Ch. 3 Neurobiology and Pharmacotherapy

A 38-year-old client diagnosed with major depression states, "my provider said something about the medicine I've been prescribed will affect my neurotransmitters. What exactly are neurotransmitters?" What is the nurse's best response to the client's question?

"I will ask your provider to give you a more in-depth explanation about why this medication will help your depression."

"Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood and make you less depressed."

"Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression."

"Neurotransmitters are chemicals in the brain that are the reason you are depressed."

"Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression."

Neurotransmitters are chemicals released from neurons that function as a neuromessenger and influence brain functions. Telling the client that the answer is too complicated belittles the client by implying she cannot understand, while stating that neurotransmitters are the reason, she is depressed is too simplistic. Asking the provider to give the education abdicates your responsibility to provide client education.

Which assessment should the nurse perform to evaluate the pharmacokinetic effect of a monoamine oxidase inhibitors (MAOIs) antidepressant medication?

The results of the liver function test

The status of the client's appetite

The level of depression exhibited by the client

The client's current sleeping patterns

The results of the liver function test

Pharmacokinetics refers to the movement of a drug through the body. Four basic processes of pharmacokinetics which determine the concentration of a drug at its sites of action are easily remembered with the acronym ADME: absorption, distribution, metabolism, and excretion. MAOIs can affect liver function and require monitoring. The other options are related to the medication's pharmacodynamic effects.

A prescription for which medication would require the nurse to monitor the client for potential development of the side effect of hypothyroidism?

Lithium

Imipramine

Bupropion

Fluoxetine

Lithium

Long-term use of lithium may cause hypothyroidism. The other options refer to drugs whose long-term use does not cause hypothyroidism.

A 49-year-old client diagnosed with schizophrenia at 22 years old is prescribed risperidone. Which nursing assessment is the priority for this client?

Monitoring blood levels to avoid toxicity

Monitoring for abnormal involuntary movements

Observing for secondary mania

Observing for memory changes

Monitoring for abnormal involuntary movements

Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-generation antipsychotic medications, thus making it imperative to monitor for EPSs. Risperidone is not monitored with blood levels and does not cause mania or memory changes.

Based on the current understanding of brain physiology, which neurotransmitter would be the expected target of medication prescribed to manage depression? (Select all that apply.)

Serotonin

Norepinephrine

Dopamine

Acetylcholine

γ-aminobutyric acid (GABA)

Serotonin, Norepinephrine, Dopamine

Antidepressant medication targets serotonin and norepinephrine. While dopamine is implicated in schizophrenia (increase) and Parkinson's disease (decrease), it is also believed to be a factor in depression. GABA is implicated in anxiety disorders. Acetylcholine is implicated in Alzheimer's disease as well as Huntington's disease and Parkinson's disease.

What is the basic functional unit of the nervous system called?

receptor.

synapse.

neurotransmitter.

neuron.

neuron.

Neurons are nerve cells. Cells are the basic unit of function. A neurotransmitter is a chemical substance that functions as a neuromessenger. This neurotransmitter then diffuses across a space, or synapse, to an adjacent postsynaptic neuron, where it attaches to receptors on the neuron's surface.

When treating mental illnesses with psychotropic drugs what is the focus of the treatment?

Regulating social behaviors.

Altering brain neurochemistry.

Correcting brain anatomical defects.

Activating the body's normal response to stress.

Altering brain neurochemistry.

Psychotropic drugs act to increase or decrease neurotransmitter substances within the brain, thus altering brain neurochemistry.

Which function is classified as a circadian rhythm?

Skeletal muscle contraction

Sleep cycle

Sex drive

Maintenance of a focused stream of consciousness

Sleep cycle

Circadian rhythms are biological rhythms that influence specific regulatory functions such as body temperature, sleeping and waking, and the secretion of certain hormones and neurotransmitters.

The incoherent thought and speech patterns of the client diagnosed with schizophrenia are related to the brain's inability to perform which function?

Maintain homeostasis.

Retain and recall past experience.

Regulate social behavior.

Regulate conscious mental activity.

Regulate conscious mental activity.

When the brain cannot regulate conscious mental activity, the individual's speech patterns demonstrate incoherence and lack of reality orientation.

Homeostasis is promoted by interaction between the brain and internal organs and is mediated by component of the nervous system?

The autonomic nervous system

The parasympathetic nervous system

The sympathetic nervous system

The central nervous system

The autonomic nervous system

The function of the autonomic nervous system is to transmit messages between the brain and the internal organs. This linkage promotes the maintenance of homeostasis.

Cells that respond to stimuli, conduct electrical impulses, and release neurotransmitters are called

neurons.

dendrites.

receptors.

synapses.

neurons.

Neurons are the basic functional unit of the nervous system responsible for sending and receiving messages as electrochemical events.

Which imaging technique can provide information about brain function?

Positron emission tomography (PET) scan

Skull radiograph

Magnetic resonance imaging (MRI) scan

Computed tomography (CT) scan

Positron emission tomography (PET) scan

The positron emission tomography scan provides information about function; the other imaging techniques provide information about structure

The nurse responsible for the care of a client prescribed clonazepam should evaluate treatment as being successful when the client demonstrates which behavior?

Normal appetite

Improved physical balance

Less anxiety

Reduced auditory hallucinations

Less anxiety

Clonazepam is a benzodiazepine thought to enhance the effects of GABA. GABA is associated with the production of a calming emotional state. None of the other options are associated with clonazepam.

The medication prescribed for a client acts by blocking reuptake of both serotonin and norepinephrine. The nurse evaluates the treatment as successful when observing which client behavior?

Apologizing for being sarcastic

Laughing at a joke

Going to his room to "calm down"

Writing down a telephone number

Laughing at a joke

Depression is thought to be at least in part caused by lowered levels of serotonin and norepinephrine. Increasing the amount of these transmitters in the brain by blocking reuptake may result in mood elevation. While the other options demonstrate positive behaviors, none are directly associated with such a medication

When a tumor of the cerebellum is present, the nurse should expect that the client would initially demonstrate which sign/symptom?

Impaired balance

Abnormal eye movement

Blood pressure irregularities

Impaired social judgment

Impaired balance

The cerebellum is the organ primarily responsible for symptoms of equilibrium or imbalance and would not be a likely source of any of the other options.

The nurse caring for a client prescribed risperidone observes the client carefully for which possible side effects? (Select all that apply.)

A weight gain

Reports of heartburn

Daytime sleepiness

A rapid heartbeat

Sexual dysfunction

A weight gain, daytime sleepiness, and sexual dysfunction

Risperidone is a D2 antagonist that can produce extrapyramidal symptoms and has the potential to produce sedation, weight gain, and sexual dysfunction. None of the other side effects are generally associated with this medication.

The nurse caring for a client prescribed an antidepressant medication that produces anticholinergic side effects should assess for which possible side effects? (Select all that apply.)

Memory dysfunction

Ejaculatory dysfunction

Dry mouth

Constipation

Blurred vision

Dry mouth, constipation, Blurred vision

Anticholinergic effects are the effects produced by atropine: dry mouth, dry eyes, blurred vision, constipation, and urinary retention. None of the remaining options are associated with anticholinergic side effects.

Which organ secretes hormones that are a normal component of the body's general response to stress? (Select all that apply.)

Adrenal glands

Thyroid gland

Pituitary gland

Parathyroid glands

Hypothalamus

Adrenal glands, Pituitary gland, Hypothalamus

The hypothalamus, pituitary, and adrenal glands act as a system that responds to mental and physical stress. The organs secrete corticotropin-releasing hormone, corticotropin, and cortisol; all influence the function of nerve cells of the brain. None of the remaining options secrete hormones associated with general stress.