TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY: NEUROS
z z z z z z
CIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION z z z z z z
Stahl's Essential Psychopharmacology z z
NeuroscientificzBasiszandzPracticalzApplicationszTESTBANK/STUDYzGUIDE
Chapter 1 Chemical neurotransmissionz z z
MULTIPLE CHOICE z
1. A patient with depression mentions to the nurse, My mother says depression isa c
z z z z z z z z z z z z z z
hemical disorder. What does she mean? The nurses response is based on the theoryt
z z z z z z z z z z z z z
hat depression primarily involves which of the following
z z z z z z z
neurotransmitters?
a. Cortisol and GABA z z
b. COMT and glutamate z z
c. Monamine and glycine z z
d. Serotonin and norepinephrine z z
ANS: D z
One possible cause of depression is thought to involve one or more neurotransmitte
z z z z z z z z z z z z
rs.Serotonin and norepinephrine have been found to be importantin the regulation o
z z z z z z z z z z z z
f depression. There is no research to support that the other options play a significant
z z z z z z z z z z z z z z
zrole in the development of depression.
z z z z z
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted i
z z z z z z z z z z z z
n damage to the Broca area. Which evaluation does the nurse conduct to reinforce thisdia
z z z z z z z z z z z z z z
gnosis?
a. Observing the patient pick up a spoon z z z z z z
b. Asking the patient to recite the alphabet z z z z z z
c. Monitoring the patients blood pressure z z z z
d. Comparing the patients grip strength in both hands z z z z z z z
ANS: B z
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
z z z z z z z z z z z z z z
motor aphasia). Fine motor skills, blood pressure control, and muscle strengthare not
z z z z z z z z z z z z z
controlled by the Broca area of the left frontal lobe.
z z z z z z z z z
3. The patient diagnosed with schizophrenia asks why psychotropic medicationsa
z z z z z z z z z
re always prescribed by the doctor. The nurses answer will be based on informatio
z z z z z z z z z z z z z
n thatthe therapeutic action of psychotropic drugs is the result of their
z z z z z z z z z z z
effect on: z
a. The temporal lobe; especially Wernickes area z z z z z
b. Dendrites and their ability to transmit electrical impulses z z z z z z z
c. The regulation of neurotransmitters especially dopamine
z z z z z
d. The peripheral nervous system sensitivity to the psychotropic medications
z z z z z z z z
,ANS: C z
Medications used to treat psychiatric disorders operate in and around the synaptic clef
z z z z z z z z z z z z
tand have action at the neurotransmitter level, especially in the case of schizophrenia,
z z z z z z z z z z z z z
on dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripher
z z z z z z z z z z z z
al nervous system are not relevant to either schizophreniaor psychotropic medication
z z z z z z z z z z z
s.
4. A student nurse mutters that it seems entirely unnecessary to have to strugglewi
z z z z z z z z z z z z z
thunderstanding the anatomy and physiology of the neurologic system. The ment z z z z z z z z z z
or would base a response on the understanding that it is:
z z z z z z z z z z
Necessary but generally for psychiatric nurses who focus primarilyo z z z z z z z z z
a. nbehavioral interventions z
A complex undertaking that advance practice psychiatric nurses frequentlyusein
z z z z z z z z z z
b. their practice z
Important primarily for the nursing assessment of patients withbraintraumacause z z z z z z z z z
c. d cognitive symptoms z z
Necessary for planning psychiatric care for all patients especiallythoseexperienc z z z z z z z z z
d. ing psychiatric disorders z z
ANS: D z
Nurses must understand that many symptoms of psychiatric disorders have a neurol
z z z z z z z z z z z
ogic basis, although the symptoms are manifested behaviorally. This understanding
z z z z z z z z z z
facilitates effective care planning. The foundation of knowledge isnotused exclusiv
z z z z z z z z z z
ely by advanced practice psychiatric nurses nor is it relevant for only behavior thera
z z z z z z z z z z z z z
pies or brain trauma since dealing with the results of normal and abnormal brain fun
z z z z z z z z z z z z z z
ction is a responsibility of all nurses providing all types ofcare tothe psychiatric patie
z z z z z z z z z z z z z z
nt.
5. A patient asks the nurse, My wife has breast cancer. Could it be caused byher
z z z z z z z z z z z z z z z
chronic depression? Which response is supported by research data?
z z z z z z z z
a. Too much stress has been proven to cause all kinds of cancer.
z z z z z z z z z z z
b. There have been no research studies done on stress and disease yet.
z z z z z z z z z z z
c. Stress does cause the release of factors that suppress the immune system.
z z z z z z z z z z z
d. There appears to be little connection between stress and diseases of the body
z z z z z z z z z z z z
ANS: C z
Research indicates that stress causes a release of corticotropin-
z z z z z z z z
releasing factors that suppress the immune system. Studies indicate that psychiatric
z z z z z z z z z z z
disorders suchas mooddisorders are sometimes associated with decreased functioni
z z z z z z z z z
ng of the immune system.Research does not support a connection between many ca
z z z z z z z z z z z z
ncers and stress. There is a significant amount of research about stress and the body.
z z z z z z z z z z z z z z
Research has shown that there are some connections between stress and physicaldi
z z z z z z z z z z z z
sease.
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric reh
z z z z z z z z z z z z z
abilitation needs. Of the aspects of functioning listed, which will the nurseidenti
z z z z z z z z z z z z
fyas a focus of nursing intervention?
z z z z z
a. Expression of emotion z z
b. Detecting auditory stimuli z z
c. Receiving visual images z z
d. Processing associations z
ANS: D z
The parietal lobe is responsible for associating and processing sensory informationtha
z z z z z z z z z z z
t allows for functions such as following directions on a map, reading a clock, dressing
z z z z z z z z z z z z z z z
self, keeping appointments, and distinguishing right from left. Emotional expression
z z z z z z z z z z
is associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe f
z z z z z z z z z z z z z
unction. Receiving visual images is related to occipital lobe function.
z z z z z z z z z
7. At admission, the nurse learns that some time ago the patient had an infarct inthe
z z z z z z z z z z z z z z z
right cerebral cortex. During assessment, the nurse would expect to find that the pa
z z z z z z z z z z z z z
tient:
a. Demonstrates major deficiencies in speech z z z z
b. Is unable to effectively hold a spoon in the left hand
z z z z z z z z z z
c. Has difficulty explaining how to go about using the telephone
z z z z z z z z z
d. Cannot use his right hand to shave himself or comb his own hair z z z z z z z z z z z z
ANS: B z
The cerebral hemispheres are responsible for functions such as control of muscles.Th
z z z z z z z z z z z z
e right hemisphere mainly controls the motor and sensory functions on the left sideof t
z z z z z z z z z z z z z z
he body. Damage to the right side would result in impaired function on theleft side of t
z z z z z z z z z z z z z z z z z
he body. The motor cortex controls voluntary motor activity. Brocas area controls mo
z z z z z z z z z z z z
tor speech. Cognitive functions are attributed to the association cortex.
z z z z z z z z z
The right side of the bodys motor activity is controlled by the left cerebral cortex.
z z z z z z z z z z z z z z
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. Th
z z z z z z z z z z z
epatient will be discharged on low doses of haloperidol. The nurse will need toindivi
z z z z z z z z z z z z z z
dualize the patients medication teaching by:
z z z z z
a. Including the patients caregiver in the education z z z z z z
b. Being careful to stress the importance of taking the medication as prescribed
z z z z z z z z z z z
Providing the education at a time when the patient is emotionally calmandrelaxe
z z z z z z z z z z z z
c. d
Encouraging the patient to crush or dissolve the medication to helpwithswallowi z z z z z z z z z z z
d. ng
ANS: A z
, The hippocampus plays a major role in short-
z z z z z z z
term memory and, hence, in learning. Taking the medication as prescribed and provi
z z z z z z z z z z z z
ding the education at a time when the patient is calm and relaxed is information or co
z z z z z z z z z z z z z z z z
nsiderations that allpatients should begiven. The medication does not necessarily ne
z z z z z z z z z z z
ed to be crushed or dissolved since the stroke would not have caused difficulty with s
z z z z z z z z z z z z z z z
wallowing.
9. The physician tells the nurse, The medication Im prescribing for the patie
z z z z z z z z z z z
nt enhances the g-
z z z
aminobutyric acid (GABA) system. Which patientbehavior willprovide evi z z z z z z z z
dence that the medication therapy is successful?
z z z z z z
a. The patient is actively involved in playing cards with other patients.
z z z z z z z z z z
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
z z z z z z z z z z z z z z z z
c. The patient reports that both auditory and visual hallucinations havedecrea
z z z z z z z z z z
sed.
d. The patient says that, I am much happier than before I came to the hospital.
z z z z z z z z z z z z z z
ANS: B z
GABA is the principle inhibitory neurotransmitter. The medication should provideanantia
z z z z z z z z z z
nxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally affecte
z z z z z z z z z z z
d by g-aminobutyric acid.
z z z
10. The patients family asks whether a diagnosis of Parkinsons disease createsan
z z z z z z z z z z z
increased risk for any mental health issues. What question would the nurse ask to
z z z z z z z z z z z z z z
assess for such a comorbid condition?
z z z z z
a. Has your father exhibited any signs of depression? z z z z z z z
b. Does your father seem to experience mood swings? z z z z z z z
c. Have you noticed your father talking about seeing things you cant see?
z z z z z z z z z z z
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
z z z z z z z z z z z z z
ANS: A z
Serotonin and its close chemical relatives, dopamine and norepinephrine, are thene
z z z z z z z z z z z
urotransmitters that are most widely involved in various forms of depression. Most z z z z z z z z z z z
researchers agree that the immediate cause of parkinsonism is a deficiency of dopa
z z z z z z z z z z z z
mine and so a patient with Parkinsons disease should be monitored for depression,
z z z z z z z z z z z z z
The other mental health disorders (bipolar disorder, hallucinations, and obsessive
z z z z z z z z z z
compulsive disorder) have not been connected to Parkinsons disease.
z z z z z z z z
11. Which explanation for the prescription of donepezil (Aricept) would then
z z z z z z z z z z
urseprovide for a patient in the early stage of Alzheimers disease?
z z z z z z z z z z
a. It will increase the metabolism of excess GABA.
z z z z z z z
b. Excess dopamine will be prevented from attaching to receptor sites. z z z z z z z z z
c. Serotonin deficiency will be managed through a prolonged reuptake period. z z z z z z z z z
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
z z z z z z z z
ANS: D z
z z z z z z
CIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION z z z z z z
Stahl's Essential Psychopharmacology z z
NeuroscientificzBasiszandzPracticalzApplicationszTESTBANK/STUDYzGUIDE
Chapter 1 Chemical neurotransmissionz z z
MULTIPLE CHOICE z
1. A patient with depression mentions to the nurse, My mother says depression isa c
z z z z z z z z z z z z z z
hemical disorder. What does she mean? The nurses response is based on the theoryt
z z z z z z z z z z z z z
hat depression primarily involves which of the following
z z z z z z z
neurotransmitters?
a. Cortisol and GABA z z
b. COMT and glutamate z z
c. Monamine and glycine z z
d. Serotonin and norepinephrine z z
ANS: D z
One possible cause of depression is thought to involve one or more neurotransmitte
z z z z z z z z z z z z
rs.Serotonin and norepinephrine have been found to be importantin the regulation o
z z z z z z z z z z z z
f depression. There is no research to support that the other options play a significant
z z z z z z z z z z z z z z
zrole in the development of depression.
z z z z z
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted i
z z z z z z z z z z z z
n damage to the Broca area. Which evaluation does the nurse conduct to reinforce thisdia
z z z z z z z z z z z z z z
gnosis?
a. Observing the patient pick up a spoon z z z z z z
b. Asking the patient to recite the alphabet z z z z z z
c. Monitoring the patients blood pressure z z z z
d. Comparing the patients grip strength in both hands z z z z z z z
ANS: B z
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
z z z z z z z z z z z z z z
motor aphasia). Fine motor skills, blood pressure control, and muscle strengthare not
z z z z z z z z z z z z z
controlled by the Broca area of the left frontal lobe.
z z z z z z z z z
3. The patient diagnosed with schizophrenia asks why psychotropic medicationsa
z z z z z z z z z
re always prescribed by the doctor. The nurses answer will be based on informatio
z z z z z z z z z z z z z
n thatthe therapeutic action of psychotropic drugs is the result of their
z z z z z z z z z z z
effect on: z
a. The temporal lobe; especially Wernickes area z z z z z
b. Dendrites and their ability to transmit electrical impulses z z z z z z z
c. The regulation of neurotransmitters especially dopamine
z z z z z
d. The peripheral nervous system sensitivity to the psychotropic medications
z z z z z z z z
,ANS: C z
Medications used to treat psychiatric disorders operate in and around the synaptic clef
z z z z z z z z z z z z
tand have action at the neurotransmitter level, especially in the case of schizophrenia,
z z z z z z z z z z z z z
on dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripher
z z z z z z z z z z z z
al nervous system are not relevant to either schizophreniaor psychotropic medication
z z z z z z z z z z z
s.
4. A student nurse mutters that it seems entirely unnecessary to have to strugglewi
z z z z z z z z z z z z z
thunderstanding the anatomy and physiology of the neurologic system. The ment z z z z z z z z z z
or would base a response on the understanding that it is:
z z z z z z z z z z
Necessary but generally for psychiatric nurses who focus primarilyo z z z z z z z z z
a. nbehavioral interventions z
A complex undertaking that advance practice psychiatric nurses frequentlyusein
z z z z z z z z z z
b. their practice z
Important primarily for the nursing assessment of patients withbraintraumacause z z z z z z z z z
c. d cognitive symptoms z z
Necessary for planning psychiatric care for all patients especiallythoseexperienc z z z z z z z z z
d. ing psychiatric disorders z z
ANS: D z
Nurses must understand that many symptoms of psychiatric disorders have a neurol
z z z z z z z z z z z
ogic basis, although the symptoms are manifested behaviorally. This understanding
z z z z z z z z z z
facilitates effective care planning. The foundation of knowledge isnotused exclusiv
z z z z z z z z z z
ely by advanced practice psychiatric nurses nor is it relevant for only behavior thera
z z z z z z z z z z z z z
pies or brain trauma since dealing with the results of normal and abnormal brain fun
z z z z z z z z z z z z z z
ction is a responsibility of all nurses providing all types ofcare tothe psychiatric patie
z z z z z z z z z z z z z z
nt.
5. A patient asks the nurse, My wife has breast cancer. Could it be caused byher
z z z z z z z z z z z z z z z
chronic depression? Which response is supported by research data?
z z z z z z z z
a. Too much stress has been proven to cause all kinds of cancer.
z z z z z z z z z z z
b. There have been no research studies done on stress and disease yet.
z z z z z z z z z z z
c. Stress does cause the release of factors that suppress the immune system.
z z z z z z z z z z z
d. There appears to be little connection between stress and diseases of the body
z z z z z z z z z z z z
ANS: C z
Research indicates that stress causes a release of corticotropin-
z z z z z z z z
releasing factors that suppress the immune system. Studies indicate that psychiatric
z z z z z z z z z z z
disorders suchas mooddisorders are sometimes associated with decreased functioni
z z z z z z z z z
ng of the immune system.Research does not support a connection between many ca
z z z z z z z z z z z z
ncers and stress. There is a significant amount of research about stress and the body.
z z z z z z z z z z z z z z
Research has shown that there are some connections between stress and physicaldi
z z z z z z z z z z z z
sease.
,6. A patient who has a parietal lobe injury is being evaluated for psychiatric reh
z z z z z z z z z z z z z
abilitation needs. Of the aspects of functioning listed, which will the nurseidenti
z z z z z z z z z z z z
fyas a focus of nursing intervention?
z z z z z
a. Expression of emotion z z
b. Detecting auditory stimuli z z
c. Receiving visual images z z
d. Processing associations z
ANS: D z
The parietal lobe is responsible for associating and processing sensory informationtha
z z z z z z z z z z z
t allows for functions such as following directions on a map, reading a clock, dressing
z z z z z z z z z z z z z z z
self, keeping appointments, and distinguishing right from left. Emotional expression
z z z z z z z z z z
is associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe f
z z z z z z z z z z z z z
unction. Receiving visual images is related to occipital lobe function.
z z z z z z z z z
7. At admission, the nurse learns that some time ago the patient had an infarct inthe
z z z z z z z z z z z z z z z
right cerebral cortex. During assessment, the nurse would expect to find that the pa
z z z z z z z z z z z z z
tient:
a. Demonstrates major deficiencies in speech z z z z
b. Is unable to effectively hold a spoon in the left hand
z z z z z z z z z z
c. Has difficulty explaining how to go about using the telephone
z z z z z z z z z
d. Cannot use his right hand to shave himself or comb his own hair z z z z z z z z z z z z
ANS: B z
The cerebral hemispheres are responsible for functions such as control of muscles.Th
z z z z z z z z z z z z
e right hemisphere mainly controls the motor and sensory functions on the left sideof t
z z z z z z z z z z z z z z
he body. Damage to the right side would result in impaired function on theleft side of t
z z z z z z z z z z z z z z z z z
he body. The motor cortex controls voluntary motor activity. Brocas area controls mo
z z z z z z z z z z z z
tor speech. Cognitive functions are attributed to the association cortex.
z z z z z z z z z
The right side of the bodys motor activity is controlled by the left cerebral cortex.
z z z z z z z z z z z z z z
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. Th
z z z z z z z z z z z
epatient will be discharged on low doses of haloperidol. The nurse will need toindivi
z z z z z z z z z z z z z z
dualize the patients medication teaching by:
z z z z z
a. Including the patients caregiver in the education z z z z z z
b. Being careful to stress the importance of taking the medication as prescribed
z z z z z z z z z z z
Providing the education at a time when the patient is emotionally calmandrelaxe
z z z z z z z z z z z z
c. d
Encouraging the patient to crush or dissolve the medication to helpwithswallowi z z z z z z z z z z z
d. ng
ANS: A z
, The hippocampus plays a major role in short-
z z z z z z z
term memory and, hence, in learning. Taking the medication as prescribed and provi
z z z z z z z z z z z z
ding the education at a time when the patient is calm and relaxed is information or co
z z z z z z z z z z z z z z z z
nsiderations that allpatients should begiven. The medication does not necessarily ne
z z z z z z z z z z z
ed to be crushed or dissolved since the stroke would not have caused difficulty with s
z z z z z z z z z z z z z z z
wallowing.
9. The physician tells the nurse, The medication Im prescribing for the patie
z z z z z z z z z z z
nt enhances the g-
z z z
aminobutyric acid (GABA) system. Which patientbehavior willprovide evi z z z z z z z z
dence that the medication therapy is successful?
z z z z z z
a. The patient is actively involved in playing cards with other patients.
z z z z z z z z z z
b. The patient reports that, I dont feel as anxious as I did a couple of days ago.
z z z z z z z z z z z z z z z z
c. The patient reports that both auditory and visual hallucinations havedecrea
z z z z z z z z z z
sed.
d. The patient says that, I am much happier than before I came to the hospital.
z z z z z z z z z z z z z z
ANS: B z
GABA is the principle inhibitory neurotransmitter. The medication should provideanantia
z z z z z z z z z z
nxiety effect. Alertness, psychotic behaviors, and mood elevation are not generally affecte
z z z z z z z z z z z
d by g-aminobutyric acid.
z z z
10. The patients family asks whether a diagnosis of Parkinsons disease createsan
z z z z z z z z z z z
increased risk for any mental health issues. What question would the nurse ask to
z z z z z z z z z z z z z z
assess for such a comorbid condition?
z z z z z
a. Has your father exhibited any signs of depression? z z z z z z z
b. Does your father seem to experience mood swings? z z z z z z z
c. Have you noticed your father talking about seeing things you cant see?
z z z z z z z z z z z
d. Is your dad preoccupied with behaviors that he needs to repeat over and over?
z z z z z z z z z z z z z
ANS: A z
Serotonin and its close chemical relatives, dopamine and norepinephrine, are thene
z z z z z z z z z z z
urotransmitters that are most widely involved in various forms of depression. Most z z z z z z z z z z z
researchers agree that the immediate cause of parkinsonism is a deficiency of dopa
z z z z z z z z z z z z
mine and so a patient with Parkinsons disease should be monitored for depression,
z z z z z z z z z z z z z
The other mental health disorders (bipolar disorder, hallucinations, and obsessive
z z z z z z z z z z
compulsive disorder) have not been connected to Parkinsons disease.
z z z z z z z z
11. Which explanation for the prescription of donepezil (Aricept) would then
z z z z z z z z z z
urseprovide for a patient in the early stage of Alzheimers disease?
z z z z z z z z z z
a. It will increase the metabolism of excess GABA.
z z z z z z z
b. Excess dopamine will be prevented from attaching to receptor sites. z z z z z z z z z
c. Serotonin deficiency will be managed through a prolonged reuptake period. z z z z z z z z z
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.
z z z z z z z z
ANS: D z
