test bank for stahls essential psychopharmacology 4th edition.

, Stahl's Essential Psychopharmacology E E



NeuroscientificEBasisEandEPracticalEApplicationsETESTBANK/STUDYEGUIDE

Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE E


1. A patient with depression mentions to the nurse, My mother says depression is a c
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hemical disorder. What does she mean? The nurses response is based on the theory t
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hat depression primarily involves which of the following neurotransmitters?
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a. Cortisol and GABA E E



b. COMT and glutamate E E



c. Monamine and glycine E E



d. Serotonin and norepinephrine E E


EANS: D E


One possible cause of depression is thought to involve one or more neurotransmitters.
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Serotonin and norepinephrine have been found to be important in the regulation of
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depression. There is no research to support that the other options play a significant
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role in the development of depression.
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2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in
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damage to the Broca area. Which evaluation does the nurse conduct to reinforce this
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diagnosis?
a. Observing the patient pick up a spoon E E E E E E



b. Asking the patient to recite the alphabet
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c. Monitoring the patients blood pressure E E E E



d. Comparing the patients grip strength in both hands E E E E E E E E


ANS: B E


Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
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motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not cont
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rolled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are a
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lways prescribed by the doctor. The nurses answer will be based on information that t
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he therapeutic action of psychotropic drugs is the result of their effect on:
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a. The temporal lobe; especially Wernickes area
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b. Dendrites and their ability to transmit electrical impulses
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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 E


Medications used to treat psychiatric disorders operate in and around the synaptic cleft
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and have action at the neurotransmitter level, especially in the case of schizophrenia, o
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n dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral
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nervous system 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 with
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understanding the anatomy and physiology of the neurologic system. The mentor wo
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uld base a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily on
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a. behavioral interventions E



A complex undertaking that advance practice psychiatric nurses frequently use i
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b. n their practice
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Important primarily for the nursing assessment of patients with brain traumacause
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c. d cognitive symptoms
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Necessary for planning psychiatric care for all patients especially those experienci
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d. ng psychiatric disorders
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ANS: D E


Nurses must understand that many symptoms of psychiatric disorders have a neurologi
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c basis, although the symptoms are manifested behaviorally. This understanding facilit
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ates effective care planning. The foundation of knowledge is not used exclusively by ad
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vanced practice psychiatric nurses nor is it relevant for only behavior therapies or brain
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Etrauma since dealing with the results of normal and abnormal brain function is a respo
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nsibility of all nurses providing all types of care to the psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her
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chronic 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.
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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.
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d. There appears to be little connection between stress and diseases of the body
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ANS: C E


Research indicates that stress causes a release of corticotropin-releasing factors that
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suppress the immune system. Studies indicate that psychiatric disorders such as mood
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disorders are sometimes associated with decreased functioning of the immune system.
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Research does not support a connection between many cancers and stress. There is a si
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gnificant amount of research about stress and the body. Research has shown that there
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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 rehabilitat
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ion needs. Of the aspects of functioning listed, which will the nurse identify as a focus
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of nursing intervention?
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a. Expression of emotion E E



b. Detecting auditory stimuli E E



c. Receiving visual images E E



d. Processing associations E


EANS: D E


The parietal lobe is responsible for associating and processing sensory information
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that allows for functions such as following directions on a map, reading a clock, dressi
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ng self, keeping appointments, and distinguishing right from left. Emotional expressio
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n is associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe
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function. Receiving 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 the
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right cerebral cortex. During assessment, the nurse would expect to find that the pati
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ent:
a. Demonstrates major deficiencies in speech E E E E



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


ANS: B E


The cerebral hemispheres are responsible for functions such as control of muscles.
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The right hemisphere mainly controls the motor and sensory functions on the left side
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of the body. Damage to the right side would result in impaired function on the left side
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of the body. The motor cortex controls voluntary motor activity. Brocas area controls
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motor speech. Cognitive 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. The
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patient will be discharged on low doses of haloperidol. The nurse will need to individ
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ualize the patients medication teaching by:
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a. Including the patients caregiver in the education E E E E E E



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 and
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c. relaxed
Encouraging the patient to crush or dissolve the medication to help with swallowi
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d. ng
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