PrepU Chapter 46 4, Pharmacology 1: Prep U-Ch 19 3 to add, Chapter 19 PrepU, Pharmacology Prep U Chapter 19 Nerves and the Nervous System
A patient with Parkinson's disease is being cared for on your unit. The nurse would be correct in identifying what neurotransmitter as being decreased in this disease?
Dopamine
Parkinson's disease is associated with a decrease in which of the following neurotransmitters?
Dopamine
Which neurotransmitter is involved in the coordination of impulses?
Dopamine
Which is the most primitive area of the brain and contains the brain stem?
Hindbrain
The nurse administers a medication that stimulates the parasympathetic nervous system (PNS). What manifestations would indicate the medication is having the desired effect?
Hyperactive bowel sounds Increased saliva production Constricted pupils
A 25-year-old young female client arrives at the community clinic reporting changes in her eating habits. She reports a sudden loss of appetite with no apparent reason. The nurse understands that which part of the brain could be responsible for the client's condition?
Hypothalamus
A client presented with signs and symptoms of hypothyroidism and subsequent diagnostic testing revealed low levels of thyrotropin-releasing hormone (TRH) and thyroid stimulating hormone. The care team should focus assessments and interventions on the client's:
Hypothalamus
After teaching a group of students about major divisions of the brain, the instructor determines that additional teaching is needed when the students identify what as part of the hindbrain?
Hypothalamus
What would be found in the midbrain?
Hypothalamus
The nursing student knows that the function of the thalamus is most accurately described by which statement?
It relays motor impulses from the cerebral cortex to the spinal cord.
The nurse is teaching a client with depression about the structure and function of the limbic system. The nurse should describe the roles of what neurotransmitters? (Select all that apply.)
• Serotonin • Epinephrine • Norepinephrine
When levels of serotonin are high in the RAS, the system shuts off and what occurs?
Sleep
Where are alpha-receptors found?
Smooth muscles
The nurse is caring for a client who is recovering in the hospital from a stroke. What statement by the client suggests a need for further education?
"I'm eager to start rehabilitation because I want new nerves to grow as quickly as possible."
The nurse is describing the differing functions of the sympathetic nervous system (SNS) and parasympathetic nervous system to a client. The nurse has explained how the SNS is associated with a "fight-or-flight" reaction. How should the nurse describe the characteristics of the parasympathetic nervous system?
"Rest and digest"
A client with neurologic symptoms has presented for diagnostic testing that will evaluate nerve impulse transmission. The nurse assisting with the procedure should be aware of what expected process of nerve impulse transmission?
"The impulse travels from the central nervous system (CNS) to the preganglionic neuron to the ganglia to the postganglionic neuron to the neuroeffector cells."
A client is recovering from an ischemic stroke that caused a significant brain infarction and loss of neurons. The client's family member asks the nurse, "How long will it take before new brain cells replace the ones that died?" What is the nurse's best response?
"Unfortunately, the destruction of nerves is permanent and they're unable to reproduce."
The anatomy and physiology instructor is talking about the nervous system. What would the instructor tell the students about the cerebrum? (Select all that apply.)
-It has a parietal lobe. -It has a frontal lobe. -It has a temporal lobe. -It has an occipital lobe.
A nurse is caring for client experiencing pain. The client describes the pain as "9" on a scale of 1 to 10, with 10 being the worst pain. What nursing interventions would be necessary for the nurse to assess? Select all that apply.
-count respirations -assess blood pressure -evaluate pupils
After studying for a test on the brain and spinal cord, the students demonstrate understanding when they identify the spinal cord as being made up of how many pairs of nerves?
31
How many segments does the spinal cord contain?
31
The neurological nurse is caring for a diverse group of clients. For which client would the role of the blood-brain barrier be most significant during treatment?
A client who has been diagnosed with an infection of brain tissue
Which client is most directly exhibiting the function of afferent nerves?
A client who has winced with pain during an intramuscular injection
Which client's nicotinic receptors are likely being stimulated the most?
A client who is in anxious while waiting in the pre-operative area
What client has suffered an injury to the forebrain?
A client whose cerebrum has an infarct from a stroke
The client is undergoing chronic stress and is experiencing negative health effects. What type of drug could this client receive to reduce the autonomic nervous response?
A drug that reduces sympathetic response A drug that increases parasympathetic response A drug that reduces central nervous system (CNS) response
The nurse is providing a continuing education program to teenagers about the nervous system. The nurse is reviewing the parts of the neuron with the students. Based on this information, the nurse asks a student to describe the axon of a neuron. Which explanation by the student best describes a synapse?
A junction or space between one neuron and dendrites of the next
A client's nerve has been stimulated by pain and the resulting electrical action potential has reached the end of the axon. What will happen next?
A neurotransmitter will be released into the synaptic cleft
Several substances act as neurotransmitters in the human body. Which is a neurotransmitter?
Acetylcholine
Which neurotransmitter communicates between nerves and muscles?
Acetylcholine
After the effector cell has been stimulated by acetylcholine (ACh), what enzyme stops this stimulation and allows the effector membrane to repolarize?
Acetylcholinesterase
A nurse is reviewing the structure and function of the blood--brain barrier. This anatomical feature would have the greatest effect on what aspect of nursing care?
Administering antibiotics to treat brain infections
Nicotinic receptors would be found in which location?
Adrenal medulla
Nerve fibers secreting norepinephrine are called:
Adrenergic fibers
The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the blood vessels, iris, and urinary bladder?
Alpha 1
The nurse administers a drug that causes vasoconstriction, contracted piloerection muscles, pupil dilation and urinary retention. What receptor is this drug most likely stimulating?
Alpha 1 receptors
In response to a stimulus, a client's nerve has released a neurotransmitter. From what component of the nerve would the neurotransmitter be released?
Axon
What would a nurse identify as being responsible for carrying information from the nerve to the effector cell?
Axon
A nurse is preparing to assess a patient's cerebellar function. What would the nurse expect to test?
Balance
A client in distress has been given dobutamine, a medication intended to increase myocardial activity and heart rate. This medication likely stimulates what adrenergic receptor?
Beta 1
The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate?
Beta 1
The physiology instructor explains to the nursing students that stimulation of what leads to vasodilation of blood vessels?
Beta 2 stimulation
A client has taken a blow to the back of the head and the hindbrain is thought to have a lesion. What nursing assessments should the nurse include when monitoring for effects of a lesion in this region? (Select all that apply.)
Blood pressure Swallowing assessment Respiratory assessment
Which would a nurse identify as a component of the hindbrain?
Brain stem
Assessment of a client with a complex neurologic history reveals that the client follows instructions but is unable to produce clear speech despite making great effort to do so. The nurse recognizes that diagnostic imaging is likely to reveal a lesion in what location?
Broca's area
Which effect results from activation of beta2 receptors?
Bronchodilation
A client's nerves have been stimulated and the signal has reached the axon. How will communication continue?
By the release of a neurotransmitter
A client is diagnosed with a sleep disorder. Which neurotransmitter is most likely to be dysfunctional for this client?
Serotonin
The nurse is providing a continuing education program to teenagers about the nervous system. The nurse is reviewing the parts of the neuron with the students. Based on this information, the nurse asks a student to describe the axon of a neuron. Which explanation by the student best describes the axon?
Carries impulses away from the neuron cell body
A patient exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination?
Cerebellum
What part of the brain controls and coordinates muscle movement?
Cerebellum
An elderly client arrives at a health care facility with reports of loss of sensation. The nurse understands that a change in which part of the brain is responsible for changes in the client's ability to perceive sensation?
Cerebral cortex
Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells?
Chemically
The carotids and the vertebrals deliver blood to which common vessel at the bottom of the brain?
Circle of Willis
Neurotransmission is important in the function of the central nervous system. Which is a characteristic of neurons that allows them to communicate with other cells?
Conductivity
A patient has sustained an injury to the cerebellum. Which area would be the primary area for assessment?
Coordination
A client is experiencing major depressive disorder. Which neurotransmitter is most likely implicated?
Serotonin
Stimulation of the sympathetic nervous system results in all of the following EXCEPT:
Decreased rate of cellular metabolism.
What best describes the blood-brain barrier?
Defensive mechanism
Information has been received by a client's neuron and transmitted into the cell body. What component of the neurologic system performed this function?
Dendrite
Stimulation of a nerve results in:
Depolarization
A stroke has caused an infarct in a client's cerebral cortex. What deficit should the nurse anticipate?
Diminished processing of intellectual information
A client's left adrenal medulla has been injured in a motor vehicle accident. What is a possible implication of this injury?
Disruptions in the levels of norepinephrine and epinephrine
What is responsible for carrying nerve impulses from the central nervous system to stimulate a muscle?
Efferent fibers
Which is considered a neurotransmitter and hormone released by the adrenal medulla?
Epinephrine
Dendrites route information away from the nerve cell while axons bring information to the nerve.
False
Serotonin produces arousal and decreases the sleep-wake cycle. True or false?
False
A client with a longstanding diagnosis of schizophrenia has taken haloperidol for several years and has recently developed tremors, a shuffling gait and repetitive motor movements. How should the nurse best interpret this change in the client's status?
Function of the client's extrapyramidal system has been altered
Which substance is required for brain cell metabolism?
Glucose
A 10-year-old child has been playing soccer and sustains a closed head injury in a collision with another player. The parent states that the child was unconscious for 5 minutes. Upon admission to the emergency department, the child has difficulty breathing. What area of the brain will have developed cerebral edema?
Medulla oblongata
The physiology instructor is teaching the class about neurotransmitters and their functions. According to the instructor, what is regulated by serotonin receptors?
Mood
Which neurons transmit impulses from the CNS?
Motor
Which would be associated with the forebrain? (Select all that apply.)
Motor neurons Speech area
During which neurologic disease process do the Schwann cells become enlarged and block the nodes of Ranvier?
Multiple sclerosis
Cholinergic receptors are classified as nicotinic or muscarinic. What is a result of the stimulation of the nicotinic receptors?
Muscle contraction
What would be identified as the basic unit of the nervous system?
Neuron
Which would be responsible for the transmission of an electrical impulse along a nerve axon?
Nodes of Ranvier
The anatomy and physiology instructor is discussing neurotransmitters with the pre-nursing A&P class. What would the instructor tell the students is a catecholamine that is classed as a hormone when it is released from the adrenal medulla?
Norephinphrine
A nurse is reading an article about the fight or flight response that includes a discussion of a neurotransmitter. Which neurotransmitter most likely would be addressed?
Norepinephrine
The anatomy and physiology instructor is discussing the role of neurotransmitters in the autonomic nervous system. Which would the instructor identify as the main adrenergic neurotransmitter?
Norepinephrine
Which is an important function of serotonin?
Prevents depression
Parasympathetic stimulation causes the release of nitrous oxide from the endothelium of blood vessels. Which of the following results from this release?
Relaxation of vascular smooth muscle
What occurs when the cell returns to the resting membrane potential?
Repolarization
The nurse administers a drug that stimulates beta2 receptors. What type of health condition would this drug treat?
Respiratory disease
The nurse is caring for a client with asthma who has been experiencing shortness of breath and who has been administered a medication to cause bronchodilation. What aspect of autonomic nervous function has the nurse most likely influenced?
Stimulation of beta-adrenergic receptors
The nurse assessed a client at 0800 and obtained a blood pressure of 111/70 mmHg. Two hours later, the client's blood pressure is 130/81 mmHg. The nurse should attribute this change to what action within the autonomic nervous system?
Stimulation of beta-receptors
Which would be most important for an action potential to occur?
Sufficient strength of a stimulus
When working with a client who is experiencing a stress response, the nurse should anticipate what effects? Select all that apply.
Tachycardia Pupil dilation Diaphoresis
What areas are mainly responsible for coordinating internal and external responses?
Thalamus and hypothalamus
A nurse is reviewing the structure and function of the neurologic system in preparation for a work placement on a neurologic unit? What statement most accurately describes an aspect of the autonomic nervous system?
The autonomic nervous spans the central and peripheral nervous systems
A client has suffered an injury to the limbic system. What assessment finding should the nurse attribute to this injury?
The client exhibits bizarre behavior and unpredictable emotions
The nurse is conducting an assessment of a newly admitted client. What assessment finding should suggest to the nurse that the client's muscarinic cholinergic receptors are being stimulated?
The client has "pinpoint" pupils.
What assessment finding of a client should the nurse attribute to the stimulation of muscarinic receptors?
The client is drooling
A client has been prescribed a medication that antagonizes the beta receptors of the sympathetic nervous system. What assessment finding should the nurse attribute to the effects of this medication?
The client's blood pressure is decreased
The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function?
The client's respiratory rate is 22 breaths per minute
What statement best explains the central and peripheral nervous system?
The two main divisions that control the nervous system are the central and peripheral nervous system.
The nurse is working with a client who has been diagnosed with depression and the nurse has described the role that selective serotonin reuptake inhibitors (SSRIs) play in depression. The nurse should describe what effect on this neurotransmitter?
There are increased levels of serotonin in the synapses
The neurologic nurse is aware that spinal nerves are classified as mixed nerves. This implies what characteristic of spinal nerves?
They contain both motor and sensory components
The brain stem holds the medulla oblongata. What is the function of the medulla oblongata?
Transmits motor impulses from the brain to the spinal cord
GABA plays an important role in preventing overexcitability.
True
The central nervous system consists of the brain and spinal cord.
True
The body makes norepinephrine using what from the diet?
Tyrosine
The physiology instructor explains to the nursing students that beta-2 stimulation leads to:
Vasodilation of vessels
Which areas are responsible for speech comprehension?
Wernicke's area
A client has a neurologic disorder characterized by a deficiency of acetylcholine. In what location is acetylcholine normally synthesized?
Within cholinergic nerves themselves
Most acute CNS responses are caused by fast-acting neurotransmitters, which include:
acetylcholine, dopamine, norepinephrine, and serotonin.
Which receptor is responsible for increasing blood pressure?
alpha1 receptors
Norepinephrine is mainly:
an excitatory neurotransmitter that stimulates the brain to generalized increased activity.
Sympathetic stimulation of the heart causes:
an increased rate and force of myocardial contraction.
The CNS structure involved in all higher order functions, including conscious processes containing both motor and sensory areas, is the:
cerebral cortex.
After teaching a group of students about the functions of the nervous system, the instructor determines that the teaching was effective when the students identify that a function is:
control of body functions
After teaching a group of students about the functions of the nervous system, the instructor determines that the teaching was effective when the students identify that a function is:
control of body functions.
The nurse is caring for a client who is known to have deficient levels of dopamine because of a dietary lack of tyrosine. The nurse should expect to assess for evidence of:
decreased adrenergic response.
The nursing instructor is explaining the role of the parasympathetic nervous system in influencing body functions. Which change in a patient's body functions would be directly related to the stimulation of the parasympathetic nervous system?
decreased heart rate
Which of the following effects might occur following the administration of a cholinergic drug?
decreased heart rate
A client presented with signs and symptoms of hypothyroidism and subsequent diagnostic testing revealed low levels of thyrotropin-releasing hormone (TRH) and thyroid stimulating hormone. The care team should focus assessments and interventions on the client's:
hypothalamus
A nurse is caring for client experiencing pain. The client describes the pain as "9" on a scale of 1 to 10, with 10 being the worst pain. Which are expected SNS responses by the client?
increased blood pressure increased rate of respiration pupillary dilation
A 46-year-old male client sustained a closed head injury four hours ago. He now presents to the emergency department because he is having difficulty breathing. This is a result of swelling around the:
medulla oblongata
A 46-year-old male client sustained a closed head injury four hours ago. He now presents to the emergency department because he is having difficulty breathing. This is a result of swelling around the:
medulla oblongata.
The CNS structure containing groups of neurons responsible for vital cardiac, respiratory, and vasomotor functions is the:
medulla oblongata.
A nurse is caring for a client who has excessive salivation. Which muscarinic receptor is responsible for activation of the salivary glands?
muscarinic1
Several factors impact synaptic transmission. What would a nurse know increases synaptic transmission?
neurotransmitter
A client's neuron has repolarized. The nurse understands that this neuron:
now has more sodium ions outside its membrane
The cell body of one of a client's nerves is intact but communication with the muscle which it normally innervates has been severed by a laceration. The nurse teaches the client that normal resumption of nerve function will depend on:
regeneration of the nerve's axon.
The nurse is providing an overview of the structure and function of the nervous system to a client with a new diagnosis of multiple sclerosis. The nurse describes how a stimulus normally travels down the axon of a nerve and stimulates an effector cell by:
releasing one or more neurotransmitters into the synapse.
A comatose client is being cared for by a critical care nurse who documents that the client responds only to very painful stimuli by fragmentary, delayed reflex withdrawal. The nurse knows that reflexes in the body are centered in the:
spinal cord.
The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by:
stimulating beta2-receptors.
A client has begun to experience post-operative pain and the client's heart rate has increased from 72 beats per minute to 96 beats per minute. The nurse should attribute this change to the effect of:
stimulation of beta1 receptors in the sympathetic nervous system.
Characteristics that allow neurons to communicate with other body cells include:
the ability to be stimulated and to convey electrical impulses.
A client is acutely ill with a brain abscess and the family has questioned why the client is not receiving intravenous antibiotics. When providing education to the family, the nurse should explain:
the structure and function of the blood-brain barrier.
A client has taken a blow to the back of the head and the hindbrain is thought to have a lesion. What nursing assessments should the nurse include when monitoring for effects of a lesion in this region? (Select all that apply.)
• Blood pressure • Swallowing assessment • Respiratory assessment
Which are the properties of the neurotransmitter dopamine? Select all that apply.
• It is an adrenergic neurotransmitter. • It is essential for normal function of the brain. • It produces vasodilation in the periphery.
Place these events in neurotransmission in the correct sequence from first to last.
• Neurotransmitter molecules are released from synaptic vesicles. • Neurotransmitter molecules cross the synapse. • Neurotransmitter molecules bind to receptors in the cell membrane of the postsynaptic neuron. • Neurotransmitter molecules exert their effects on postsynaptic neurons.
Magnetic resonance imaging of a client's brain indicates a lesion in Wernicke's area. What assessment should the nurse perform when gauging the effects of this lesion?
Assess the client's ability to comprehend spoken instructions.
The nurse is performing an assessment of a client's neurologic system. What nursing assessment best addresses the functioning of the client's limbic system?
Assessing the client's mood and affect
A client's recent history and neuroimaging results suggest a disorder involving the reticular activating system (RAS). What assessment should the nurse prioritize in this client's care?
Assessment of sleep-wake cycles
A client has a diagnosis of Parkinson disease, a health problem that has effects on motor function and cognition. What neurotransmitter is most likely deficient in this client's CNS?
Dopamine
The nurse has admitted a client who has been diagnosed with multiple sclerosis. The nurse should choose assessments and interventions that address the effects of what pathophysiological process?
Distortions in the structure and function of Schwann cells
A nurse is reviewing the structure and function of the nervous system in preparation for working on a neurological floor. What characteristic of neurons should the nurse identify?
Neurons convey action potentials to other neurons without being in physical contact.
The body uses tyrosine in the diet to make what substance?
Norepinephrine
A client is brought to the emergency room following a motor vehicle accident in which the client sustained head trauma. The client reports blindness in the left eye. The nurse would be correct in documenting this abnormal finding as corresponding to which cerebral lobe?
Occipital
A nurse is reading an article about sleep and arousal that includes a discussion of a neurotransmitter. Which neurotransmitter would most likely be discussed?
Serotonin
A patient reports depression and insomnia. A patient with these issues could have an abnormality of which neurotransmitter?
Serotonin
Nerve stimulation has caused the release of serotonin into many of a client's synaptic clefts, causing stimulation of the effector cell. How will the effector cell be returned to a resting state so that it can be stimulated again?
Serotonin will be reabsorbed by the axon of the presynaptic nerve
The functions of the autonomic nervous system (ANS) can be broadly described as:
activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues.
Stimulation of a nerve results in:
depolarization
The nurse is planning the care of a client who has been diagnosed with a cerebellar disorder. What should the nurse prioritize in this client's plan of care?
Implement falls precautions
A young woman who lives alone comes home at night to find a man in her apartment. What body responses would be expected for the young woman?
Increased BP, increased heart rate, and pupil dilation
What is the resulting physiologic effect when the parasympathetic nervous system is stimulated?
Increased GI motility
The nursing instructor is talking with their clinical group about the central nervous system. What should the instructor tell the students about the function of the spinal cord?
Serves as a conduit for impulses to and from the brain
A signal has reached the terminus of a client's nerve and is in the space where the nerve is closest to the effector cell in a muscle. At what location is this signal?
Synapse
A client's nerve cell is at rest. What is true of this nerve cell at this time?
The membrane is permeable to potassium ions
What is the defining criterion of an adrenergic nerve?
The nerve can produce epinephrine
A nurse is reviewing the structure and function of the blood--brain barrier . This anatomical feature would have the greatest effect on what aspect of nursing care?
Administering antibiotics to treat brain infections
A client has dysfunction in his GABA neurotransmission. Which disorder would the client be likely to exhibit?
Anxiety disorders
A client has had an injury to the cerebellum. The nurse is collecting data from the client and family to document in preparing an individualized nursing care plan. Which is the best description of the function of the cerebellum that has to be considered when collecting data from the client?
Responsible for muscle control
The nurse accompanies the health care provider into the client's room and remains after the client is told he has cancer and a poor prognosis. The client's respirations become rapid and deep, his pupils dilate and he appears diaphoretic. What type of response is the nurse witnessing?
Sympathetic nervous system (SNS) response
