Stahl’s Essential Psychopharmacology 5th
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,STAHL’S ESSENTIAL PSYCHOPHARMACOLOGY 5TH EDITION
Chapter 1 Chemical Neurotransmission
Multiple Choice
1. A Patient With Depression Mentions To The Nurse, My Mother Says Depression Is A
Chemical Disorder. What Does She Mean? The Nurses Response Is Based On The
Theory That Depression Primarily Involves Which Of The Following
Neurotransmitters? A. Cortisol And Gaba
B. Comt And Glutamate
C. Monamine And Glycine
D. Serotonin And Norepinephrine
Ans: D
One Possible Cause Of Depression Is Thought To Involve One Or More
Neurotransmitters. Serotonin And Norepinephrine Have Been Found To Be Important
In The Regulation Of Depression. There Is No Research To Support That The Other
Options Play A Significant Role In The Development Of Depression.
2. A Patient Has Experienced A Stroke (Cerebral Vascular Accident) That Has Resulted
In
Damage To The Broca Area. Which Evaluation Does The Nurse Conduct To Reinforce
This Diagnosis?
a. Observing The Patient Pick Up A Spoon
b. Asking The Patient To Recite The Alphabet
c. Monitoring The Patients Blood Pressure
d. Comparing The Patients Grip Strength In Both Hands
Ans: B
Accidents Or Strokes That Damage Brocas Area May Result In The Inability To Speak
(I.E., Motor Aphasia). Fine Motor Skills, Blood Pressure Control, And Muscle
Strength Are Not Controlled By The Broca Area Of The Left Frontal Lobe.
3. The Patient Diagnosed With Schizophrenia Asks Why Psychotropic Medications Are
Always Prescribed By The Doctor. The Nurses Answer Will Be Based On Information
That The Therapeutic Action Of Psychotropic Drugs Is The Result Of Their Effect On:
a. The Temporal Lobe; Especially Wernickes Area
b. Dendrites And Their Ability To Transmit Electrical Impulses
c. The Regulation Of Neurotransmitters Especially Dopamine
,STAHL’S ESSENTIAL PSYCHOPHARMACOLOGY 5TH EDITION
d. The Peripheral Nervous System Sensitivity To The Psychotropic Medications
Ans: C
Medications Used To Treat Psychiatric Disorders Operate In And Around The Synaptic
Cleft And Have Action At The Neurotransmitter Level, Especially In The Case Of
Schizophrenia, On Dopamine. The Wernickes Area, Dendrite Function, Or The
Sensitivity Of The Peripheral Nervous System Are Not Relevant To Either
Schizophrenia Or Psychotropic Medications.
4. A Student Nurse Mutters That It Seems Entirely Unnecessary To Have To Struggle
With Understanding The Anatomy And Physiology Of The Neurologic System. The
Mentor Would Base A Response On The Understanding That It Is:
Necessary But Generally For Psychiatric Nurses Who Focus Primarily On
a. Behavioral Interventions
A Complex Undertaking That Advance Practice Psychiatric Nurses Frequently Use B. In Their
Practice
Important Primarily For The Nursing Assessment Of Patients With Brain
c. Traumacaused Cognitive Symptoms
Necessary For Planning Psychiatric Care For All Patients Especially Those
d. Experiencing Psychiatric Disorders
Ans: D
Nurses Must Understand That Many Symptoms Of Psychiatric Disorders Have A
Neurologic Basis, Although The Symptoms Are Manifested Behaviorally. This
Understanding Facilitates Effective Care Planning. The Foundation Of Knowledge Is
Not Used Exclusively By Advanced Practice Psychiatric Nurses Nor Is It Relevant
For Only Behavior Therapies Or Brain Trauma Since Dealing With The Results Of
Normal And Abnormal Brain Function Is A Responsibility Of All Nurses Providing
All Types Of Care To The Psychiatric Patient.
5. A Patient Asks The Nurse, My Wife Has Breast Cancer. Could It Be Caused By Her
Chronic Depression? Which Response Is Supported By Research Data?
a. Too Much Stress Has Been Proven To Cause All Kinds Of Cancer.
b. There Have Been No Research Studies Done On Stress And Disease Yet.
c. Stress Does Cause The Release Of Factors That Suppress The Immune System.
d. There Appears To Be Little Connection Between Stress And Diseases Of The
Body
Ans: C
, STAHL’S ESSENTIAL PSYCHOPHARMACOLOGY 5TH EDITION
Research Indicates That Stress Causes A Release Of Corticotropin-Releasing Factors
That Suppress The Immune System. Studies Indicate That Psychiatric Disorders Such
As Mood Disorders Are Sometimes Associated With Decreased Functioning Of The
Immune System. Research Does Not Support A Connection Between Many Cancers
And Stress. There Is A Significant Amount Of Research About Stress And The Body.
Research Has Shown That There Are Some Connections Between Stress And Physical
Disease.
6. A Patient Who Has A Parietal Lobe Injury Is Being Evaluated For Psychiatric
Rehabilitation Needs. Of The Aspects Of Functioning Listed, Which Will The Nurse
Identify As A Focus Of Nursing Intervention?
A. Expression Of Emotion
B. Detecting Auditory Stimuli
C. Receiving Visual Images
D. Processing Associations
Ans: D
The Parietal Lobe Is Responsible For Associating And Processing Sensory
Information That Allows For Functions Such As Following Directions On A Map,
Reading A Clock, Dressing Self, Keeping Appointments, And Distinguishing Right
From Left. Emotional Expression Is Associated With Frontal Lobe Function.
Detecting Auditory Stimuli Is A Temporal Lobe Function. Receiving Visual Images
Is Related To Occipital Lobe Function. 7. At Admission, The Nurse Learns That
Some Time Ago The Patient Had An Infarct In The Right Cerebral Cortex. During
Assessment, The Nurse Would Expect To Find That The Patient:
a. Demonstrates Major Deficiencies In Speech
b. Is Unable To Effectively Hold A Spoon In The Left Hand
c. Has Difficulty Explaining How To Go About Using The Telephone
d. Cannot Use His Right Hand To Shave Himself Or Comb His Own Hair
Ans: B
The Cerebral Hemispheres Are Responsible For Functions Such As Control Of
Muscles. The Right Hemisphere Mainly Controls The Motor And Sensory Functions