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