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Test Bank for Prescriber's Guide Stahl's Essential Psychopharmacology 7th Edition by Stephen M. Stahl Complete Guide . Questions with verified Answers. A+ GRADE GUARANTEED.

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Test Bank for Prescriber's Guide Stahl's Essential Psychopharmacology 7th Edition by Stephen M. Stahl Complete Guide . Questions with verified Answers. A+ GRADE GUARANTEED. Chapter 1 Chemical neurotransmission MULTIPLE CHOICE 1. A client 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. b. c. d. Cortisol and GABA COMT and glutamate Monamine and glycine Serotonin and norepinephrine CORRECT: 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 client 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 client pick up a spoon b. c. d. Asking the client to recite the alphabet Monitoring the clients blood pressure Comparing the clients grip strength in both hands CORRECT: 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 client 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 d. The peripheral nervous system sensitivity to the psychotropic medications M CORRECT: 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 clients with brain c. d. CORR ECT: D traumacaused cognitive symptoms Necessary for planning psychiatric care for all clients especially those experiencing psychiatric disorders 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 client. 5. A client 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 CORRECT: C 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 client 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 CORRECT: 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 client had an infarct in the right cerebral cortex. During assessment, the nurse would expect to find that the client: 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 CORRECT: B The cerebral hemispheres are responsible for functions such as control of muscles. The right hemisphere mainly controls the motor and sensory functions on the left side of the body. Damage to the right side would result in impaired function on the left side of the body. The motor cortex controls voluntary motor activity. Brocas area controls motor speech. Cognitive functions are attributed to the association cortex. The right side of the bodys motor activity is controlled by the left cerebral cortex. 8. A client with chronic schizophrenia had a stroke involving the hippocampus. The client will be discharged on low doses of haloperidol. The nurse will need to individualize the clients medication teaching by: a. b. c. Including the clients caregiver in the education Being careful to stress the importance of taking the medication as prescribed Providing the education at a time when the client is emotionally calm and relaxed Encouraging the client to crush or dissolve the medication to help with d. swallowing CORR ECT: A The hippocampus plays a major role in short-term memory and, hence, in learning. Taking the medication as prescribed and providing the education at a time when the client is calm and relaxed is information or considerations that all clients should be given. The medication does not necessarily need to be crushed or dissolved since the stroke would not have caused difficulty with swallowing. 9. The physician tells the nurse, The medication Im prescribing for the client enhances the g-aminobutyric acid (GABA) system. Which client behavior will provide evidence that the medication therapy is successful? a. b. c. d. The client is actively involved in playing cards with other clients. The client reports that, I dont feel as anxious as I did a couple of days ago. The client reports that both auditory and visual hallucinations have decreased. The client says that, I am much happier than before I came to the hospital. CORRECT: B GABA is the principle inhibitory neurotransmitter. The medication should provide an antianxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally affected by g-aminobutyric acid. 10. The clients family asks whether a diagnosis of Parkinsons disease creates an increased risk for any mental health issues. What question would the nurse ask to assess for such a comorbid condition? a. b. c. d. Has your father exhibited any signs of depression? Does your father seem to experience mood swings? Have you noticed your father talking about seeing things you cant see? Is your dad preoccupied with behaviors that he needs to repeat over and over? CORRECT: A Serotonin and its close chemical relatives, dopamine and norepinephrine, are the neurotransmitters that are most widely involved in various forms of depression. Most researchers agree that the immediate cause of parkinsonism is a deficiency of dopamine and so a client with Parkinsons disease should be monitored for depression, The other mental health disorders (bipolar disorder, hallucinations, and obsessive compulsive disorder) have not been connected to Parkinsons disease.

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