Chapter 18 advanced patho

A psychiatrist is providing care for a 68-year-old female whose anxiety disorder is significantly decreasing her quality of life. The nurse knows that the client will likely benefit from which of the following pharmacologic therapies listed below? A) A drug that influences gamma-aminobutyric acid (GABA) levels B) An MAO inhibitor to increase the concentration of serotonin and norepinephrine C) An antipsychotic medication that blocks dopamine receptors D) A calcium channel-blocking agent

A) A drug that influences gamma-aminobutyric acid (GABA) levels

During an acute phase of schizophrenia when the patient is experiencing hallucinations and delusions, the nurse should anticipate that the physician will prescribe which of the following medication categories listed below? A) An antipsychotic like risperidone B) A benzodiazepine like lorazepam C) A cholinesterase inhibitor like donepezil D) An opioid receptor antagonist like naltrexone

A) An antipsychotic like risperidone

A 50-year-old woman has experienced devastating consequences in her family and work life as a result of her long-standing alcohol addiction. The levels and pathways of which of the following neurotransmitters in her body are likely to differ from an individual without addiction? A) Dopamine B) Acetylcholine C) Serotonin D) Norepinephrine

A) Dopamine

Which of the following is the most likely course of Wernicke syndrome? A) If the symptoms are correctly diagnosed, most of the effects of the disease can be reversed through better nutrition and supplemental thiamine. B) Wernicke syndrome is uniformly fatal, with death most often occurring within a few months of onset. C) Wernicke syndrome has no treatment, but drugs may be used to treat its associated dyskinesias and behavioral disturbances. D) The course of the disease is relentless, and most affected persons will die of infection within 2 to 10 years.

A) If the symptoms are correctly diagnosed, most of the effects of the disease can be reversed through better nutrition and supplemental thiamine.

A 20-year-old college student has presented to his campus medical clinic because of his unshakable despondency in recent months. He has been diagnosed with depression based on his signs, symptoms, and history. The nurse knows that which of the following treatments will likely be prescribed for this student? A) Medication that inhibits the reuptake of serotonin in his presynaptic space B) Drugs that inhibit the accumulation of cyclic adenosine monophosphate (cAMP) C) Benzodiazepines such as clonazepam that modulate his GABA receptors. D) Cholinesterase inhibitors that potentiate the action of available acetylcholine E) Antipsychotics such as olanzapine

A) Medication that inhibits the reuptake of serotonin in his presynaptic space

A student notices that at certain times during his studying for final exams, he is more awake and his ability to think at a higher level is happening easier. The nurse knows that this experience may be attributed to which of the following neurological functions? A) Release of excitatory neurotransmitters such as glutamate B) Release of GABA, an inhibitory neurotransmitter C) Release of corticotrophin-releasing hormone D) Heightened precortex processes

A) Release of excitatory neurotransmitters such as glutamate

A 44-year-old female has been diagnosed with major depression. Which of the following neuroimaging findings is most congruent with the woman's diagnosis? A) Decreased brain activity in the pons and brain stem B) Reduced activity and gray matter volume in the prefrontal cortex C) Atrophy and decreased blood flow in the amygdala D) Enlargement of the lateral and third ventricles and reduction in frontal and temporal volumes

B) Reduced activity and gray matter volume in the prefrontal cortex

Which of the following statements on the final diagnostic report regarding a computerized tomography (CT) of the head with contrast would lead health care providers to diagnose a patient with Alzheimer disease? A) Large area of ischemia noted in the temporal lobe B) Too numerous to count beta-amyloid (βA) deposits noted C) Ninety percent obstruction in the posterior cerebral artery D) Mural thrombus of vertebrobasilar arteries

B) Too numerous to count beta-amyloid (βA) deposits noted

An adult, who was sexually abused as a child, has been displaying some stress. She seems to complain of increasing medical problems when she is under more stress. The nurse would classify this as an example of: A) vitamin deficiency. B) the stress-diathesis theory. C) mendelian research. D) parental disassociation.

B) the stress-diathesis theory.

Parents of a 16-year-old male who has been behaving in increasingly bizarre ways in recent months are distraught that he has been diagnosed with schizophrenia. Which of the mother's following statements about her son's diagnosis demonstrates an accurate understanding of the disease? A) "It's disturbing to know that what I did when I was pregnant and the way we raised him contributed to this." B) "We are somewhat relieved that psychotherapy and a supportive environment will resolve most of the positive and negative symptoms." C) "This makes us even more worried about his younger brother and whether he might develop schizophrenia." D) "We're committed to lovingly but firmly convincing him that his delusions aren't based in reality."

C) "This makes us even more worried about his younger brother and whether he might develop schizophrenia."

Which of the following statements best captures the current understanding of the etiology of mental illness? A) The role of "nurture," experiences, and relationships has been largely disproven. B) Mental illness can be attributed to organic brain changes and pathophysiological processes. C) Mental illness exists from the interplay of biologic factors and psychosocial influences. D) Current understanding of mental illness has shown that both biologic psychiatry and psychosocial psychiatry are incorrect.

C) Mental illness exists from the interplay of biologic factors and psychosocial influences.

A toddler brought up in a chaotic, nonnurturing environment may suffer neurological consequences if the parent does not achieve attachment with the child. The nurse knows that which of the following nervous systems listed below is the first to respond to the safety needs of the child? A) Parasympathetic nervous system B) Autonomic nervous system C) Sympathetic nervous system D) Limbic system

C) Sympathetic nervous system

A geriatrician and social worker are facilitating a family meeting for the children and wife of a 79-year-old man who has been diagnosed with Alzheimer disease. What goal of treatment will the clinicians most likely prioritize in their interactions with the family? A) Modest reversal of brain plaque formation and improved symptomatology through cholinesterase inhibitors B) Surgical treatment of the underlying ischemic changes that underlie the manifestations of the man's disease C) The use of medications such as donepezil and rivastigmine to slow the progression of the disease D) Cognitive and behavioral therapy to counteract the agitation, depression, and suspiciousness associated with Alzheimer disease

C) The use of medications such as donepezil and rivastigmine to slow the progression of the disease

A woman has a long-running compulsion to repeatedly check if the doors of her home are locked and has received a diagnosis of obsessive-compulsive disorder (OCD). Her husband is at a loss to understand her irrational behavior and has sought help from a therapist himself to deal with the effect that his wife's OCD is having on their daily lives. Which of the husband's following statements would require correction? A) "It's a relief to know that this can be changed if she continues with therapy and the medications she's been prescribed." B) "It's odd that someone like her and someone who's depressed might both respond positively to the same drugs." C) "I thought that this was something exceedingly rare, but I'm actually a bit relieved to learn that others have this disorder as well." D) "I'm glad that this is something that's a result of life stressors and is not associated with any dysfunction in her br

D) "I'm glad that this is something that's a result of life stressors and is not associated with any dysfunction in her brain."

Which of the following is a negative symptom of schizophrenia? A) Hallucinations B) Incoherence C) Word salad D) Affective flattening

D) Affective flattening

As part of a diagnostic workup of a 22-year-old male with recently diagnosed schizophrenia, a neurologist wants to examine the levels of metabolic activity in particular areas of the client's brain. Which of the following diagnostic procedures is the physician most likely to order? A) Computed tomography (CT) B) Electroencephalography (EEG) C) Magnetic resonance imaging (MRI) D) Positron emission tomography (PET)

D) Positron emission tomography (PET)

After surviving an ischemic stroke, a 79-year-old male has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings with exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which of the following brain structures? A) The man's occipital lobe B) The client's temporal lobe in general and Wernicke area in particular C) The man's parietal lobe D) The components of the client's limbic system

D) The components of the client's limbic system