Deck 3: Biological Basis for Understanding Psychiatric Disorders and Treatments

Question 1

A patient tells the nurse,"My doctor prescribed Paxil (paroxetine)for my depression.I assume I'll have side effects like I had when I was taking Tofranil (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) MAO inhibitor.
D) SSRI.

Answer 1

SSRI.

Question 2

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) Computed tomography (CT) scan
C) Positron-emission tomography (PET)
D) Single-photon emission computed tomography (SPECT)

Answer 2

Computed tomography (CT) scan

Question 3

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.

Answer 3

parasympathetic nervous system.

Question 4

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

A) Reduced anxiety
B) Improved memory
C) More organized thinking
D) Fewer sensory perceptual alterations

Question 5

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.

Question 6

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) Antimanic drugs
D) Benzodiazepines

Question 7

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

A) lithium (Lithobid).
B) buspirone (BuSpar).
C) imipramine (Tofranil).
D) risperidone (Risperdal).

Question 8

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

A) dry mouth.
B) gynecomastia.
C) pseudoparkinsonism.
D) orthostatic hypotension.

Question 9

A patient asks,"What are neurotransmitters? The 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."

Question 10

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."

Question 11

A 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

Question 12

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

A) inhibit gamma-aminobutyric acid (GABA).
B) prevent destruction of acetylcholine.
C) reduce serotonin metabolism.
D) increase dopamine activity.

Question 13

Which instruction has priority when teaching a patient about clozapine (Clozaril)?

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."

Question 14

A patient is hospitalized for severe depression.Of the medications listed below,the nurse can expect to provide the patient with teaching about:

A) chlordiazepoxide (Librium).
B) clozapine (Clozaril).
C) sertraline (Zoloft).
D) tacrine (Cognex).

Question 15

A patient diagnosed with bipolar disorder has an unstable mood,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

Question 16

The nurse prepares to assess a patient diagnosed with major depression 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?"

Question 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.

Question 18

A patient has fear as well as increased heart rate and blood pressure.The nurse suspects increased activity of which neurotransmitter?

A) Gamma-aminobutyric acid (GABA)
B) Norepinephrine
C) Acetylcholine
D) Histamine

Question 19

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

Question 20

A patient's history shows drinking 4 to 6 liters 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) Amydala
B) Parietal lobe
C) Hippocampus
D) Hypothalamus

Question 21

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 (Lithobid).
B) clozapine (Clozaril).
C) fluoxetine (Prozac).
D) venlafaxine (Effexor).

Question 22

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) Gamma-aminobutyric acid (GABA)

Question 23

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

Question 24

Questions the nurse could ask that would be nonjudgmental when obtaining information about patient use of 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 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?"

Question 25

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.

Question 26

A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO)to avoid certain foods and drugs because of the risk of:

A) cardiac dysrhythmia.
B) hypotensive shock.
C) hypertensive crisis.
D) hypoglycemia.

Question 27

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) "Tell me more about what kinds of tests your brother's health insurance plan covers."
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 doctor."

Question 28

A nurse caring for a patient taking a selective serotonin reuptake inhibitor (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.

Question 29

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.

Question 30

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

Question 31

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.

Question 32

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.

Question 33

Consider these medications: carbamazepine (Tegretol),lamotrigine (Lamictal),gabapentin (Neurontin).Which medication below also belongs with this group?

A) Galantamine (Reminyl)
B) Valproate (Depakote)
C) Buspirone (BuSpar)
D) Tacrine (Cognex)

Question 34

A nurse cares for a group of patients receiving various medications,including haloperidol (Haldol),carbamazepine (Tegretol),trazodone (Desyrel),and phenelzine (Nardil).The nurse will order a special diet for the patient who takes:

A) carbamazepine.
B) haloperidol.
C) phenelzine.
D) trazodone.

Question 35

By which mechanism do selective serotonin reuptake inhibitors (SSRI)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 a1 norepinephrine receptors