Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications 4th Edition Test Bank

Chapter 1: Chemical Neurotransmission

MULTIPLE CHOICE QUESTIONS

1. A patient with depression mentions to the nurse, “My mother says depression is a chemical disorder. What does she mean?” The nurse’s response is based on the theory that depression primarily involves which of the following neurotransmitters?

• a. Cortisol and GABA
• b. COMT and glutamate
• c. Monamine and glycine
• d. Serotonin and norepinephrine

Answer: D
Explanation: One possible cause of depression is thought to involve an imbalance of certain neurotransmitters. Serotonin and norepinephrine have been identified as key players in the regulation of mood. There is no significant research supporting the involvement of the other neurotransmitters listed in the development of depression.

2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage to the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?

• a. Observing the patient pick up a spoon
• b. Asking the patient to recite the alphabet
• c. Monitoring the patient’s blood pressure
• d. Comparing the patient’s grip strength in both hands

Answer: B
Explanation: Damage to Broca’s area, located in the left frontal lobe, can result in motor aphasia, where the patient may lose the ability to speak. The evaluation of speech, such as reciting the alphabet, is directly related to this area of the brain. Fine motor skills, blood pressure, and grip strength are controlled by other brain regions.

3. The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor. The nurse’s answer will be based on the understanding that the therapeutic action of psychotropic drugs is the result of their effect on:

• a. The temporal lobe, especially Wernicke’s area
• b. Dendrites and their ability to transmit electrical impulses
• c. The regulation of neurotransmitters, especially dopamine
• d. The peripheral nervous system’s sensitivity to psychotropic medications

Answer: C
Explanation: Psychotropic medications primarily work at the neurotransmitter level, particularly dopamine in the case of schizophrenia. These medications influence neurotransmitter activity within the synaptic cleft. Wernicke’s area, dendrite function, and peripheral nervous system sensitivity are not directly relevant to schizophrenia or the action of psychotropic drugs.

4. A student nurse mutters that it seems entirely unnecessary to struggle with understanding the anatomy and physiology of the neurologic system. The mentor would base a response on the understanding that it is:

• a. Necessary but generally for psychiatric nurses who focus primarily on behavioral interventions
• b. A complex undertaking that advanced practice psychiatric nurses frequently use in their practice
• c. Important primarily for the nursing assessment of patients with brain trauma-caused cognitive symptoms
• d. Necessary for planning psychiatric care for all patients, especially those experiencing psychiatric disorders

Answer: D
Explanation: Understanding the neurological basis of psychiatric symptoms is crucial for all nurses involved in psychiatric care. This knowledge underpins effective care planning and is essential for addressing both normal and abnormal brain function, which often manifests behaviorally in psychiatric patients.

5. A patient asks the nurse, “My wife has breast cancer. Could it be caused by her chronic depression?” Which response is supported by research data?

• a. Too much stress has been proven to cause all kinds of cancer.
• b. There have been no research studies done on stress and disease yet.
• c. Stress does cause the release of factors that suppress the immune system.
• d. There appears to be little connection between stress and diseases of the body.

Answer: C
Explanation: Research has shown that stress leads to the release of corticotropin-releasing factors that can suppress immune system function. While stress has been linked to certain physical diseases, including some mood disorders, the connection between stress and cancer is not well established in current research.