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A comprehensive set of multiple-choice questions and answers covering key concepts in neurobiology and mental health, relevant to the nsg 552 course. It explores topics such as neurotransmitters, brain structures, psychiatric disorders, and medication effects. The questions are designed to test understanding of the underlying mechanisms of mental health conditions and the role of neurobiology in their development and treatment.
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A patient with depression mentions to the nurse, My mother says depression is a chemical disorder. What does she mean? The nurses 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. Serotonin and norepinephrine 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 patients blood pressure d. Comparing the patients grip strength in both - ANSWER -b. Asking the patient to recite the alphabet The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor. The nurses answer will be based on information that the therapeutic action of psychotropic drugs is the result of their effect on: a. The temporal lobe; especially Wernickes area b. Dendrites and their ability to transmit electrical impulses c. The regulation of neurotransmitters especially dopamine d. The peripheral nervous system sensitivity to the psychotropic medications - ANSWER -c. The regulation of neurotransmitters especially dopamine A student nurse mutters that it seems entirely unnecessary to have 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 advance 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. Necessary for planning psychiatric care for all patients especially those experiencing psychiatric disorders 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. Stress does cause the release of factors that suppress the immune system. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs. Of the aspects of functioning listed, which will the nurse identify as a focus of nursing intervention? a. Expression of emotion b. Detecting auditory stimuli c. Receiving visual images d. Processing associations - ANSWER -d. Processing associations At admission, the nurse learns that some time ago the patient had an infarct in the right cerebral cortex. During assessment, the nurse would expect to find that the patient: a. Demonstrates major deficiencies in speech b. Is unable to effectively hold a spoon in the left hand c. Has difficulty explaining how to go about using the telephone d. Cannot use his right hand to shave himself or comb his own - ANSWER -b. Is unable to effectively hold a spoon in the left hand A patient with chronic schizophrenia had a stroke involving the hippocampus. The patient will be discharged on low doses of haloperidol. The nurse will need to individualize the patients medication teaching by: a. Including the patients caregiver in the education b. Being careful to stress the importance of taking the medication as prescribed
d. Regularly praising the patient for seeking and complying with appropriate treatment - ANSWER -a. Providing educational programming for patients and the public The wife of a patient with paranoid schizophrenia tells the nurse, Ive learned that my husband has several close relatives with the same disorder. Does this problem run in families? The response based on recent discoveries in the field of genetics would be: a. Your children should be monitored closely for the disorder. b. Research tends to support a familiar tendency to schizophrenia. c. There is no concrete evidence; it is just as likely a coincidence. d. Only bipolar disorder has been identified to have a genetic - ANSWER -b. Research tends to support a familiar tendency to schizophrenia. A patient whose symptoms of mild depression have been managed with antidepressants is concerned about the affect of accepting a promotion that will require working the night shift. What will be the basis of the response the nurse gives to address the patients concern? a. The connection between a new job and possible depression does exist. b. The medication can be adjusted to manage any increase in depression. c. The interruption in normal wake-sleep patterns can influence mood disorders. d. The change in sleep routine can be managed with a healthy sleep hygiene routine. - ANSWER -c. The interruption in normal wake-sleep patterns can influence mood disorders. The nurse is discouraged because the patient exhibiting negative symptoms of schizophrenia has shown no improvement with the planned interventions to reduce the symptoms. The mentors remark that helps place the problem in perspective is: a. You aren't responsible for the behavior of any other person. b. Patients can be perverse and cling to symptoms despite our efforts. c. Negative symptoms have been associated with genetic pathology. d. It will take several trail and error attempts to get the right combination - ANSWER -c. Negative symptoms have been associated with genetic pathology. The somatic nervous system provides sensory and motor innervation for: A) peripheral nerves. B) abdominal viscera. C) secretory glands.
D) smooth muscle. - ANSWER -A) peripheral nerves. The proteins and other materials used by the axon are synthesized and then flow down the axon through its cytoplasm. A) in the cell body B) by Nissl bodies C) through dendrites D) across synapses - ANSWER -A) in the cell body Supporting cells of the nervous system, such as Schwann cells, satellite cells, and types of glial cells, function to provide neurons with: A) local protection. B) control functions. C) membrane permeability. D) integrative metabolism. - ANSWER -A) local protection. Neurons are characterized by the ability to communicate with other neurons and body cells through: A) astrocytes. B) axon hillocks. C) nodes of Ranvier. D) action potentials. - ANSWER -D) action potentials. Chemical synapses rely on in order to provide communication between neurons. A) diffusion B) gap junctions C) satellite cells D) transmitter molecules - ANSWER -D) transmitter molecules The blood-brain and CSF-brain barriers control the chemical environment of the brain by allowing easy entrance to only a few chemicals that include:
Which of the following substances provides the majority of the fuel needs of the neurologic system? A) Glycogen B) Glucose C) Amino acids D) Triglycerides - ANSWER -B) Glucose A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the patients central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely be affected by this disease process? A) Oxygen metabolism B) Neurotransmitter synthesis C) Nerve conduction D) Production of cerebrospinal fluid - ANSWER -C) Nerve conduction A neuron has been hyperpolarized. How will this affect the excitability of the neuron? A) The neuron will have a membrane potential farther from the threshold. B) The neuron will be more difficult to repolarize after firing. C) The membrane potential of the neuron will be closer to the threshold. D) The neurons excitability will be significantly increased. - ANSWER -A) The neuron will have a membrane potential farther from the threshold. A pregnant womans most recent ultrasound is suggestive of spina bifida, and her primary care provider has subsequently order further diagnostic testing. The pathophysiologic effects of this disease are due to: A) malformation of the mesoderm. B) abnormal closure of the neural tube. C) lesions in the dorsal root ganglia. D) hypertrophy of the primary vesicles. - ANSWER -B) abnormal closure of the neural tube. Which of the following messages is most likely to be carried by general somatic afferent (GSA) neurons? A) The sensation of cold when touching ice B) The message to move a finger and thumb
C) The message to move the larynx during speech D) Information about the position of a joint - ANSWER -A) The sensation of cold when touching ice Which of the following processes is most likely to occur as a result of a spinal reflex? A) Peristalsis of the small and large bowel B) Control of oculomotor function in changing light levels C) Pain sensation from a potentially damaging knee movement D) Withdrawal of a hand from a hot stove element - ANSWER -D) Withdrawal of a hand from a hot stove element A patient has required mechanical ventilation following a traumatic head injury sustained in a motorcycle crash, during which he sustained damage to his respiratory center. Which of the patient's brain structures has been injured? A) Brain stem B) Midbrain C) Diencephalon D) Frontal lobe - ANSWER -A) Brain stem A patient with a diagnosis of epilepsy has required surgical removal of part of her prefrontal cortex. Which of the following effects should her family and care team anticipate? A) Lapses in balance and coordination B) Deficits in regulation of the endocrine system C) Sensory losses D) Changes in behavior and judgment - ANSWER -D) Changes in behavior and judgment A patient's primary care provider has prescribed a b-adrenergic receptor blocker. Which of the following therapeutic effects do the patient and care provider likely seek? A) Reduction in heart rate and blood pressure B) Slowing of gastrointestinal motility C) Increase in mental acuity D) Decreased production of gastric acid - ANSWER -A) Reduction in heart rate and blood pressure
B) Concept formation C) Receptive speech D) Hearing - ANSWER -B) Concept formation The nurse is caring for a patient who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the patient with have difficulty with which of the following? A) Perceiving sensory input B) Calculating a math problem C) Seeing objects in front of him D) Speaking fluently - ANSWER -B) Calculating a math problem A patient has been diagnosed with memory dysfunction associated with Alzheimers disease. The nurse determines that damage to the patients brain includes deterioration of temporal lobe structures and the nerves of which of the following? A) Basal ganglia B) Limbic system C) Frontal lobe D) Hippocampus - ANSWER -D) Hippocampus The nurse is caring for a hospitalized patient who has a disorder of the hypothalamus. When developing the patients plan of care, in which of the following areas would the nurse anticipate a problem? A) Sleep B) Constipation C) Speech D) Motor activity - ANSWER -A) Sleep A patient who is scheduled to undergo a sleep deprivation electroencephalogram (EEG) in the morning is experiencing moderate anxiety about the procedure. Based on an understanding of this test, which of the following would the nurse avoid? A) Explaining in depth what to expect during the upcoming procedure B) Administering a benzodiazepine medication prescribed for anxiety
C) Taking a thorough history of her use of prescribed and illicit drugs D) Giving her a noncaffeinated beverage of her choice - ANSWER -B) Administering a benzodiazepine medication prescribed for anxiety A nursing instructor asks a student to explain the influence of chronobiology on depression. Which of the following would the student include when responding? A) The exact location of genes leads to identifying the gene responsible for causing depression. B) A break in the corpus coliseum blocks information exchange between the right and left hemispheres. C) Damage to the posterior areas of the parietal lobe leads to altered discriminative sensory function. D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression. - ANSWER -D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression. When describing the various neurotransmitters, which of the following would the nurse identify as the primary cholinergic neurotransmitter? A) Dopamine B) Acetylcholine C) Norepinephrine D) Serotonin - ANSWER -B) Acetylcholine A group of nursing students are reviewing the various neurotransmitters. The students demonstrate understanding when they identify which of the following as a neuropeptide? A) Melatonin B) Serotonin C) Glutamate D) Gamma-aminobutyric acid - ANSWER -A) Melatonin The nurse is assessing a patient experiencing anxiety and observes increased sweating and gooseflesh. The nurse understands that these are the result of which substance? A) Acetylcholine B) Norepinephrine C) Serotonin D) Histamine - ANSWER -B) Norepinephrine
D) Hypothalamic damage leading to immune dysfunction A patient is scheduled for a challenge test. Which of the following would the nurse include when explaining this test to the patient? A) Intravenous administration of a substance to induce symptoms B) Application of electrodes to the scalp for monitoring C) Evaluation electrical impulses recorded on graph paper D) Exposure to a flashing strobe light to elicit abnormal activity - ANSWER -A) Intravenous administration of a substance to induce symptoms A patient with depression tells the nurse that he is to have a test that involves the recording of an electroencephalogram (EEG) throughout the night. The 18. nurse most likely identifies this testing as which of the following? A) Sleep deprivation EEG B) Polysomnography C) Evoked potentials D) Functional magnetic resonance imaging - ANSWER -B) Polysomnography A group of nursing students are reviewing the role of serotonin in psychiatric disorders. The students demonstrate a need for additional study when they identify which disorder as being associated with its dysfunction? A) Depression B) Obsessive-compulsive disorder C) Panic disorder D) Schizophrenia - ANSWER -D) Schizophrenia When describing neuronal transmission, an instructor describes the area where the electrical intracellular signal becomes a chemical one. The instructor is describing which of the following? A) Soma B) Synaptic cleft C) Terminal D) Receptor - ANSWER -B) Synaptic cleft
A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior observed in the patient supports that diagnosis? a. Uses a rhyming form of speech b. Refuses to eat any unwrapped foods c. Laughs when watching a sad movie d. Maintains an immobilized state for hours - ANSWER -d. Maintains an immobilized state for hours What would be an appropriate short-term outcome for a patient diagnosed with residual schizophrenia who exhibits ambivalence? a. Decide their own daily schedule. b. Decide which unit groups they will attend. c. Choose which clinic staff member to work with. d. Choose between two outfits to wear each morning. - ANSWER -d. Choose between two outfits to wear each morning. What is the priority nursing diagnosis for a catatonic patient? a. Ineffective coping b. Impaired physical mobility c. Impaired social interaction d. Risk for deficient fluid volume - ANSWER -d. Risk for deficient fluid volume Which nursing diagnosis is appropriate for a patient who insists being called Your Highness and demonstrates loosely associated thoughts? a. Risk for violence b. Defensive coping c. Impaired memory d. Disturbed thought processes - ANSWER -d. Disturbed thought processes Which initial short-term outcome would be appropriate for a patient who was admitted expressing delusional thoughts?
A 19-year-old patient is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The patient sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes, and that the world is burning. The nurse assesses the primary deficit associated with the patient's condition as: a. Social isolation b. Disturbed thinking c. Altered mood states d. Poor impulse - ANSWER -b. Disturbed thinking A patient has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another patient a jerk without provocation. The nurse asks the patient how he is feeling, and he responds, Everybody picks on me. They frobitz me. The patients communication exhibits: a. A neologism b. Loose associations c. Delusional thinking d. Circumstantial speech - ANSWER -a. A neologism A patient has been admitted with disorganized type schizophrenia. The nurse asks the patient how he is feeling, and he responds, Everybody picks on me. They frobitz me. The best response for the nurse to make would be: a. Thats really too bad that you are being treated that way. b. Who do you mean when you say everybody? c. What difference does frobitzing make? d. Why do they frobitz? - ANSWER -b. Who do you mean when you say everybody? Which patient behavior would support the diagnosis of residual schizophrenia with negative symptoms? a. Communicating using only rhyming phases b. Claims that worms are crawling in my brain c. Maintaining both arms suspended awkwardly overhead d. Shows no emotion when telling the story of a sisters recent death - ANSWER -d. Shows no emotion when telling the story of a sisters recent death By discharge, which outcome is appropriate for a patient who hears voices telling him he is evil?
a. Respond verbally to the voices. b. Verbalize the reason the voices say he is evil. c. Identify events that increase anxiety and promote hallucinations. d. Integrate the voices into his personality structure in a positive manner. - ANSWER -c. Identify events that increase anxiety and promote hallucinations. Which response by the nurse would best assist a patient in deescalating aggressive behavior? a. Tell me whats going on. b. Why are you getting so upset? c. If you throw something, you will be restrained. d. Its time for group therapy. You can talk there. - ANSWER -a. Tell me whats going on. A 34-year-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission. He still appears stuporous in the hospital. Which nursing intervention would be an initial priority? a. Orienting the patient to the unit b. Reinforcing reality with the patient c. Establishing a nonthreatening relationship d. Assessing the patient for physical problems - ANSWER -d. Assessing the patient for physical problems Which response is appropriate when a patients mother expresses guilt over causing my child to be schizophrenic? a. I can see how you would be upset over this turn of events. b. New findings suggest this disorder is biological in nature. c. Dont be so hard on yourself; your daughter needs you to be strong. d. Its difficult to see what produces stress for the child at the time its occurring. - ANSWER -b. New findings suggest this disorder is biological in nature. Which response demonstrates both empathy and understanding of the relationship genetics has to the development of schizophrenia in twins? a. In fraternal twins, the chance of the other twin developing the disorder is quite small. b. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.
b. Development of dystonic reactions c. Improvement in tardive dyskinesia d. Worsening of anticholinergic symptoms - ANSWER -c. Improvement in tardive dyskinesia A patient admitted with the diagnosis of schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the patient will: a. Be scheduled for a magnetic resonance imaging (MRI) test b. See a mental health specialist for extensive psychological testing c. Have an immunologic assay performed within 2 days of the admission d. Participate in a dexamethasone suppression test (DST) administered by the staff - ANSWER -a. Be scheduled for a magnetic resonance imaging (MRI) test In planning aftercare for a patient with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the patient to have stimulation, structure, socialization, and support. Which option would best incorporate these factors? a. Day hospitalization b. Attending a psychosocial club c. Living with his elderly mother d. Spending free time in the mall - ANSWER -b. Attending a psychosocial club A patient with catatonic schizophrenia has been standing with his left arm upraised and his right foot off the floor for the majority of the last 20 hours, eating only when allowed to eat standing up. Which nursing intervention has priority for this patient? a. Providing high-calorie drinks hourly b. Assessing for lower extremity edema bid c. Taking the patient to activities therapy once daily d. Encouraging the patient to sit or lie down for 30 minutes hourly - ANSWER -b. Assessing for lower extremity edema bid Which nursing action best addresses the needs of a paranoid patient who believes the food is poisoned? a. Explaining that others eat the food and are not harmed b. Allowing the patient to select food from vending machines
c. Encouraging the patient to discuss why someone would poison the food d. Taking steps to prevent the patient from verbalizing the delusional thoughts - ANSWER -b. Allowing the patient to select food from vending machines Prior to discharge, the nurse plans to teach the patient and family about relapse. Which items will the nurse include in the teaching? a. Recognizing warning signs of relapse b. Using street drugs judiciously and only in small amounts c. Lowering medication dosage to manage emerging side effects d. Notifying the nurse of warning signs present for more than one month - ANSWER -a. Recognizing warning signs of relapse Because of the cognitive disturbances associated with schizophrenia, which technique will be useful as the nurse teaches a patient about self management? a. Use only verbal instruction. b. Teach material in small segments. c. Offer opportunities for making numerous choices. d. Plan the teaching for a time when the patient has been recently medicated - ANSWER -b. Teach material in small segments. The wife of a patient newly diagnosed with paranoid schizophrenia is concerned that her husband will be this sick for the rest of his life. What information can the nurse provide to the wife? a. This disorder generally responds well with treatment and follow-up. b. All types of schizophrenia by their nature are chronic relapsing disorders. c. Outcomes are related to the patients pre-hospital symptoms of disorganization. d. The typical outcome for this diagnosis is that total remission is not achievable. - ANSWER -a. This disorder generally responds well with treatment and follow-up. A patient is exhibiting auditory hallucinations in addition to being forgetful and easily confused. Which diagnosis does the nurse base this patients interventions on? a. Social isolation b. Deficient knowledge