANS: A w
Serotonin and its close chemical relatives, dopamine and norepinephrine, are the
w w w w w w w w w w w
neurotransmitters that are most widely involved in various forms of depression. w w w w w w w w w w w
Mostresearchers agree that the immediate cause of parkinsonism is a deficiency
w w w w w w w w w w w
of dopamine and so a patient with Parkinsons disease should be monitored for de
w w w w w w w w w w w w w
pression, The other mental health disorders (bipolar disorder, hallucinations, and
w w w w w w w w w w
obsessive compulsive disorder) have not been connected to Parkinsons disease.
w w w w w w w w w
11. Which explanation for the prescription of donepezil (Aricept) would the
w w w w w w w w w
wnurseprovide for a patient in the early stage of Alzheimers disease?
w w w w w w w w w w
a. It will increase the metabolism of excess GABA.
w w w w w w w
b. Excess dopamine will be prevented from attaching to receptor sites.
w w w w w w w w w
c. Serotonin deficiency will be managed through a prolonged reuptake period. w w w w w w w w w
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
w w w w w w w w
ANS: D w
