Stahl's Essential Psychopharmacology
Neuroscientific Basis and Practical
Applications TESTBANK/STUDY GUIDE
Chapter 1 Chemical neurotransmission
MULTIPLE CHOICE
1. A patient 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. Cortisol and GABA
b. COMT and glutamate
c. Monamine and glycine
d. Serotonin and norepinephrine
ANS: 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 patient 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 patient pick up a spoon
b. Asking the patient to recite the alphabet
c. Monitoring the patients blood pressure
d. Comparing the patients grip strength in both hands
ANS: 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 patient 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:
,Stahl's Essential Psychopharmacology
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
ANS: 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:
a. Necessary but generally for psychiatric nurses who focus primarily on behavioral
interventions
b. A complex undertaking that advance practice psychiatric nurses frequently use in their
practice
c. Important primarily for the nursing assessment of patients with brain traumacaused
cognitive symptoms
d. Necessary for planning psychiatric care for all patients especially those experiencing
psychiatric disorders
ANS: D
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 patient.
,Stahl's Essential Psychopharmacology
5. A patient 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
ANS: 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 patient 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
ANS: 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 patient had an infarct in the right
cerebral cortex. During assessment, the nurse would expect to find that the patient:
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
, Stahl's Essential Psychopharmacology
d. Cannot use his right hand to shave himself or comb his own hair
ANS: 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 patient with chronic schizophrenia had a stroke involving the hippocampus. The patient
will be discharged on low doses of haloperidol. The nurse will need to individualize the patients
medication teaching by:
a. Including the patients caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed
c. Providing the education at a time when the patient is emotionally calm and relaxed
d. Encouraging the patient to crush or dissolve the medication to help with swallowing
ANS: 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 patient is calm and relaxed
is information or considerations that all patients 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 patient enhances the g-
aminobutyric acid (GABA) system. Which patient behavior will provide evidence that the medication
therapy is successful?
a. The patient is actively involved in playing cards with other patients.
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
c. The patient reports that both auditory and visual hallucinations have decreased.
d. The patient says that, I am much happier than before I came to the hospital.
ANS: B
Neuroscientific Basis and Practical
Applications TESTBANK/STUDY GUIDE
Chapter 1 Chemical neurotransmission
MULTIPLE CHOICE
1. A patient 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. Cortisol and GABA
b. COMT and glutamate
c. Monamine and glycine
d. Serotonin and norepinephrine
ANS: 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 patient 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 patient pick up a spoon
b. Asking the patient to recite the alphabet
c. Monitoring the patients blood pressure
d. Comparing the patients grip strength in both hands
ANS: 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 patient 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:
,Stahl's Essential Psychopharmacology
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
ANS: 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:
a. Necessary but generally for psychiatric nurses who focus primarily on behavioral
interventions
b. A complex undertaking that advance practice psychiatric nurses frequently use in their
practice
c. Important primarily for the nursing assessment of patients with brain traumacaused
cognitive symptoms
d. Necessary for planning psychiatric care for all patients especially those experiencing
psychiatric disorders
ANS: D
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 patient.
,Stahl's Essential Psychopharmacology
5. A patient 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
ANS: 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 patient 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
ANS: 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 patient had an infarct in the right
cerebral cortex. During assessment, the nurse would expect to find that the patient:
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
, Stahl's Essential Psychopharmacology
d. Cannot use his right hand to shave himself or comb his own hair
ANS: 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 patient with chronic schizophrenia had a stroke involving the hippocampus. The patient
will be discharged on low doses of haloperidol. The nurse will need to individualize the patients
medication teaching by:
a. Including the patients caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed
c. Providing the education at a time when the patient is emotionally calm and relaxed
d. Encouraging the patient to crush or dissolve the medication to help with swallowing
ANS: 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 patient is calm and relaxed
is information or considerations that all patients 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 patient enhances the g-
aminobutyric acid (GABA) system. Which patient behavior will provide evidence that the medication
therapy is successful?
a. The patient is actively involved in playing cards with other patients.
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
c. The patient reports that both auditory and visual hallucinations have decreased.
d. The patient says that, I am much happier than before I came to the hospital.
ANS: B
