MH Ch 3; Psychobiology & Psychopharmacology

1. A patient asks, "What are neurotransmitters? My doctor said mine are imbalanced." Select the nurse's best response.

a. "How do you feel about having imbalanced neurotransmitters?"

b. "Neurotransmitters protect us from harmful effects of free radicals."

c. "Neurotransmitters are substances we consume that influence memory and mood."

d. "Neurotransmitters are natural chemicals that pass messages between brain cells."

d. "Neurotransmitters are natural chemicals that pass messages between brain cells."

2. The parent of an adolescent diagnosed with schizophrenia asks the nurse, "My child's doctor ordered a PET. What kind of test is that?" Select the nurse's best reply.

a. "This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?"

b. "PET means positron-emission tomography. It is a special type of scan that shows blood flow and activity in the brain."

c. "A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures."

d. "It's a special x-ray that shows structures of the brain and whether there has ever been a brain injury."

b. "PET means positron-emission tomography. It is a special type of scan that shows blood flow and activity in the brain."

3. A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?

a. Skull x-rays

b. CT scan

c. PET

d. Single photon emission computed tomography (SPECT)

b. CT scan

4. A patient's history shows drinking 4 to 6 L of fluid and eating more than 6,000 calories per day. Which part of the central nervous system is most likely dysfunctional for this patient?

a. Amygdala

b. Parietal lobe

c. Hippocampus

d. Hypothalamus

d. Hypothalamus

5. The nurse prepares to assess a patient diagnosed with major depressive disorder for disturbances in circadian rhythms. Which question should the nurse ask this patient?

a. "Have you ever seen or heard things that others do not?"

b. "What are your worst and best times of the day?"

c. "How would you describe your thinking?"

d. "Do you think your memory is failing?"

b. "What are your worst and best times of the day?"

6. The nurse administers a medication that potentiates the action of ã-aminobutyric acid (GABA). Which effect would be expected?

a.Reduced anxiety

b.Improved memory

c.More organized thinking

d.Fewer sensory perceptual alterations

a.Reduced anxiety

7 nurse would anticipate that treatment for a patient with memory difficulties might include medications designed to

a. inhibit GABA.

b. prevent destruction of acetylcholine.

c. reduce serotonin metabolism.

d. increase dopamine activity.

b. prevent destruction of acetylcholine.

8. patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain?

a. Hippocampus

b. Frontal lobe

c. Cerebellum

d. Brainstem

b. Frontal lobe

9. The nurse should assess a patient taking a drug with anticholinergic properties for inhibited function of the

a. parasympathetic nervous system.

b. sympathetic nervous system.

c. reticular activating system.

d. medulla oblongata.

a. parasympathetic nervous system.

10. The therapeutic action of neurotransmitter inhibitors that block reuptake cause

a. decreased concentration of the blocked neurotransmitter in the central nervous system.

b. increased concentration of the blocked neurotransmitter in the synaptic gap.

c. destruction of receptor sites specific to the blocked neurotransmitter.

d. limbic system stimulation.

b. increased concentration of the blocked neurotransmitter in the synaptic gap.

11. A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop?

a. Anticholinergic effects

b. Dopamine-blocking effects

c. Endocrine-stimulating effects

d. Ability to stimulate spinal nerves

b. Dopamine-blocking effects

12. A fearful patient has an increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?

a. GABA

b. Norepinephrine

c. Acetylcholine

d. Histamine

b. Norepinephrine

13. A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group?

a. Tricyclic antidepressants

b. Antipsychotic drugs

c. Mood stabilizers

d. Benzodiazepines

d. Benzodiazepines

14. A patient is hospitalized for severe major depressive disorder. Of the medications listed below, the nurse can expect to provide the patient with teaching about

a. chlordiazepoxide.

b. clozapine.

c. sertraline.

d. tacrine.

c. sertraline.

15. A patient diagnosed with bipolar disorder displays aggressiveness, agitation, talkativeness, and irritability. The nurse expects the health care provider to prescribe a medication from which group?

a. Psychostimulants

b. Mood stabilizers

c. Anticholinergics

d. Antidepressants

b. Mood stabilizers

16. A drug causes muscarinic receptor blockade. The nurse will assess the patient for

a. dry mouth.

b. gynecomastia.

c. pseudoparkinsonism.

d. orthostatic hypotension.

a. dry mouth.

17. A patient begins therapy with a phenothiazine medication. What teaching should the nurse provide related to the drug's strong dopaminergic effect?

a. Chew sugarless gum.

b. Increase dietary fiber.

c. Arise slowly from bed.

d. Report changes in muscle movement.

d. Report changes in muscle movement.

18. A patient tells the nurse, "My doctor prescribed paroxetine for my depression. I assume I'll have side effects like I had when I was taking imipramine." The nurse's reply should be based on the knowledge that paroxetine is a(n)

a. selective norepinephrine reuptake inhibitor.

b. tricyclic antidepressant.

c. monoamine oxidase (MAO) inhibitor.

d. SSRI.

d. SSRI.

19. A nurse can anticipate anticholinergic side effects are likely when a patient takes

a. lithium.

b. buspirone.

c. imipramine.

d. risperidone.

c. imipramine.

20. Which instruction has priority when teaching a patient about clozapine?

a. "Avoid unprotected sex."

b. "Report sore throat and fever immediately."

c. "Reduce foods high in polyunsaturated fats."

d. "Use over-the-counter preparations for rashes."

b. "Report sore throat and fever immediately."

21. A nurse cares for a group of patients receiving various medications, including haloperidol, carbamazepine, trazodone, and phenalgine. The nurse will order a special diet for the patient who takes

a. carbamazepine.

b. haloperidol.

c. phenelzine.

d. trazodone

c. phenelzine.

22. A nurse instructs a patient taking a drug that inhibits MAO to avoid certain foods and drugs because of the risk of

a. cardiac dysrhythmia.

b. hypotensive shock.

c. hypertensive crisis.

d. hypoglycemia.

c. hypertensive crisis.

23. A nurse caring for a patient taking a SSRI will develop outcome criteria related to

a. coherent thought processes.

b. improvement in depression.

c. reduced levels of motor activity.

d. decreased extrapyramidal symptoms.

b. improvement in depression.

24. By which mechanism do SSRI medications improve depression?

a. Destroying increased amounts of serotonin

b. Making more serotonin available at the synaptic gap

c. Increasing production of acetylcholine and dopamine

d. Blocking muscarinic and á1 norepinephrine receptors

b. Making more serotonin available at the synaptic gap

25.The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm3. Select the nurse's best action.

a. Report the results to the health care provider immediately.

b. Administer the next dose as prescribed.

c. Give aspirin and force fluids.

d. Repeat the laboratory test.

a. Report the results to the health care provider immediately.

26. A drug blocks the attachment of norepinephrine to a1 receptors. The patient may experience

a. hypertensive crisis.

b. orthostatic hypotension.

c. severe appetite disturbance.

d. an increase in psychotic symptoms.

b. orthostatic hypotension.

27. A nurse cares for four patients who are receiving clozapine, lithium, fluoxetine, and venlafaxine, respectively. With which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance? The patient receiving

a. lithium.

b. clozapine.

c. fluoxetine.

d. venlafaxine.

a. lithium.

28. An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain?

a. H1

b. 5 HT2

c. Acetylcholine

d. GABA

a. H1

29. An individual hiking in the forest encounters a large poisonous snake on the path. Which change in this individual's vital signs is most likely?

a. Pulse rate changes from 90 to 72.

b. Respiratory rate changes from 22 to 18.

c. Complaints of intestinal cramping begin.

d. Blood pressure changes from 114/62 to 136/78.

d. Blood pressure changes from 114/62 to 136/78.

30. Consider these medications: carbamazepine, lamotrigine, gabapentin. Which medication below also belongs to this group?

a. Galantamine

b. Valproate

c. Buspirone

d. Tacrine

b. Valproate

31. A professional football player is seen in the emergency department after losing consciousness from an illegal block. Prior to discharge, the nurse assists the patient to schedule an outpatient computed tomography (CT) scan for the next day. Which strategy should the nurse use to ensure the patient remembers the appointment?

a. Write the appointment day, time, and location on a piece of paper and give it to the player.

b. Log the appointment day, time, and location into the player's cell phone calendar feature.

c. Ask the health care provider to admit the patient to the hospital overnight.

d. Verbally inform the patient of the appointment day, time, and location.

b. Log the appointment day, time, and location into the player's cell phone calendar feature.

32. A nurse prepares to administer a second-generation antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring for adverse effects will be most important if the patient has which co-morbid health problems? (Select all that apply.)

a. Parkinson's disease

b. Grave's disease

c. Hyperlipidemia

d. Osteoarthritis

e. Diabetes

a. Parkinson's disease

c. Hyperlipidemia

e. Diabetes

33. Questions the nurse could ask that would be nonjudgmental when obtaining information about a patient's use of complementary and herbal remedies include (Select all that apply)

a. "You don't regularly take herbal remedies, do you?"

b. "What herbal medicines have you used to relieve your symptoms?"

c. "What over-the-counter medicines, vitamins, and nutritional supplements do you use?"

d. "What differences in your symptoms do you notice when you take herbal supplements?"

e. "Have you experienced problems from using herbal and prescription drugs at the same time?"\\ ANS B, C, D, E,

B, C, D, E

The correct responses are neutral in tone and do not express bias for or against the use of complementary or herbal medicines. The distracter, worded in a negative way, makes the nurse's bias evident.

34. An individual is experiencing problems with memory. Which of these structures are most likely to be involved in this deficit? (Select all that apply.)

a. Amygdala

b. Hippocampus

c. Occipital lobe

d. Temporal lobe

e. Basal ganglia

a. Amygdala

b. Hippocampus

d. Temporal lobe

35. A patient's sibling says, "My brother has a mental illness, but the doctor ordered a functional magnetic resonance image (fMRI) test. That test is too expensive and will just increase the hospital bill." Select the nurse's best responses. (Select all that apply.)

a. "Sometimes there are physical causes for psychiatric symptoms. This test will help us understand whether that is the situation."

b. "Some mental illnesses are evident on fMRIs. This test will give information to help us plan the best care for your brother."

c. "This test will indicate whether your brother has been taking his psychotropic medications as prescribed."

d. "It sounds like you do not truly believe your brother had a mental illness."

e. "It would be better for you to discuss your concerns with the health care provider."

a. "Sometimes there are physical causes for psychiatric symptoms. This test will help us understand whether that is the situation."

b. "Some mental illnesses are evident on fMRIs. This test will give information to help us plan the best care for your brother."