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Test Bank.
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, Stahl'sEssentialPsychopharmacology .7 .7
NeuroscientificBasisandPracticalApplications5th EditionTestbank/StudyGuide .7 .7 .7 .7 .7 .7 .7 .7
Chapter1Chemicalneurotransmission .7 .7 .7
MULTIPLECHOICE .7
1. A patient with depression mentions to the nurse, My mother says depression is a
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chemicaldisorder.Whatdoesshemean?Thenursesresponseisbasedonthetheory that
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depression primarily involves which of the following neurotransmitters?
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a. CortisolandGABA .7 .7
b. COMTandglutamate .7 .7
c. Monamineandglycine .7 .7
d. Serotoninandnorepinephrine .7 .7
ANS: D
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Onepossiblecauseofdepressionisthoughttoinvolveoneormoreneurotransmitters.
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Serotonin and norepinephrine have been found to be important in the regulation of
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depression. Thereis no research tosupport thattheother options playa significant role in
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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?
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a. Observingthepatientpickupaspoon .7 .7 .7 .7 .7 .7
b. Askingthepatienttorecitethealphabet .7 .7 .7 .7 .7 .7
c. Monitoringthepatientsbloodpressure .7 .7 .7 .7
d. Comparingthepatientsgripstrengthinbothhands .7 .7 .7 .7 .7 .7 .7
ANS: B
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AccidentsorstrokesthatdamageBrocasareamayresultintheinabilitytospeak(i.e.,
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motoraphasia).Finemotorskills,bloodpressurecontrol,andmusclestrengtharenot controlled by
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the Broca area of the left frontal lobe.
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3. The patient diagnosed with schizophrenia asks why psychotropic medications are
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alwaysprescribedbythedoctor.Thenursesanswerwillbebasedoninformationthat the
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therapeutic action of psychotropic drugs is the result of their effect on:
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a. Thetemporallobe;especiallyWernickesarea .7 .7 .7 .7 .7
b. Dendritesandtheirabilitytotransmitelectricalimpulses .7 .7 .7 .7 .7 .7 .7
c. Theregulationofneurotransmittersespeciallydopamine .7 .7 .7 .7 .7
d. Theperipheralnervoussystemsensitivitytothepsychotropicmedications
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,ANS:C .7
Medicationsusedtotreatpsychiatricdisordersoperateinandaroundthesynapticcleft and .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
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
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nervous system are not relevant to either schizophrenia or psychotropic medications.
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4. Astudentnursemuttersthatitseemsentirelyunnecessarytohavetostrugglewith
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understanding the anatomy and physiology of the neurologic system. The mentor would
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base a response on the understanding that it is:
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Necessarybutgenerallyforpsychiatricnurseswhofocusprimarilyon .7 .7 .7 .7 .7 .7 .7 .7 .7
a. behavioralinterventions .7
Acomplexundertakingthatadvancepracticepsychiatricnursesfrequentlyuse in
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b. their practice
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Importantprimarilyforthenursingassessmentofpatientswithbrain traumacaused .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
c. cognitive symptoms
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Necessaryforplanningpsychiatriccareforallpatientsespeciallythose experiencing .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
d. psychiatric disorders
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ANS:D .7
Nurses must understand that many symptoms of psychiatric disorders have a neurologic
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basis, although the symptoms are manifested behaviorally. This understandingfacilitates
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effectivecareplanning.Thefoundationofknowledgeisnot used exclusively by advanced
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practice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma
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since dealing with the results of normal and abnormalbrainfunctionis aresponsibility ofall
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nursesprovidingalltypes of careto the psychiatric patient.
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5. Apatientasksthenurse,Mywifehasbreastcancer.Coulditbecausedbyher chronic
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depression? Which response is supported by research data?
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a. Toomuchstresshasbeenproventocauseallkindsof cancer. .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
b. Therehavebeennoresearchstudiesdoneonstress anddiseaseyet. .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
c. Stressdoescausethereleaseoffactorsthatsuppresstheimmunesystem. .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
d. Thereappearstobelittleconnectionbetweenstressanddiseasesofthebody ANS: .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
C
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Researchindicatesthatstresscausesareleaseofcorticotropin-releasingfactorsthat
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suppress theimmunesystem.Studies indicatethatpsychiatricdisorders suchasmood
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disordersaresometimesassociatedwithdecreasedfunctioningoftheimmunesystem.
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Research does not support a connection between many cancers and stress. There is a
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significant amount of research about stress and the body. Research has shown that there are
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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 rehabilitation
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needs.Oftheaspectsoffunctioninglisted,whichwillthenurseidentify as a focus of nursing
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intervention?
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a. Expressionofemotion .7 .7
b. Detectingauditorystimuli .7 .7
c. Receivingvisualimages .7 .7
d. Processingassociations .7
ANS: D
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Theparietallobeisresponsibleforassociatingandprocessingsensoryinformation
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that allows for functions such as following directions on a map, reading a clock, dressing
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self, keeping appointments, and distinguishing right from left. Emotional expression is
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associated with frontal lobe function. Detecting auditory stimuli is a temporallobe
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function.Receivingvisualimagesisrelatedtooccipitallobefunction.
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7. Atadmission,thenurselearnsthatsometimeagothepatienthadaninfarctinthe right
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cerebral cortex. During assessment, the nurse would expect to find that the patient:
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a. Demonstratesmajordeficienciesinspeech .7 .7 .7 .7
b. Is unabletoeffectivelyholdaspooninthelefthand
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c. Hasdifficultyexplaininghowtogoaboutusingthetelephone
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d. Cannotusehisrighthandtoshavehimselforcombhisownhair ANS: .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
B
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Thecerebralhemispheresareresponsibleforfunctionssuchascontrolofmuscles.
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Therighthemispheremainlycontrolsthemotorandsensoryfunctionsontheleftside of the
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body. Damage to the right side would result in impaired function on the left side of the
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body. The motor cortex controls voluntary motor activity. Brocas area controls motor
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speech. Cognitive functions are attributed to the association cortex.
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Therightsideofthebodysmotoractivityiscontrolledbythe leftcerebralcortex.
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8. Apatientwithchronicschizophreniahadastrokeinvolvingthehippocampus.The
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patient will be discharged on low doses of haloperidol. The nurse will need to
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individualize the patients medication teaching by:
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a. Includingthepatientscaregiverintheeducation .7 .7 .7 .7 .7 .7
b. Beingcarefultostresstheimportanceoftakingthemedicationasprescribed .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
Providing the education at a time when the patient is emotionally calm and
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c. relaxed
Encouragingthepatienttocrushordissolvethemedicationtohelpwith swallowing .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7 .7
d.
ANS:A .7
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