neuroscientific basis and practical applications 5th
edition | complete guide | Chapter 1-13
, Stahl's Essential Psychopharmacology S S
NeuroscientificSBasisSandSPracticalSApplicationsS 5thSEditionSTestbank/StudySGuide
Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE S
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 theoryth
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at depression primarily involves which of the following neurotransmitters?
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a. Cortisol and GABA S S
b. COMT and glutamate S S
c. Monamine and glycine S S
d. Serotonin and norepinephrine S S
ANS: D S
One possible cause of depression is thought to involve one or more neurotransmitters.S
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erotonin and norepinephrine have been found to be important in the regulation of depre
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ssion. There is no research to support that the other options play a significant role in the
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Sdevelopment of depression. S S
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted ind
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amage to the Broca area. Which evaluation does the nurse conduct to reinforce thisdi
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agnosis?
a. Observing the patient pick up a spoon S S S S S S
b. Asking the patient to recite the alphabet
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c. Monitoring the patients blood pressure S S S S
d. Comparing the patients grip strength in both hands S S S S S S S
ANS: B S
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 notc
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ontrolled by the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are al
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ways prescribed by the doctor. The nurses answer will be based on information thatthe
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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 S
Medications used to treat psychiatric disorders operate in and around the synaptic clefta
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nd have action at the neurotransmitter level, especially in the case of schizophrenia, on
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dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral ne
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rvous 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 withu
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nderstanding the anatomy and physiology of the neurologic system. The mentor woul
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d base a response on the understanding that it is:
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Necessary but generally for psychiatric nurses who focus primarily on S S S S S S S S S S
a. behavioral interventions S
A complex undertaking that advance practice psychiatric nurses frequently usei
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b. n their practice
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Important primarily for the nursing assessment of patients with braint
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c. raumacaused cognitive symptoms S S
Necessary for planning psychiatric care for all patients especially thosee
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d. xperiencing psychiatric disorders S S
ANS: D S
Nurses must understand that many symptoms of psychiatric disorders have a neurolog
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ic basis, although the symptoms are manifested behaviorally. This understanding facil
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itates effective care planning. The foundation of knowledge is notused exclusively by
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advanced practice psychiatric nurses nor is it relevant for only behavior therapies or br
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ain trauma since dealing with the results of normal and abnormal brain function is a re
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sponsibility of all nurses providing all types of care tothe psychiatric patient.
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5. A patient asks the nurse, My wife has breast cancer. Could it be caused by herc
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hronic 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 S
Research indicates that stress causes a release of corticotropin-
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releasing factors that suppress the immune system. Studies indicate that psychiatric dis
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orders such as mooddisorders are sometimes associated with decreased functioning of t
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he immune system.Research does not support a connection between many cancers and
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stress. There is a significant amount of research about stress and the body. Research ha
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s shown that there 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 rehabilitati
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on needs. Of the aspects of functioning listed, which will the nurse identifyas a focus o
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f nursing intervention?
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a. Expression of emotion S S
b. Detecting auditory stimuli S S
c. Receiving visual images S S
d. Processing associations S
ANS: D S
The parietal lobe is responsible for associating and processing sensory information that
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Sallows for functions such as following directions on a map, reading a clock, dressing s
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elf, keeping appointments, and distinguishing right from left. Emotional expression is
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associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe fun
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ction. 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 theri
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ght cerebral cortex. During assessment, the nurse would expect to find that the patien
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t:
a. Demonstrates major deficiencies in speech S S S S
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
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ANS: B S
The cerebral hemispheres are responsible for functions such as control of muscles. The
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Sright hemisphere mainly controls the motor and sensory functions on the left sideof th
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e body. Damage to the right side would result in impaired function on the left side of th
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e body. The motor cortex controls voluntary motor activity. Brocas area controls motor
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Sspeech. 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. Thep
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atient will be discharged on low doses of haloperidol. The nurse will need to individua
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lize the patients medication teaching by:
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a. Including the patients caregiver in the education S S S S S S
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 andr
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c. elaxed
Encouraging the patient to crush or dissolve the medication to help withs
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d. wallowing
ANS: A S