, Stahl's Essential Psychopharmacology f f
Neuroscientific fBasis fand fPractical fApplications f5th fEdition fTestbank/Study fGuide
Chapter 1 Chemical neurotransmissionf f f
MULTIPLE CHOICE f
1. A patient with depression mentions to the nurse, My mother says depression is a
f f f f f f f f f f f f f
chemical disorder. What does she mean? The nurses response is based on the theory
f f f f f f f f f f f f f f
that depression primarily involves which of the following neurotransmitters?
f f f f f f f f f
a. Cortisol and GABA f f
b. COMT and glutamate f f
c. Monamine and glycine f f
d. Serotonin and norepinephrine f f
ANS: D
f f
One possible cause of depression is thought to involve one or more neurotransmitters.
f f f f f f f f f f f f
Serotonin and norepinephrine have been found to be important in the regulation of
f f f f f f f f f f f f
depression. There is no research to support that the other options play a significant
f f f f f f f f f f f f f f
role in the development of depression.
f f f f f f
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in
f f f f f f f f f f f f
damage to the Broca area. Which evaluation does the nurse conduct to reinforce this
f f f f f f f f f f f f f f
diagnosis?
f
a. Observing the patient pick up a spoon f f f f f f
b. Asking the patient to recite the alphabet f f f f f f
c. Monitoring the patients blood pressure f f f f
d. Comparing the patients grip strength in both hands f f f f f f f
ANS: B
f f
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
f f f f f f f f f f f f f f
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not controlled
f f f f f f f f f f f f f
by the Broca area of the left frontal lobe.
f f f f f f f f f
3. The patient diagnosed with schizophrenia asks why psychotropic medications are
f f f f f f f f f
always prescribed by the doctor. The nurses answer will be based on information that
f f f f f f f f f f f f f f
the therapeutic action of psychotropic drugs is the result of their effect on:
f f f f f f f f f f f f f
a. The temporal lobe; especially Wernickes area f f f f f
b. Dendrites and their ability to transmit electrical impulses f f f f f f f
c. The regulation of neurotransmitters especially dopamine
f f f f f
d. The peripheral nervous system sensitivity to the psychotropic medications
f f f f f f f f
,ANS: C f
Medications used to treat psychiatric disorders operate in and around the synaptic cleft
f f f f f f f f f f f f
and have action at the neurotransmitter level, especially in the case of schizophrenia,
f f f f f f f f f f f f f
on dopamine. The Wernickes area, dendrite function, or the sensitivity of the
f f f f f f f f f f f f
peripheral nervous system are not relevant to either schizophrenia or psychotropic
f f f f f f f f f f f
medications.
f
4. A student nurse mutters that it seems entirely unnecessary to have to struggle with
f f f f f f f f f f f f f
understanding the anatomy and physiology of the neurologic system. The mentor
f f f f f f f f f f f
would base a response on the understanding that it is:
f f f f f f f f f f
Necessary but generally for psychiatric nurses who focus primarily on f f f f f f f f f
a. behavioral interventions f
A complex undertaking that advance practice psychiatric nurses frequently use
f f f f f f f f f
b. in their practice
f f f
Important primarily for the nursing assessment of patients with brain f f f f f f f f f
c. traumacaused cognitive symptoms
f f f
Necessary for planning psychiatric care for all patients especially those f f f f f f f f f
d. experiencing psychiatric disorders
f f f
ANS: D f
Nurses must understand that many symptoms of psychiatric disorders have a
f f f f f f f f f f
neurologic basis, although the symptoms are manifested behaviorally. This
f f f f f f f f f
understanding facilitates effective care planning. The foundation of knowledge is not
f f f f f f f f f f f
used exclusively by advanced practice psychiatric nurses nor is it relevant for only
f f f f f f f f f f f f f
behavior therapies or brain trauma since dealing with the results of normal and
f f f f f f f f f f f f f
abnormal brain function is a responsibility of all nurses providing all types of care to
f f f f f f f f f f f f f f f
the psychiatric patient.
f f f
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her
f f f f f f f f f f f f f f f
chronic depression? Which response is supported by research data?
f f f f f f f f f
a. Too much stress has been proven to cause all kinds of cancer. f f f f f f f f f f f
b. There have been no research studies done on stress and disease yet.
f f f f f f f f f f f
c. Stress does cause the release of factors that suppress the immune system.
f f f f f f f f f f f
d. There appears to be little connection between stress and diseases of the body f f f f f f f f f f f f
ANS: C
f f
Research indicates that stress causes a release of corticotropin-releasing factors that
f f f f f f f f f f
suppress the immune system. Studies indicate that psychiatric disorders such as mood
f f f f f f f f f f f
disorders are sometimes associated with decreased functioning of the immune system.
f f f f f f f f f f f
Research does not support a connection between many cancers and stress. There is a
f f f f f f f f f f f f f f
significant amount of research about stress and the body. Research has shown that
f f f f f f f f f f f f f
there are some connections between stress and physical disease.
f f f f f f f f f
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
f f f f f f f f f f f f
rehabilitation needs. Of the aspects of functioning listed, which will the nurse identify
f f f f f f f f f f f f f
as a focus of nursing intervention?
f f f f f f
a. Expression of emotion f f
b. Detecting auditory stimuli f f
c. Receiving visual images f f
d. Processing associations f
ANS: D
f f
The parietal lobe is responsible for associating and processing sensory information
f f f f f f f f f f
that allows for functions such as following directions on a map, reading a clock,
f f f f f f f f f f f f f
dressing self, keeping appointments, and distinguishing right from left. Emotional
f f f f f f f f f f
expression is associated with frontal lobe function. Detecting auditory stimuli is a
f f f f f f f f f f f f
temporal lobe function. Receiving visual images is related to occipital lobe function.
f f f f f f f f f f f f
7. At admission, the nurse learns that some time ago the patient had an infarct in the
f f f f f f f f f f f f f f f
right cerebral cortex. During assessment, the nurse would expect to find that the
f f f f f f f f f f f f f
patient:
f
a. Demonstrates major deficiencies in speech f f f f
b. Is unable to effectively hold a spoon in the left hand
f f f f f f f f f f
c. Has difficulty explaining how to go about using the telephone
f f f f f f f f f
d. Cannot use his right hand to shave himself or comb his own hair f f f f f f f f f f f f
ANS: B
f f
The cerebral hemispheres are responsible for functions such as control of muscles.
f f f f f f f f f f f
The right hemisphere mainly controls the motor and sensory functions on the left side of
f f f f f f f f f f f f f f
the body. Damage to the right side would result in impaired function on the left side
f f f f f f f f f f f f f f f f
of the body. The motor cortex controls voluntary motor activity. Brocas area controls
f f f f f f f f f f f f f
motor speech. Cognitive functions are attributed to the association cortex.
f f f f f f f f f f
The right side of the bodys motor activity is controlled by the left cerebral cortex.
f f f f f f f f f f f f f f
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The
f f f f f f f f f f f
patient will be discharged on low doses of haloperidol. The nurse will need to
f f f f f f f f f f f f f f
individualize the patients medication teaching by:
f f f f f f
a. Including the patients caregiver in the education f f f f f f
b. Being careful to stress the importance of taking the medication as prescribed
f f f f f f f f f f f
Providing the education at a time when the patient is emotionally calm and
f f f f f f f f f f f f f
c. relaxed
Encouraging the patient to crush or dissolve the medication to help with f f f f f f f f f f f
d. swallowing f
ANS: A f
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Neuroscientific fBasis fand fPractical fApplications f5th fEdition fTestbank/Study fGuide
Chapter 1 Chemical neurotransmissionf f f
MULTIPLE CHOICE f
1. A patient with depression mentions to the nurse, My mother says depression is a
f f f f f f f f f f f f f
chemical disorder. What does she mean? The nurses response is based on the theory
f f f f f f f f f f f f f f
that depression primarily involves which of the following neurotransmitters?
f f f f f f f f f
a. Cortisol and GABA f f
b. COMT and glutamate f f
c. Monamine and glycine f f
d. Serotonin and norepinephrine f f
ANS: D
f f
One possible cause of depression is thought to involve one or more neurotransmitters.
f f f f f f f f f f f f
Serotonin and norepinephrine have been found to be important in the regulation of
f f f f f f f f f f f f
depression. There is no research to support that the other options play a significant
f f f f f f f f f f f f f f
role in the development of depression.
f f f f f f
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in
f f f f f f f f f f f f
damage to the Broca area. Which evaluation does the nurse conduct to reinforce this
f f f f f f f f f f f f f f
diagnosis?
f
a. Observing the patient pick up a spoon f f f f f f
b. Asking the patient to recite the alphabet f f f f f f
c. Monitoring the patients blood pressure f f f f
d. Comparing the patients grip strength in both hands f f f f f f f
ANS: B
f f
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
f f f f f f f f f f f f f f
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not controlled
f f f f f f f f f f f f f
by the Broca area of the left frontal lobe.
f f f f f f f f f
3. The patient diagnosed with schizophrenia asks why psychotropic medications are
f f f f f f f f f
always prescribed by the doctor. The nurses answer will be based on information that
f f f f f f f f f f f f f f
the therapeutic action of psychotropic drugs is the result of their effect on:
f f f f f f f f f f f f f
a. The temporal lobe; especially Wernickes area f f f f f
b. Dendrites and their ability to transmit electrical impulses f f f f f f f
c. The regulation of neurotransmitters especially dopamine
f f f f f
d. The peripheral nervous system sensitivity to the psychotropic medications
f f f f f f f f
,ANS: C f
Medications used to treat psychiatric disorders operate in and around the synaptic cleft
f f f f f f f f f f f f
and have action at the neurotransmitter level, especially in the case of schizophrenia,
f f f f f f f f f f f f f
on dopamine. The Wernickes area, dendrite function, or the sensitivity of the
f f f f f f f f f f f f
peripheral nervous system are not relevant to either schizophrenia or psychotropic
f f f f f f f f f f f
medications.
f
4. A student nurse mutters that it seems entirely unnecessary to have to struggle with
f f f f f f f f f f f f f
understanding the anatomy and physiology of the neurologic system. The mentor
f f f f f f f f f f f
would base a response on the understanding that it is:
f f f f f f f f f f
Necessary but generally for psychiatric nurses who focus primarily on f f f f f f f f f
a. behavioral interventions f
A complex undertaking that advance practice psychiatric nurses frequently use
f f f f f f f f f
b. in their practice
f f f
Important primarily for the nursing assessment of patients with brain f f f f f f f f f
c. traumacaused cognitive symptoms
f f f
Necessary for planning psychiatric care for all patients especially those f f f f f f f f f
d. experiencing psychiatric disorders
f f f
ANS: D f
Nurses must understand that many symptoms of psychiatric disorders have a
f f f f f f f f f f
neurologic basis, although the symptoms are manifested behaviorally. This
f f f f f f f f f
understanding facilitates effective care planning. The foundation of knowledge is not
f f f f f f f f f f f
used exclusively by advanced practice psychiatric nurses nor is it relevant for only
f f f f f f f f f f f f f
behavior therapies or brain trauma since dealing with the results of normal and
f f f f f f f f f f f f f
abnormal brain function is a responsibility of all nurses providing all types of care to
f f f f f f f f f f f f f f f
the psychiatric patient.
f f f
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her
f f f f f f f f f f f f f f f
chronic depression? Which response is supported by research data?
f f f f f f f f f
a. Too much stress has been proven to cause all kinds of cancer. f f f f f f f f f f f
b. There have been no research studies done on stress and disease yet.
f f f f f f f f f f f
c. Stress does cause the release of factors that suppress the immune system.
f f f f f f f f f f f
d. There appears to be little connection between stress and diseases of the body f f f f f f f f f f f f
ANS: C
f f
Research indicates that stress causes a release of corticotropin-releasing factors that
f f f f f f f f f f
suppress the immune system. Studies indicate that psychiatric disorders such as mood
f f f f f f f f f f f
disorders are sometimes associated with decreased functioning of the immune system.
f f f f f f f f f f f
Research does not support a connection between many cancers and stress. There is a
f f f f f f f f f f f f f f
significant amount of research about stress and the body. Research has shown that
f f f f f f f f f f f f f
there are some connections between stress and physical disease.
f f f f f f f f f
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
f f f f f f f f f f f f
rehabilitation needs. Of the aspects of functioning listed, which will the nurse identify
f f f f f f f f f f f f f
as a focus of nursing intervention?
f f f f f f
a. Expression of emotion f f
b. Detecting auditory stimuli f f
c. Receiving visual images f f
d. Processing associations f
ANS: D
f f
The parietal lobe is responsible for associating and processing sensory information
f f f f f f f f f f
that allows for functions such as following directions on a map, reading a clock,
f f f f f f f f f f f f f
dressing self, keeping appointments, and distinguishing right from left. Emotional
f f f f f f f f f f
expression is associated with frontal lobe function. Detecting auditory stimuli is a
f f f f f f f f f f f f
temporal lobe function. Receiving visual images is related to occipital lobe function.
f f f f f f f f f f f f
7. At admission, the nurse learns that some time ago the patient had an infarct in the
f f f f f f f f f f f f f f f
right cerebral cortex. During assessment, the nurse would expect to find that the
f f f f f f f f f f f f f
patient:
f
a. Demonstrates major deficiencies in speech f f f f
b. Is unable to effectively hold a spoon in the left hand
f f f f f f f f f f
c. Has difficulty explaining how to go about using the telephone
f f f f f f f f f
d. Cannot use his right hand to shave himself or comb his own hair f f f f f f f f f f f f
ANS: B
f f
The cerebral hemispheres are responsible for functions such as control of muscles.
f f f f f f f f f f f
The right hemisphere mainly controls the motor and sensory functions on the left side of
f f f f f f f f f f f f f f
the body. Damage to the right side would result in impaired function on the left side
f f f f f f f f f f f f f f f f
of the body. The motor cortex controls voluntary motor activity. Brocas area controls
f f f f f f f f f f f f f
motor speech. Cognitive functions are attributed to the association cortex.
f f f f f f f f f f
The right side of the bodys motor activity is controlled by the left cerebral cortex.
f f f f f f f f f f f f f f
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The
f f f f f f f f f f f
patient will be discharged on low doses of haloperidol. The nurse will need to
f f f f f f f f f f f f f f
individualize the patients medication teaching by:
f f f f f f
a. Including the patients caregiver in the education f f f f f f
b. Being careful to stress the importance of taking the medication as prescribed
f f f f f f f f f f f
Providing the education at a time when the patient is emotionally calm and
f f f f f f f f f f f f f
c. relaxed
Encouraging the patient to crush or dissolve the medication to help with f f f f f f f f f f f
d. swallowing f
ANS: A f
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