Chapter j 1 j Chemical j neurotransmission
MULTIPLE j CHOICE
1. jA j patient j with j depression j mentions j to j the j nurse, j My j mother j says
jdepression j is j a j chemical j disorder. j What j does j she j mean? j The j nurses
j response jis j based j on j the j theorythat j depression j primarily j involves j which
j of j the jfollowing j neurotransmitters?
a. Cortisol j and j GABA
b. COMT j and j glutamate
c. Monamine j and j glycine
d. Serotonin j and
j norepinephrine jANS: j D
One j possible j cause j of j depression j is j thought j to j involve j one j or j more
neurotransmitters.Serotonin j and j norepinephrine j have j been j found j to j be
j important jin j the j regulation j of j depression. j There j is j no j research j to j support
j that j the j other joptions j play j a j significant j role j in j the j development j of
j depression.
2. A j patient j has j experienced j a j stroke j (cerebral j vascular j accident) j that j has
jresulted j indamage j to j the j Broca j area. j Which j evaluation j does j the j nurse
j conduct jto j reinforce j thisdiagnosis?
a. Observing j the j patient j pick j up j a j spoon
b. Asking j the j patient j to j recite j the j alphabet
c. Monitoring j the j patients j blood j pressure
d. Comparing j the j patients j grip j strength j in j both
j hands jANS: j B
Accidents j or j strokes j that j damage j Brocas j area j may j result j in j the j inability
j to
speak j (i.e.,motor j aphasia). j Fine j motor j skills, j blood j pressure j control, j and j muscle
jstrength j are j notcontrolled j by j the j Broca j area j of j the j left j frontal j lobe.
3. The j patient j diagnosed j with j schizophrenia j asks j why j psychotropic
j medications jare j always j prescribed j by j the j doctor. j The j nurses j answer j will
j be j based j on jinformation j thatthe j therapeutic j action j of j psychotropic j drugs
j is j the j result j of j their j effect j on:
a. The j temporal j lobe; j especially j Wernickes j area
b. Dendrites j and j their j ability j to j transmit j electrical j impulses
ANS: j C
Medications j used j to j treat j psychiatric j disorders j operate j in j and j around j the
synaptic j cleftand j have j action j at j the j neurotransmitter j level, j especially j in j the
j case jof j schizophrenia, j on j dopamine. j The j Wernickes j area, j dendrite j function,
j or j the jsensitivity j of j the j peripheral j nervous j system j are j not j relevant j to
j either jschizophrenia j or j psychotropic j medications.
4. A j student j nurse j mutters j that j it j seems j entirely j unnecessary j to j have
j to jstruggle j withunderstanding j the j anatomy j and j physiology j of j the
j neurologic jsystem. j The j mentor j would j base j a j response j on j the
j understanding j that j it jyis:
Necessary j but j generally j for j psychiatric j nurses j who j focus
a. primarily j onbehavioral j interventions
A j complex j undertaking j that j advance j practice j psychiatric jynurses
b. j frequently jusein j their j practice
Important j primarily j for j the j nursing j assessment j of j patients j with
c. jbraintraumacaused j cognitive j symptoms
Necessary j for j planning j psychiatric j care j for jyall jypatients j especially
d. jthoseexperiencing j psychiatric j disorders
ANS:
jD
Nurses j must j understand j that j many j symptoms jyof j psychiatric j disorders j have
j a jneurologic j basis, j although j the j symptoms jyare jymanifested j behaviorally.
j This junderstanding j facilitates j effective j care jyplanning. j The j foundation j of
j knowledge jis j notused j exclusively j by j advanced jypractice j psychiatric j nurses
j nor j is j it j relevant j for j only j behavior j therapies j or j brain j trauma j since
j dealing j with j the jresults j of j normal j and j abnormal jybrain j function j is j a
j responsibility j of j all j nurses jproviding j all j types j of j care jytothe j psychiatric
j patient.
5. A j patient j asks j the jynurse, jyMy j wife j has j breast j cancer. j Could j it j be
j caused jby j herchronic j depression? j Which j response j is j supported j by
j research j data?
a. Too j much jystress j has j been j proven j to j cause j all j kinds j of j cancer.
b. There jyhave j been j no j research j studies j done j on j stress j and j disease j yet.
c. Stress j does j cause j the j release j of j factors j that j suppress j the j immune
j system.
d. There j appears j to j be j little j connection j between j stress j and j diseases j of j the
ybody
ANS: j C
Research j indicates j that j stress j causes j a j release j of j corticotropin-releasing
j factors jthat j suppress j the j immune j system. j Studies j indicate j that j psychiatric
j disorders jsuch j as j mooddisorders j are j sometimes j associated j with j decreased
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