Tb stahls essential psycho pharmacology 4th edition test bank tankk

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ank 100% Questions And Answers Graded A
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Stahl's Essential Psychopharmacology v v



NeuroscientificvBasisvandvPracticalvApplicationsvTESTBANK/STUDYvGUIDE

Chapter 1 Chemical neurotransmission
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MULTIPLE CHOICE v


1. A patient with depression mentions to the nurse, My mother says depression is a ch
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emical disorder. What does she mean? The nurses response is based on the theorythat
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depression primarily involves which of the following neurotransmitters?
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a. Cortisol and GABA v v



b. COMT and glutamate v v



c. Monamine and glycine v v


d. Serotonin and norepinephrine v v


ANS: D v


One possible cause of depression is thought to involve one or more neurotransmitters.Se
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rotonin and norepinephrine have been found to be important in the regulation of depress
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ion. There is no research to support that the other options play a significant role in the de
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velopment of depression. v v


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 thisdia
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gnosis?
a. Observing the patient pick up a spoon v v v v v v



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


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


ANS: B v


Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,m
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otor aphasia). Fine motor skills, blood pressure control, and muscle strength are notcont
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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 al
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ways prescribed by the doctor. The nurses answer will be based on information thatthe t
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herapeutic action of psychotropic drugs is the result of their effect on:
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a. The temporal lobe; especially Wernickes area v v v v v



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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ank 100% Questions And Answers Graded A
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ANS: C v


Medications used to treat psychiatric disorders operate in and around the synaptic cleftan
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d have action at the neurotransmitter level, especially in the case of schizophrenia, on do
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pamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral nervo
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us 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 onb v v v v v v v v v v


a. ehavioral interventions v



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 braintraumacaused
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c. cognitive symptoms v


Necessary for planning psychiatric care for all patients especially thoseexperiencin
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d. g psychiatric disorders
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ANS: D v


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 facilita
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tes effective care planning. The foundation of knowledge is notused exclusively by adva
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nced practice psychiatric nurses nor is it relevant for only behavior therapies or brain tra
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uma since dealing with the results of normal and abnormal brain function is a responsibi
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lity 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 herch
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ronic 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 v


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 s
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tress. There is a significant amount of research about stress and the body. Research has s
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hown 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 of
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nursing intervention? v


a. Expression of emotion v v



b. Detecting auditory stimuli v v



c. Receiving visual images v v


d. Processing associations v


ANS: D v


The parietal lobe is responsible for associating and processing sensory information that
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allows for functions such as following directions on a map, reading a clock, dressing sel
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f, keeping appointments, and distinguishing right from left. Emotional expression is ass
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ociated with frontal lobe function. Detecting auditory stimuli is a temporal lobe functio
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n. 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 patient
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:
a. Demonstrates major deficiencies in speech v v v v



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 v v v v v v v v v v v v


ANS: B v


The cerebral hemispheres are responsible for functions such as control of muscles. The
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right hemisphere mainly controls the motor and sensory functions on the left sideof the
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body. Damage to the right side would result in impaired function on the left side of the b
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ody. The motor cortex controls voluntary motor activity. Brocas area controls motor sp
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eech. 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 v v v v v v



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 andrelaxed
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c.
Encouraging the patient to crush or dissolve the medication to help withswallowing
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d.
ANS: A v




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The hippocampus plays a major role in short-
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term memory and, hence, in learning. Taking the medication as prescribed and providin
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g the education at a time when the patient is calm and relaxed is information or consider
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ations that all patients should begiven. The medication does not necessarily need to be c
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rushed or dissolved since the stroke would not have caused difficulty with swallowing.
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9. The physician tells the nurse, The medication Im prescribing for the patient en
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hances the g- v v


aminobutyric acid (GABA) system. Which patient behavior willprovide evidenc v v v v v v v v v


e that the medication therapy is successful?
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a. The patient is actively involved in playing cards with other patients.
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b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
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c. The patient reports that both auditory and visual hallucinations have decreased.
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d. The patient says that, I am much happier than before I came to the hospital.
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ANS: B v


GABA is the principle inhibitory neurotransmitter. The medication should provide anan
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tianxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally af
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fected by g-aminobutyric acid. v v v


10. The patients family asks whether a diagnosis of Parkinsons disease creates ani
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ncreased risk for any mental health issues. What question would the nurse ask toas
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sess for such a comorbid condition?
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a. Has your father exhibited any signs of depression? v v v v v v v



b. Does your father seem to experience mood swings?
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c. Have you noticed your father talking about seeing things you cant see?v v v v v v v v v v v


d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
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ANS: A v


Serotonin and its close chemical relatives, dopamine and norepinephrine, are the neurot
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ransmitters that are most widely involved in various forms of depression. Mostresearch
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ers agree that the immediate cause of parkinsonism is a deficiency of dopamine and so a
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vpatient with Parkinsons disease should be monitored for depression, The other mental h
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ealth disorders (bipolar disorder, hallucinations, and obsessive compulsive disorder) ha
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ve not been connected to Parkinsons disease.
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11. Which explanation for the prescription of donepezil (Aricept) would the nursep
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rovide for a patient in the early stage of Alzheimers disease?
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a. It will increase the metabolism of excess GABA.v v v v v v v



b. Excess dopamine will be prevented from attaching to receptor sites.
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c. Serotonin deficiency will be managed through a prolonged reuptake period. v v v v v v v v v


d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
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ANS: D v




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