Chapter 22- Disorders of Thought, Emotion, and Memory

12. 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

13. 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

15. 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

20. 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

5. 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

8. 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

19. A 70-year-old woman has been brought to the emergency department by her daughter who noticed the woman is weak, confused, and forgetful in recent months, along with uncoordinated movements and visual disturbances at times. Which of the following questions by the physician are most likely to address her probable diagnosis? Select all that apply. A) "What medications is your mother currently taking?" B) "Does your mother drink alcohol?" C) "Does your mother have a history of stroke?" D) "Is your mother facing significant stressors right now?" E) "Is your mother lonely?"

a,b

9. Which of the following clinical manifestations would the nurse assess in the patient with bipolar disorder who is experiencing mania? Select all that apply. A) Labile mood B) Highly distractible C) Inflated self-esteem D) Despondent when asked questions E) Excessive sleepiness

a,b,c

16. The nurse knows that the patient admitted for opioid addiction may benefit from which of the following treatment modalities? Select all that apply. A) Prescription for dolophine (Methadone) B) Administration of a long-term pain reliever like duragesic (Fentanyl) C) Involvement in a self-help group like Opioid Anonymous (an offshoot of Alcoholics Anonymous) D) Intense exercise therapy under supervision of a body builder E) Administering beta-blocking medications to minimize agoraphobia symptoms

a,c

10. 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

17. 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

3. 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

1. 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

18. 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

4. 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

6. 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

11. 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

14. 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 brain."

d

2. 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

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

d