TEST BANK
b
,Chapterb1bChemicalbneurotransmissionbMULTIPL
EbCHOICE
1. A patient with depression mentions to the nurse, My mother says depression is a
b b b b b b b b b b b b b
chemical disorder. What does she mean? The nurses response is based on the theory that
b b b b b b b b b b b b b b b
depression primarily involves which of the following neurotransmitters?
b b b b b b b
a. Cortisol and GABA b b
b. COMT and glutamate b b
c. Monamine and glycine b b
d. Serotonin and norepinephrine b b b
ANS: D b
One possible cause of depression is thought to involve one or more neurotransmitters.
b b b b b b b b b b b b
Serotonin and norepinephrine have been found to be important in the regulation of d
b b b b b b b b b b b b b
epression. There is no research to support that the other options play a significant rol
b b b b b b b b b b b b b b
e in the development of depression.
b b b b b
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in d
b b b b b b b b b b b b b
amage to the Broca area. Which evaluation does the nurse conduct to reinforce this dia
b b b b b b b b b b b b b b
gnosis?
a. Observing the patient pick up a spoon b b b b b b
b. Asking the patient to recite the alphabet
b b b b b b
c. Monitoring the patients blood pressure b b b b
d. Comparing the patients grip strength in both hands b b b b b b b b
ANS: B b
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
b b b b b b b b b b b b b b
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not co
b b b b b b b b b b b b b
ntrolled by the Broca area of the left frontal lobe.
b b b b b b b b b
3. The patient diagnosed with schizophrenia asks why psychotropic medications are al
b b b b b b b b b b
ways prescribed by the doctor. The nurses answer will be based on information that the
b b b b b b b b b b b b b b b
therapeutic action of psychotropic drugs is the result of their effect on:
b b b b b b b b b b b
a. The temporal lobe; especially Wernickes area
b b b b b
b. Dendrites and their ability to transmit electrical impulses
b b b b b b b
c. The regulation of neurotransmitters especially dopamine
b b b b b
d. The peripheral nervous system sensitivity to the psychotropic medications
b b b b b b b b
,ANS: C b
Medications used to treat psychiatric disorders operate in and around the synaptic cleft a
b b b b b b b b b b b b b
nd have action at the neurotransmitter level, especially in the case of schizophrenia, on
b b b b b b b b b b b b b b
dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral ne
b b b b b b b b b b b b
rvous system are not relevant to either schizophrenia or psychotropic medications.
b b b b b b b b b b
4. A student nurse mutters that it seems entirely unnecessary to have to struggle with u
b b b b b b b b b b b b b b
nderstanding the anatomy and physiology of the neurologic system. The mentor woul
b b b b b b b b b b b
d base a response on the understanding that it is:
b b b b b b b b b
Necessary but generally for psychiatric nurses who focus primarily on b b b b b b b b b
a. behavioral interventions b
A complex undertaking that advance practice psychiatric nurses frequently use in
b b b b b b b b b b b
b. their practice b
Important primarily for the nursing assessment of patients with brain traumacause
b b b b b b b b b b
c. d cognitive symptoms
b b
Necessary for planning psychiatric care for all patients especially those experienc
b b b b b b b b b b
d. ing psychiatric disorders
b b
ANS: D b
Nurses must understand that many symptoms of psychiatric disorders have a neurologic
b b b b b b b b b b b
bbasis, although the symptoms are manifested behaviorally. This understanding facilitat
b b b b b b b b b
es effective care planning. The foundation of knowledge is not used exclusively by adva
b b b b b b b b b b b b b
nced practice psychiatric nurses nor is it relevant for only behavior therapies or brain tra
b b b b b b b b b b b b b b
uma since dealing with the results of normal and abnormal brain function is a responsibi
b b b b b b b b b b b b b b
lity of all nurses providing all types of care to the psychiatric patient.
b b b b b b b b b b b b
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her ch
b b b b b b b b b b b b b b b b
ronic depression? Which response is supported by research data?
b b b b b b b b
a. Too much stress has been proven to cause all kinds of cancer.
b b b b b b b b b b b
b. There have been no research studies done on stress and disease yet.
b b b b b b b b b b b
c. Stress does cause the release of factors that suppress the immune system.
b b b b b b b b b b b
d. There appears to be little connection between stress and diseases of the body A
b b b b b b b b b b b b b
NS: C b
Research indicates that stress causes a release of corticotropin-releasing factors that
b b b b b b b b b b
suppress the immune system. Studies indicate that psychiatric disorders such as mood di
b b b b b b b b b b b b
sorders are sometimes associated with decreased functioning of the immune system. Res
b b b b b b b b b b b
earch does not support a connection between many cancers and stress. There is a signifi
b b b b b b b b b b b b b b
cant amount of research about stress and the body. Research has shown that there are so
b b b b b b b b b b b b b b b
me connections between stress and physical disease.
b b b b b b
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitati
b b b b b b b b b b b b b
on needs. Of the aspects of functioning listed, which will the nurse identify as a focus of
b b b b b b b b b b b b b b b b b
nursing intervention? b
a. Expression of emotion b b
b. Detecting auditory stimuli b b
c. Receiving visual images b b
d. Processing associations b b
ANS: D b
The parietal lobe is responsible for associating and processing sensory information
b b b b b b b b b b
that allows for functions such as following directions on a map, reading a clock, dressin
b b b b b b b b b b b b b b
g self, keeping appointments, and distinguishing right from left. Emotional expression i
b b b b b b b b b b b
s associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe fun
b b b b b b b b b b b b b
ction. Receiving visual images is related to occipital lobe function.
b b b b b b b b b
7. At admission, the nurse learns that some time ago the patient had an infarct in the ri
b b b b b b b b b b b b b b b b
ght cerebral cortex. During assessment, the nurse would expect to find that the patient
b b b b b b b b b b b b b
:
a. Demonstrates major deficiencies in speech b b b b
b. Is unable to effectively hold a spoon in the left hand
b b b b b b b b b b
c. Has difficulty explaining how to go about using the telephone
b b b b b b b b b
d. Cannot use his right hand to shave himself or comb his own hair A
b b b b b b b b b b b b b
NS: B b
The cerebral hemispheres are responsible for functions such as control of muscles.
b b b b b b b b b b b
The right hemisphere mainly controls the motor and sensory functions on the left side of
b b b b b b b b b b b b b b
bthe body. Damage to the right side would result in impaired function on the left side of
b b b b b b b b b b b b b b b b b
the body. The motor cortex controls voluntary motor activity. Brocas area controls mot
b b b b b b b b b b b b
or speech. Cognitive functions are attributed to the association cortex.
b b b b b b b b b
The right side of the bodys motor activity is controlled by the left cerebral cortex.
b b b b b b b b b b b b b b
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The p
b b b b b b b b b b b b
atient will be discharged on low doses of haloperidol. The nurse will need to individua
b b b b b b b b b b b b b b
lize the patients medication teaching by:
b b b b b
a. Including the patients caregiver in the education b b b b b b
b. Being careful to stress the importance of taking the medication as prescribed P
b b b b b b b b b b b b
roviding the education at a time when the patient is emotionally calm and
b b b b b b b b b b b b
c. relaxed
Encouraging the patient to crush or dissolve the medication to help with swallowi
b b b b b b b b b b b b
d. ng
ANS: A b
b
,Chapterb1bChemicalbneurotransmissionbMULTIPL
EbCHOICE
1. A patient with depression mentions to the nurse, My mother says depression is a
b b b b b b b b b b b b b
chemical disorder. What does she mean? The nurses response is based on the theory that
b b b b b b b b b b b b b b b
depression primarily involves which of the following neurotransmitters?
b b b b b b b
a. Cortisol and GABA b b
b. COMT and glutamate b b
c. Monamine and glycine b b
d. Serotonin and norepinephrine b b b
ANS: D b
One possible cause of depression is thought to involve one or more neurotransmitters.
b b b b b b b b b b b b
Serotonin and norepinephrine have been found to be important in the regulation of d
b b b b b b b b b b b b b
epression. There is no research to support that the other options play a significant rol
b b b b b b b b b b b b b b
e in the development of depression.
b b b b b
2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in d
b b b b b b b b b b b b b
amage to the Broca area. Which evaluation does the nurse conduct to reinforce this dia
b b b b b b b b b b b b b b
gnosis?
a. Observing the patient pick up a spoon b b b b b b
b. Asking the patient to recite the alphabet
b b b b b b
c. Monitoring the patients blood pressure b b b b
d. Comparing the patients grip strength in both hands b b b b b b b b
ANS: B b
Accidents or strokes that damage Brocas area may result in the inability to speak (i.e.,
b b b b b b b b b b b b b b
motor aphasia). Fine motor skills, blood pressure control, and muscle strength are not co
b b b b b b b b b b b b b
ntrolled by the Broca area of the left frontal lobe.
b b b b b b b b b
3. The patient diagnosed with schizophrenia asks why psychotropic medications are al
b b b b b b b b b b
ways prescribed by the doctor. The nurses answer will be based on information that the
b b b b b b b b b b b b b b b
therapeutic action of psychotropic drugs is the result of their effect on:
b b b b b b b b b b b
a. The temporal lobe; especially Wernickes area
b b b b b
b. Dendrites and their ability to transmit electrical impulses
b b b b b b b
c. The regulation of neurotransmitters especially dopamine
b b b b b
d. The peripheral nervous system sensitivity to the psychotropic medications
b b b b b b b b
,ANS: C b
Medications used to treat psychiatric disorders operate in and around the synaptic cleft a
b b b b b b b b b b b b b
nd have action at the neurotransmitter level, especially in the case of schizophrenia, on
b b b b b b b b b b b b b b
dopamine. The Wernickes area, dendrite function, or the sensitivity of the peripheral ne
b b b b b b b b b b b b
rvous system are not relevant to either schizophrenia or psychotropic medications.
b b b b b b b b b b
4. A student nurse mutters that it seems entirely unnecessary to have to struggle with u
b b b b b b b b b b b b b b
nderstanding the anatomy and physiology of the neurologic system. The mentor woul
b b b b b b b b b b b
d base a response on the understanding that it is:
b b b b b b b b b
Necessary but generally for psychiatric nurses who focus primarily on b b b b b b b b b
a. behavioral interventions b
A complex undertaking that advance practice psychiatric nurses frequently use in
b b b b b b b b b b b
b. their practice b
Important primarily for the nursing assessment of patients with brain traumacause
b b b b b b b b b b
c. d cognitive symptoms
b b
Necessary for planning psychiatric care for all patients especially those experienc
b b b b b b b b b b
d. ing psychiatric disorders
b b
ANS: D b
Nurses must understand that many symptoms of psychiatric disorders have a neurologic
b b b b b b b b b b b
bbasis, although the symptoms are manifested behaviorally. This understanding facilitat
b b b b b b b b b
es effective care planning. The foundation of knowledge is not used exclusively by adva
b b b b b b b b b b b b b
nced practice psychiatric nurses nor is it relevant for only behavior therapies or brain tra
b b b b b b b b b b b b b b
uma since dealing with the results of normal and abnormal brain function is a responsibi
b b b b b b b b b b b b b b
lity of all nurses providing all types of care to the psychiatric patient.
b b b b b b b b b b b b
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her ch
b b b b b b b b b b b b b b b b
ronic depression? Which response is supported by research data?
b b b b b b b b
a. Too much stress has been proven to cause all kinds of cancer.
b b b b b b b b b b b
b. There have been no research studies done on stress and disease yet.
b b b b b b b b b b b
c. Stress does cause the release of factors that suppress the immune system.
b b b b b b b b b b b
d. There appears to be little connection between stress and diseases of the body A
b b b b b b b b b b b b b
NS: C b
Research indicates that stress causes a release of corticotropin-releasing factors that
b b b b b b b b b b
suppress the immune system. Studies indicate that psychiatric disorders such as mood di
b b b b b b b b b b b b
sorders are sometimes associated with decreased functioning of the immune system. Res
b b b b b b b b b b b
earch does not support a connection between many cancers and stress. There is a signifi
b b b b b b b b b b b b b b
cant amount of research about stress and the body. Research has shown that there are so
b b b b b b b b b b b b b b b
me connections between stress and physical disease.
b b b b b b
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitati
b b b b b b b b b b b b b
on needs. Of the aspects of functioning listed, which will the nurse identify as a focus of
b b b b b b b b b b b b b b b b b
nursing intervention? b
a. Expression of emotion b b
b. Detecting auditory stimuli b b
c. Receiving visual images b b
d. Processing associations b b
ANS: D b
The parietal lobe is responsible for associating and processing sensory information
b b b b b b b b b b
that allows for functions such as following directions on a map, reading a clock, dressin
b b b b b b b b b b b b b b
g self, keeping appointments, and distinguishing right from left. Emotional expression i
b b b b b b b b b b b
s associated with frontal lobe function. Detecting auditory stimuli is a temporal lobe fun
b b b b b b b b b b b b b
ction. Receiving visual images is related to occipital lobe function.
b b b b b b b b b
7. At admission, the nurse learns that some time ago the patient had an infarct in the ri
b b b b b b b b b b b b b b b b
ght cerebral cortex. During assessment, the nurse would expect to find that the patient
b b b b b b b b b b b b b
:
a. Demonstrates major deficiencies in speech b b b b
b. Is unable to effectively hold a spoon in the left hand
b b b b b b b b b b
c. Has difficulty explaining how to go about using the telephone
b b b b b b b b b
d. Cannot use his right hand to shave himself or comb his own hair A
b b b b b b b b b b b b b
NS: B b
The cerebral hemispheres are responsible for functions such as control of muscles.
b b b b b b b b b b b
The right hemisphere mainly controls the motor and sensory functions on the left side of
b b b b b b b b b b b b b b
bthe body. Damage to the right side would result in impaired function on the left side of
b b b b b b b b b b b b b b b b b
the body. The motor cortex controls voluntary motor activity. Brocas area controls mot
b b b b b b b b b b b b
or speech. Cognitive functions are attributed to the association cortex.
b b b b b b b b b
The right side of the bodys motor activity is controlled by the left cerebral cortex.
b b b b b b b b b b b b b b
8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The p
b b b b b b b b b b b b
atient will be discharged on low doses of haloperidol. The nurse will need to individua
b b b b b b b b b b b b b b
lize the patients medication teaching by:
b b b b b
a. Including the patients caregiver in the education b b b b b b
b. Being careful to stress the importance of taking the medication as prescribed P
b b b b b b b b b b b b
roviding the education at a time when the patient is emotionally calm and
b b b b b b b b b b b b
c. relaxed
Encouraging the patient to crush or dissolve the medication to help with swallowi
b b b b b b b b b b b b
d. ng
ANS: A b
