Ch. 18 Disorders of Though, Emotion, and Memory
A 20-year-old college student presents to the campus medical clinic because of unshakable despondency in recent months and is diagnosed with depression. What treatments should the nurse expect to be prescribed? A. Medication that inhibits the reuptake of serotonin in his pre-synaptic space. B. Drugs that inhibit the accumulation of cyclic adenosine monophosphatase (cAMP). C. Benzodiazepines such as clonazepam that modulate his GABA receptors. D. Cholinesterase inhibitors that potentiate the action of available acetylcholine.
Answer: A
A 50-year-old woman has experienced devastating consequences in her family and work life as a result of her longstanding alcohol addiction. Her levels and pathways of which neurotransmitter are likely to differ from an individual's without addiction? A. Dopamine B. Acetylcholine C. Serotonin D. Norepinephrine
Answer: A
A client has been diagnosed with an anxiety disorder and has been started on a selective serotonin reuptake inhibitor (SSRI) and a benzodiazepine (BZD). What teaching is most important for the nurse to provide? A. Due to their addictive properties, it is important you only take the BZD for a short period of time. B. SSRIs are used for depression, not anxiety. You should clarify with your health care provider. C. These medications should not be taken at the same time of day due to serious interactions. D. For your safety, it is important that you take the BZD at bedtime as it causes extreme drowsiness.
Answer: A
A clinical nurse specialist is asked to assess a client who has returned to the emergency department for the fourth time this year with a suspected myocardial infarction. All tests have consistently been negative and it is believed the origin of the symptoms are psychological; the client has been given antianxiety medication. What information should the nurse gather to best determine a possible cause for the client's symptoms? A. History of childhood trauma B. Cardiovascular health parameters C. Current rating on an anxiety scale D. History of substance use
Answer: A
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 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.
Answer: A
The family member of a client with bipolar disorder reports the client is in a manic phase. What instructions should the health care provider give the family member to watch for, because it can lead to harm? A. The client may self-medicate with alcohol or recreational drugs. B. The client will eventuallly slow down and take a nap. C. The client may become quiet and stare off in space. D. The client will begin to hallucinate and may become belligerent against the family.
Answer: A
The nurse is caring for a client who is experiencing hallucinations and delusions during an acute phase of schizophrenia. What class of medication should the nurse anticipate the health care provider will prescribe? A. An antipsychotic such as risperidone B. A benzodiazepine such as lorazepam C. A cholinesterase inhibitor such as donepezil D. An opioid receptor antagonist such as naltrexone
Answer: A
Which describes the most likely course of Wernicke-Korsakoff syndrome? A. If the symptoms are correctly diagnosed, most of the effects of the syndrome can be reversed through better nutrition and supplemental thiamine. B. The syndrome is uniformly fatal, with death most often occurring within a few months of onset. C. The syndrome has no treatment, but drugs may be used to treat its associated dyskinesias and behavioral disturbances. D. The course of the syndrome is relentless, and most affected persons will die of infection within 2 to 10 years.
Answer: A
A 70-year-old woman is brought to the emergency department by her daughter who noticed her mother has been experiencing intermittent confusion, uncoordinated movements and visual disturbances over the past several months. What should the nurse ask to best determine the cause of these symptoms? 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 internal bleeding?" D. "Is your mother facing significant stressors right now?" E. "Is your mother lonely?"
Answer: A, B
Which clinical manifestations would the nurse assess in the client 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
Answer: A, B, C
As the frontal lobe deteriorates with Huntington disease, for which manifestations should the nurse educate the family to watch? Select all that apply. A. slowing of cognitive function B. hostility C. flaccid muscle tone D. droopy eyelids E. impulsiveness
Answer: A, B, E
The nurse is caring for an 80-year-old client who has developed delirium during the shift. What focused assessments should the nurse conduct in an attempt to determine a cause for the delirium? Select all that apply. A. Recent medication changes B. Heart rate C. Urinary output D. Last bowel movement E. Dietary intake
Answer: A, C, D
A 44-year-old female has been diagnosed with major depression. Which neuroimaging finding 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
Answer: B
A 70-year-old client has just been diagnosed with a major depressive episode. For what other condition should the nurse assess? A. Metabolic syndrome B. Neurocognitive disorder C. Psychotic disorder D. Wernicke-Korsakoff syndrome
Answer: B
An adult client who was sexually abused as a child has been displaying some stress. The client seems to complain of increasing medical problems when 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.
Answer: B
The mother of an 18-year-old female has sought the advice of the nurse practitioner regarding her child's substance use. The mother states, "She has been very moody since becoming a teenager but she was so happy recently and making big plans." What should the nurse ask the mother next? A. "Do you know what type of substances your daughter uses?" B. "Is there a history of bipolar disorder in your family?" C. "Is your daughter interested in attending a support group?" D. "Were there any complications when you were pregnant with her?"
Answer: B
Which statement on the final diagnostic report regarding a computerized tomography (CT) of the head with contrast would lead health care providers to diagnose a client with Alzheimer disease? A. Large area of ischemia noted in temporal lobe B. Too numerous to count beta-amyloid (βA) deposits noted C. 90% obstruction in posterior cerebral artery D. Mural thrombus of vertebrobasilar arteries
Answer: B
The nurse is caring for a client who has been diagnosed with persistent depressive disorder. The nurse expects the client to manifest which symptoms? Select all that apply. A. The symptoms have been present for between 6 months and 1 year. B. The symptoms fluctuate from mild to severe. C. Altered sleep patterns D. Periods of increased energy followed by fatigue E. Altered eating patterns
Answer: B, C, E
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
Answer: C
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 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."
Answer: C
Which statement 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 pathophysiologic 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.
Answer: C
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 the wife's OCD is having on their daily lives. Which of the husband's 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."
Answer: D
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 brain structure? 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
Answer: D
Which client at the community mental health clinic should the nurse refer for immediate inpatient hospitalization? A. client who is displaying a posture in an odd fixed position B. client who is performing repetitive, idiosnycratic movements C. client who has a tendency to speak very little D. client who is hearing voices telling him or her to kill one's parents
Answer: D
Which of the following is a negative symptom of schizophrenia? A. Hallucinations B. Incoherence C. Word salad D. Affective flattening
Answer: D
