Psychiatric Mental Health Chapters 1 & 2

Clients diagnosed with myasthenia gravis have a decrease in which receptor? Acetylcholine Dopamine Serotonin Norepinephrine

Acetylcholine Clients diagnosed with myasthenia gravis, a neuromuscular disorder, have a decreased amount of acetylcholine. Acetylacholine is a neurotransmitter found in the brain, spinal cord, and peripheral nervous system, particularly at the neuromuscular junction of the skeletal muscle.

Which medication classification blocks serotonin reuptake? Antimanic Antidepressant Antibiotic Antianxiety

Antidepressant The medication classification, selective serotonin reuptake inhibitors, blocks the reuptake of serotonin. Antianxiety, antibiotic, and antimanic medications do not block the reuptake of serotonin.

Which is an inaccurate depiction of self-awareness? It involves self-reflection. It involves changing one's values or beliefs. There is an understanding that a nurse's belief may conflict with the client's. The nurse gains recognition of his or her feelings and beliefs.

It involves changing one's values or beliefs.

The basic units of structure and function in the nervous system are called what? Axons Glial cells Neurons Dendrites

Neurons

Benzodiazepines work by the following mechanism of action: They act directly on GABA receptors and are thought to increase the amount of GABA available. They act directly on dopaminergic neurons in the medulla. The mechanism of action of this category of drugs is unknown at this time. They act indirectly through a second messenger to affect levels of circulating GABA.

They act directly on GABA receptors and are thought to increase the amount of GABA available. Benzodiazepines act directly on GABA receptors and are thought to increase the quantity of GABA available to dampen neural overstimulation.

A client exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination? Cerebellum Midbrain Pons Medulla

cerebellum The cerebellum controls fine movement, balance, position sense, and integration of sensory input. Portions of the pons control the heart, respiration, and blood pressure. Cranial nerves IX through XII connect to the brain in the medulla. Cranial nerves III and IV originate in the midbrain.

Which mental health service is an advanced-level function? Self-care activities Psychotherapy Counseling Milieu therapy

psychotherapy

A nurse is caring for an older adult client with a psychiatric disorder who has been prescribed several medications. When educating the client on the medications, which explanation would be most appropriate? "Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic." "Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications." "Because of age-related circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly." "Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately."

"Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic." The activity of hepatic enzymes slows with age. As a result, the ability of the liver to metabolize medications may slow to as much as a fourfold decrease between the ages of 20 and 70 years. Thus, the client is at increased risk for toxicity. Gastric pH increases, and gastric emptying and motility decrease, which can influence absorption.

The prescription of clozapine requires weekly blood samples for at least: 6 months. 4 months. 2 months. 8 months.

6 months Although agranulocytosis can occur with any antipsychotic, the risk with clozapine is greater than with other antipsychotics. Therefore, prescription of clozapine requires weekly blood samples for the first 6 months of treatment, then every 2 weeks for the next 6 months if the absolute neutrophil count (ANC) stays normal. If treatment with clozapine continues after 1 year and the ANC remains normal, the client is then tested monthly for as long as the drug is taken.

In the 1970s, state mental hospitals came under increasing scrutiny and many were closed. What was the end result of this trend? Increased numbers of training programs for the mentally ill A lack of suitable housing for persons with mental illness Higher employment rates among previously institutionalized people Increased numbers of for-profit institutions for the mentally ill

A lack of suitable housing for persons with mental illness

Which is a major difference between the atypical antipsychotics (such as clozapine) and the typical antipsychotics (such as haloperidol)? Atypical antipsychotics block both serotonin and dopaminergic receptors. There are no side effects with the typical antipsychotics. Typical antipsychotics often lead to weight gain. Atypical antipsychotics can cause arrhythmias and kidney failure in rare cases.

Atypical antipsychotics block both serotonin and dopaminergic receptors. Typical antipsychotics do have side effects, often lead to weight gain, and, in rare cases, cause dysrhythmias and kidney failure. Thus, atypical antipsychotics block both serotonin and dopaminergic receptors is the correct answer.

Who was the first to introduce the concept of interpersonal relations and the therapeutic relationship? Florence Nightingale Hildegard Peplau Linda Richards Mary Nutting

Hildegard Peplau

The nurse is attempting to develop a therapeutic nurse-client relationship with a client but the client refuses to verbally communicate. Which action is best for the nurse to take to facilitate communication with the client? Identify that the client may be comfortable with the use of silence to reflect what is being said. Continue to ask the client various personal questions until they are answered. The nurse should evaluate what is being said that causes the client not to communicate. Ask the client if they would prefer that someone else be assigned to care for them.

Identify that the client may be comfortable with the use of silence to reflect what is being said.

An OB nurse is floated to the behavioral health unit to assist the staff with an overflow of newly admitted clients. When assisting with an admission, a client becomes agitated and physically aggressive with another nurse. Which is the priority action by the OB nurse? Inform the client that they will be put in a seclusion unit if the behavior does not stop. Place your hand on the client to distract them so the nurse can get away from the altercation. Step between the client and nurse to avoid the nurse from becoming harmed. Step away from the client and allow the specially trained staff to take over.

Step away from the client and allow the specially trained staff to take over.

A nurse is reading a journal article about practices involved during the moral treatment movement in psychiatric-mental health care. Which practice would most likely be included as being used during this time? asylums exorcisms blood letting incarceration

asylums

A psychiatric-mental health nurse is describing the various programs offered by the local community mental health center. When explaining how these programs work, the nurse would emphasize which concept? paternalistic decision-making complete autonomy autocratic leadership collaboration

collaboration

Which is a clinical activity of only the advanced practice registered nurse? Psychotherapy Milieu therapy Triage Crisis intervention

psychotherapy

A college student wakes up and notices a racing heart and dilated pupils. The student is scheduled to write an exam later that morning. Which system is responsible for this physiological response? The release of dopamine Cardiovascular irregularity Sympathetic nervous system Autonomic nervous system

sympathetic nervous system The sympathetic nervous system is stimulated by physical or emotional stress, such as strenuous exercise or work, pain hemorrhage, intense emotions, and temperature extremes. The specific body responses include: increased arterial blood pressure and cardiac output and pupil dilation to aid vision. The autonomic nervous system affects the cardiovascular function to decrease heart rate responses. The patient does not suffer from a cardiac irregularity. The release of dopamine will not affect pupillary response.

After educating a client who is receiving phenelzine, the nurse determines that the education was successful when the client states the need to avoid consuming which food or beverage? Fresh cottage cheese Soy Milk Tap beers Cooked sliced ham

tap beers Phenelzine is a monoamine oxidase inhibitor. The client needs to avoid foods high in tyramine, such as tap beers, matured and aged cheeses, dried aged and fermented meats, broad bean pods, concentrated yeast extract, sauerkraut, and soy sauce.

A nurse is providing community education about the prevention of mental illness. In response to the question, "What does it mean to be mentally healthy?" which is the nurse's best response? "Mental health is defined as behavior accepted as normal by the major cultural group." "Mental health is the absence of mental illness." "Mental health is difficult to define and depends on cultural norms." "Mental health is marked by productivity, fulfilling relationships, and adaptability."

"Mental health is marked by productivity, fulfilling relationships, and adaptability."

A client is prescribed medication for a psychiatric disorder. After 3 days, the client reports being constipated. Which instruction would the nurse give the client? "Ask your psychiatrist to prescribe a stool softener for you." "You need to eat more fruits and vegetables and drink more water." "You need to eat more high-protein foods such as meat and peanut butter." "This side effect should disappear within a week or so."

"You need to eat more fruits and vegetables and drink more water." The nurse should instruct the client to increase fiber and fluid intake. A mild laxative, exercise, and fiber supplement also may help the client's constipation. High-protein foods would have no effect on constipation. Stool softeners may be appropriate if an increase in fiber and fluids is ineffective. The side effect will not necessarily disappear.

The psychiatric-mental health nurse needs to have a basic understanding of information that is unique to individual medications. Which factors that affect pharmacokinetics should the nurse know? Select all that apply. Adverse reactions Cost of the medication Indications for use Contraindications Food and drug interactions

Adverse reactions, indications for use, contraindications, food and drug interactions When responsible for the administration of medications, the psychiatric-mental health nurse needs to have a basic understanding of factors affecting pharmacodynamics and pharmacokinetics that include individual drugs' contraindications, adverse reactions, indications for use, and food and drug interactions. Cost of medication is useful knowledge for cost containment; however, it does not impact client safety. Therefore, it is not considered a priority with regard to medication knowledge.

When comparing the theories of mental illness popular in ancient Greece with those popular in the Middle Ages, which is more applicable to the Middle Ages? Mental illness was considered a disturbance of the four body fluids, or "humors." Emotional disorders were believed to be an organic dysfunction. Belief in demonic possession and exorcism was common. Treatment included sedation, good nutrition and hygiene, and music and recreation.

Belief in demonic possession and exorcism was common.

The major goal of the Community Mental Health Act of 1963 was what? Develop centers in which biopsychiatric research could take place within the community. Attract more health care providers into local psychiatric clinics. Build mental health centers that would provide mental health care within the local community. Facilitate the integration of biology with the psychosocial components of treatment.

Build mental health centers that would provide mental health care within the local community.

The nurse is working as a case manager in an inpatient psychiatric unit and preparing discharge planning for a client that is homeless. Which will be the primary goal of the case manager when coordinating the discharge care of this client? Requiring family members to take responsibility for the care of the client upon discharge from the facility Coordinating all types of care so that the client does not receive fragmented care Ensuring the client is maintained in the inpatient facility for an indeterminant amount of time to receive care Obtaining the funds for the client's medical care and medications to be paid for

Coordinating all types of care so that the client does not receive fragmented care

The nurse has been unsuccessful in the psychiatric clinical placement and will be obliged to repeat it next semester. The criteria for passing or failing were based on the Psychiatric-Mental Health Nursing Scope and Standards of Practice, which are? Future goals for the nursing profession as a whole Descriptions of the responsibilities for which nurses are accountable Explanations of the ideal character of the psychiatric or mental health nurse The legal documents that allow a nurse to practice

Descriptions of the responsibilities for which nurses are accountable

The nurse has been unsuccessful in the psychiatric clinical placement and will be obliged to repeat it next semester. The criteria for passing or failing were based on the Psychiatric-Mental Health Nursing Scope and Standards of Practice, which are? The legal documents that allow a nurse to practice Future goals for the nursing profession as a whole Descriptions of the responsibilities for which nurses are accountable Explanations of the ideal character of the psychiatric or mental health nurse

Descriptions of the responsibilities for which nurses are accountable

A client with Parkinson's disease is hospitalized on a medical unit. The nurse would be correct in identifying which neurotransmitter decreased in this disease? Acetylcholine Dopamine Neurontin Serotonin

Dopamine Parkinson's disease develops from decreased availability of dopamine, while acetylcholine binding to muscle cells is impaired in myasthenia gravis. Therefore acetylcholine, neurontin, and serotonin are incorrect.

When reviewing the evolution of mental health care in the United States, a psychiatric-mental health nurse reads about the creation of state hospitals for mental health care. The nurse would attribute this concept of care as the idea supported by: Clifford Beers. Sigmund Freud. Dorothea Dix. Horace Mann.

Dorothea Dix

Which is the most commonly seen adverse side effect of typical antipsychotics? Accidental overdosage as a result of the narrow therapeutic range Auditory and visual hallucinations Serotonin syndrome Extrapyramidal symptoms and tardive dyskinesia

Extrapyramidal symptoms and tardive dyskinesia The greatest hazard of typical antipsychotics involves adverse effects, such as extrapyramidal symptoms (EPSs) and tardive dyskinesia. Risk of EPSs and other movement disorders is highest for clients who use older, high-potency neuroleptics, such as haloperidol or perphenazine, for long periods.

Which is a difference between counseling and psychotherapy? Counseling may be used in the care of acutely psychotic clients, but psychotherapy is contraindicated. Transference and countertransference are significant obstacles in psychotherapy that can be avoided in a counseling mode. Psychotherapy is reserved for clients who have a documented history of failing to respond to counseling. Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role.

Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role.

When providing care to a client, the psychiatric-mental health nurse is implementing the therapeutic use of self. The nurse is applying concepts based on the work of which individual? Florence Nightingale Sigmund Freud Hildegard E. Peplau Dorothea L. Dix

Hildegard E. Peplau

After teaching a client who is prescribed imipramine, a tricyclic antidepressant (TCA), about the drug, the nurse determines that the education was effective when the client makes what statement? "I don't have to worry about getting dizzy when I get up from lying down." "I need to avoid foods with fiber because diarrhea can occur." "I need to be careful because the drug can make me sleepy." "I might notice some excess saliva in my mouth at different times."

I need to be careful because the drug can make me sleepy Imipramine is a TCA and is associated with sedation, orthostatic hypertension, and anticholinergic effects such as dry mouth and constipation. The client needs to be careful with activities because the drug is sedating. The client should change positions slowly to minimize orthostatic hypotension. Sugarless candies, good oral hygiene, and frequent rinsing of the mouth are helpful to combat dry mouth. A high-fiber intake would be appropriate to decrease possible constipation.

A 46-year-old client sustained a closed-head injury 4 hours ago. The client now presents to the emergency department because the client is having difficulty breathing. This is a result of swelling surrounding which brain structure? Medulla oblongata Cerebrum Thalamus Pituitary

Medulla oblongata The hindbrain, which runs from the top of the spinal cord into the midbrain, is the most primitive area of the brain and contains the brain stem, where the pons and medulla oblongata are located. These areas of the brain control basic, vital functions, such as the respiratory centers, which control breathing; the cardiovascular centers, which regulate blood pressure; the chemoreceptor trigger zone and emetic zone, which control vomiting; the swallowing center, which coordinates the complex swallowing reflex; and the reticular activating system (RAS), which controls arousal and awareness of stimuli and contains the sleep center.

A client receives the first dose of fluphenazine. The next day, during the follow-up appointment, the nurse finds the client is confused and mute, and the client's temperature is 103°F. The client also presents with rigidity and diaphoresis. The nurse should investigate further for which condition? Parkinsonism Heatstroke Serotonin syndrome Neuroleptic malignant syndrome

Neuroleptic malignant syndrome The most serious and potentially fatal side effect of the typical antipsychotics is neuroleptic malignant syndrome, characterized by severe muscular rigidity, altered consciousness, disorientation, dysphagia, elevated creatinine phosphokinase, stupor, catatonia, hyperpyrexia, and labile pulse and blood pressure. This life-threatening condition can occur after a single dose of a neuroleptic; however, it is more common in the first 2 weeks of administration or with an increase in dose. It can continue for up to 2 weeks after discontinuation of the medication. Serotonin syndrome has some overlapping signs and symptoms, but it is characterized by hyperreflexia rather than rigidity and is usually the result of taking an MAOI and an SSRI.

During the mid-20th century, the focus of treatment centered on treating neurotransmitter dysfunction in the brain. As a result hospital stays were shortened due to the introduction of which? Psychopharmacology Hydrotherapy Insulin shock therapy Psychosurgery

Psychopharmacology

A client demonstrates sexually inappropriate behavior toward a student nurse. What is an effective way for the student to respond while protecting and respecting the client? Immediately inform the client that the behavior is unacceptable and will be reported to staff. React to the incident with a sense of humor at the time but minimize contact with the client in the future. Report the incident to staff and the clinical instructor so boundaries can be reenforced with the client. Ignore the behavior at the time it occurs but report it to staff before leaving clinicals for the day.

Report the incident to staff and the clinical instructor so boundaries can be reenforced with the client.

An older adult resident of a group home has been receiving treatment for schizophrenia for several decades. The nurse who oversees care at the facility believes that the resident may be developing tardive dyskinesia. What assessment findings would support this suspicion? Select all that apply. The client reports nightmares and frequent awakenings at night The client makes repetitive movements with the fingers The client often smacks lips when at rest The client recently fainted after getting up quickly from a chair The client exhibits delusional thinking that is uncharacteristic

The client makes repetitive movements with fingers The client often smacks lips when at rest Tardive dyskinesia is usually characterized by repetitive involuntary movements. Syncope, sleep disturbances, and symptom exacerbation are not suggestive of tardive dyskinesia.

The nurse is administering a sedative drug to a client before the magnetic resonance imaging (MRI) procedure. What are the possible reasons for which the nurse had to sedate the client? Select all that apply. The client may have claustrophobia. The client may have high blood pressure. The client may have severe anxiety. The client has a pacemaker. The client has not given consent for having the MRI.

The client may have claustrophobia The client may have severe anxiety The MRI procedure requires the client to lie down in a small closed chamber and be motionless for approximately 45 minutes. A client who has claustrophobia or severe anxiety may not be able to cooperate during the procedure. Thus, such clients require sedation. Clients with high blood pressure can undergo this procedure safely. High blood pressure is not an indication for the client to be sedated before procedure. Pacemakers are contraindicated for MRI. If the client has not given consent for MRI, the procedure should not be performed.

A nurse is performing an admission assessment. The client reports taking larger and larger doses of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting what possible outcome? Decreased therapeutic index Desensitization Toxicity Tolerance

Tolerance Tolerance is a gradual decrease in the action of a drug at a given dose or concentration in the blood. This decrease may take days or weeks to develop and results in a loss of the therapeutic effect of a drug, necessitating an increase in medication to achieve the desired effect.

An older adult reporting concerns of anxiety is prescribed diazepam (Valium) by a health care provider. The provider asks the office nurse to explain the problematic side effects of this medication to the client. Which instruction is most important for the nurse to emphasize about this drug? "You may feel dizzy and be prone to falls after taking this medication." "You may find that you have temporary memory disturbances." "You may experience minor urine incontinence from time to time." "You need to use this medication cautiously because it can cause dependence."

You may feel dizzy and be prone to falls after taking this medication Diazepam (Valium) is a benzodiazepine and may cause incontinence, memory disturbances, and dizziness in older adults. However, the risk for falls because of dizziness is a major concern, and this information needs to be emphasized with the client.

A hospitalized client who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. The client tells the nurse, "I just cannot sit still." The nurse documents this finding as which condition? Pseudoparkinsonism. Akathisia. Akinesia. Dystonia.

akathisia The client's inability to "sit still" and/or frequent pacing is termed "akathisia," an extrapyramidal effect of the antipsychotic medication. Akinesia is slowed movements. Dystonia involves involuntary muscle spasms that lead to abnormal postures, especially of the head and neck muscles. Pseudoparkinsonism includes rigidity, slowed movements, and tremor.

A client is currently experiencing a situational crisis and is experiencing shock and anxiety symptoms. The client is prescribed lorazepam as needed for anxiety. What would the nurse teach the client regarding the medication? Avoid grapefruit juice. Avoid alcoholic beverages. Drink 3 liters of water a day. Limit sun exposure.

avoid alcoholic beverages Medications cannot resolve a crisis but can decrease the emotional intensity the client is experiencing. Lorazepam is a benzodiazepine that may be prescribed. Education by the nurse includes: take the medication exactly as prescribed, do not abruptly stop the medication, avoid alcohol or other central nervous system depressants, avoid driving or other activities that require alertness, notify the prescriber before taking any other medications, change positions slowly, and report adverse reactions to the provider.

Which activity is a function solely of the advanced practice psychiatric-mental health nurse? Conducting individual psychotherapy Counseling and crisis management Intake screening and evaluation Conducting milieu therapy

conducting individual psychotherapy

The nurse is caring for a client diagnosed with Parkinson's disease. How would the nurse explain which transmitter is increased by taking antiparkinson's medication? norepinephrine serotonin epinephrine dopamine

dopamine Dopamine, a neurotransmitter, is involved in the control of complex movements. Dopamine is implicated in movement disorders such as Parkinson's disease. Dopamine levels are decreased in Parkinson's disease, and abnormally high activity of dopamine has been associated with schizophrenia. Norepinephrine, serotonin, and epinephrine are not correct.

When educating a black client regarding newly prescribed antipsychotic medication, it is vital that the nurse address which care issue? keeping scheduled appointments with the health care provider being aware of gastrointestinal side effects taking the medication exactly as prescribed early recognition of extrapyramidal symptoms

early recognition of extrapyramidal symptoms Thirty-three percent of black clients have been found to be slower than white clients in metabolizing psychotropic medications. This decreased metabolism can lead to an increased incidence of adverse effects, especially extrapyramidal symptoms. Taking the medication exactly as prescribed, being aware of gastrointestinal side effects, and keeping scheduled appointments with the health care provider represent recommendations applicable to all clients prescribed a psychotropic medication.

A client with a history of a traumatic brain injury is admitted for personality changes and labile mood. Upon assessment, the client has difficulty with problem solving and impaired working memory. The nurse identifies that which part of the brain was affected by the previous injury? frontal lobe occipital lobe temporal lobe parietal lobe

frontal Each hemisphere of the brain is divided by four lobes including the frontal, parietal, occipital, and temporal. The lobes work in coordinated ways, but each lobe is responsible for specific functions. The frontal lobes are responsible for working memory, insight, judgment, reasoning, self-evaluation, problem-solving, concept formation, and mood and personality.

The client cannot remember anything before an accident yesterday. Which brain structure might be injured? Reticular formation Hippocampus Midbrain Basal ganglia

hippocampus The hippocampus, part of the limbic system, controls emotions, memory, and learning. It is also thought to mediate feelings of aggression, sexual impulses, and submissive behavior. The midbrain is vital to life. It is the only brain area maintaining heart and lung function in an otherwise comatose person with no higher-level capacities. The reticular formation controls sleep and wakefulness and directs visual and auditory reflexes. The basal ganglia assume motor skills that have become automatic and also initiate and control activities and muscle tone.

The nurse prepares educational material for a client who is newly diagnosed with Alzheimer disease. Which structure of the limbic system should the nurse focus the teaching materials? amygdala thalamus hippocampus hypothalamus

hippocampus The hippocampus is involved in storing information, especially the emotions attached to memory. Deterioration of the nerves of the hippocampus and other related temporal lobe structures found in Alzheimer disease produces the disorder's hallmark symptoms of memory dysfunction. The other structures are not appropriate to focus on based on the client's diagnosis.

Which reason do clients cite most frequently as the cause for self-discontinuation of medication? Fear of becoming addicted Social stigma associated with taking psychotropic medications Desire to control their own lives Intolerable side effects

intolerable side effects Clients may have many reasons for failing to adhere to medication regimens. The most frequent reason is adverse effects, many of which are debilitating and difficult to manage.

A client with a diagnosis of schizophrenia lacks insight into the illness. The client presents with significantly declined function and is consistently nonadherent with medications. Which medication administration route is best suited for optimal treatment of this client's condition? Orally Intramuscularly Subcutaneously Intravenously

intramuscularly If a client is nonadherent and there is a significant decline in functioning, antipsychotic drugs are most often administered intramuscularly. Antipsychotic medications are not normally administered by the intravenous or subcutaneous routes, and oral administration is more challenging when a client is noncompliant with treatment.

Medical insurance coverage for medical illnesses is greater than for psychiatric illnesses. What term best describes this discrepancy? Limited access to services. Lack of parity. Medical noncompliance. Stigmatism related to medical coverage.

lack of parity

Which is considered the first-line treatment for bipolar disorder? Olanzapine Lithium Thioridazine Haloperidol

lithium Lithium is considered the first-line treatment for bipolar disorder. Lithium is the most established mood stabilizer.

Which is a true statement regarding Medicaid? It covers people with certain disabilities. It covers people 65 years of age and older. It covers people with permanent kidney failure. It covers individuals and families with low incomes.

low income

Maintaining a therapeutic environment and promoting growth through role modeling are components of which basic level function? Health teaching Case management Counseling Milieu therapy

milieu therapy

The student nurse is working with a client that presents to the mental health clinic with reports of loss of appetite, weight loss, and anhedonia. The student nurse discusses with the instructor that lack of a neurotransmitter may be affecting the client. How would the student explain what neurotransmitters do? "Connected by the corpus calosum, allows quick information exchange" "Governs basic emotions, needs, drives, and instinct" "Relay-switch of the brain, that filters information" "Molecules that control the opening/closing of ion channels"

molecules that control the opening/closing of ion chanels Neurotransmitters are the chemical substances that aid in the transmission of information throughout the body. Neurotransmitters either open or close ion channels. The neurotransmitters fit into specific receptor cells in the membrane of the dendrite, like a key fits a lock opening/closing ion channels. The limbic system, the thalamus, and the hemispheres of the brain are not molecules that control the opening/closing of ion channels. The limbic system governs basic emotions, needs, drives, and instinct. The thalamus is sometimes called the relay-switch of the brain, and it filters information. The two hemispheres of the brain are connected to the corpus callosum, allowing quick information exchange.

During the 1800s, Pinel believed that the cure for mental illness was ... use of chains. arrest and confinement. moral treatment. placement outside of the community.

moral treatment

Which client would not be able to undergo a magnetic resonance imaging scan (MRI)? A client with a pacemaker A client who is obese A client with a longstanding history of claustrophobia A client with a diagnosed anxiety disorder

pacemaker

A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter? Melatonin Calcitonin Serotonin Parathyroid

serotonin Abnormalities of serotonin are involved in mental depression and sleep disorders. Calcitonin is a hormone produced by the thyroid gland. Melatonin is a peptide hormone not a neurotransmitter. Parathyroid is a gland that secretes parathyroid hormone.

The family member of a client who experienced a stroke tells the nurse, "He just isn't the same anymore. His personality is different. I don't understand how a stroke can affect him in this way." Which response by the nurse is best? "Tell me what changes you have noted with the personality." "The stroke affected his frontal lobe, which is responsible for personality." "This is to be expected because the stroke affected the parietal lobe." "I will let the doctor know that you are concerned."

the stroke affected his frontal lobe, which is responsible for personality The nurse must address the client's family member's concern in addition to providing accurate information in a therapeutic manner; therefore, the best response by the nurse is "The stroke affected his frontal lobe, which is responsible for personality." Telling the client's family that the concern will be communicated with the health care provider is appropriate; however, the nurse has the knowledge to provide the family member with the reason for the personality change, so this response is not best. Asking for specific personality changes noted is appropriate; however, it does not address the cause of the change. Parietal lobe strokes do not affect personality; rather, a stroke in this area of the cerebrum affects sensory function.

A client is newly prescribed a medication that will block the effects of histamine postsynaptically for the treatment of a mental health disorder. The client asks, "What side effects should I anticipate with this new medication?" Which response by the nurse is accurate? "You should expect your blood pressure to increase." "You should expect to experience insomnia." "You should expect to feel drowsy." "You should expect weight loss."

you should expect to feel drowsy The function of histamine is not well known, but it appears to have a role in autonomic and neuroendocrine regulation. Many psychiatric medications can block the effects of histamine postsynaptically and produce side effects such as hypotension, sedation, and weight gain. Based on this information, the response by the nurse that is accurate is "You should expect to feel drowsy." This is due to the sedative effect. Blood pressure decreases, not increases. Sedation is a side effect; therefore, insomnia is not anticipated. Weight gain, not loss, is another anticipated side effect.