EAQs neurotransmitters

a. The drug has a sedative effect.· Rationale: GABA is the opposite affect of Glutamate. It reduces anxiety and excitement.

According to the monograph a psychotropic drug enhances the gamma-aminobutyric (GABA) receptor activity. What effect would the drug have on the client?· a. The drug has a sedative effect.· b. The drug has a pain-relieving effect.· c. The drug stimulates gastric secretion.· d. The drug helps in improving cognitive performance.

b. A decrease in serotonin level·

Based on the current understanding of neurotransmitters, what event is responsible for a client's symptoms of profound depression?· a. An increase in dopamine level· b. A decrease in serotonin level· c. An increase in norepinephrine level· d. A decrease in acetylcholine level

2 Decrease levels of dopamine to decrease positive symptoms in schizophrenia

First-generation antipsychotics have which mechanism of action and therapeutic effect? 1 Increase levels of dopamine to decrease positive symptoms in schizophrenia 2 Decrease levels of dopamine to decrease positive symptoms in schizophrenia 3 Increase levels of dopamine to increase positive symptoms in schizophrenia 4 Decrease levels of dopamine to increase positive symptoms in schizophrenia

2 Decrease levels of dopamine to decrease positive symptoms in schizophrenia The dopamine hypothesis of schizophrenia originated from the observation that certain drugs that stimulate dopamine activity can induce psychotic symptoms. Increased levels of dopamine lead to positive symptoms of schizophrenia, which include hallucinations and delusions.

First-generation antipsychotics have which mechanism of action and therapeutic effect? 1 Increase levels of dopamine to decrease positive symptoms in schizophrenia 2 Decrease levels of dopamine to decrease positive symptoms in schizophrenia 3 Increase levels of dopamine to increase positive symptoms in schizophrenia 4 Decrease levels of dopamine to increase positive symptoms in schizophrenia

4 Deficient production of serotonin 1 Deficient production of norepinephrine

Which abnormality in neurotransmitter levels is a possible cause of depression? Select all that apply. One, some, or all responses may be correct. 1 Deficient production of norepinephrine 2 Excessive transmission of dopamine 3 Deficient production of gamma-aminobutyric acid (GABA) 4 Deficient production of serotonin 5 Excessive production of glutamate

1 Motor function and judgment

Which anticipated functional problems would the nurse focus initial interventions on when caring for an adult with a frontal lobe brain tumor? 1 Motor function and judgment 2 Sensory and calculation abilities 3 Interpretation of visual stimuli 4 Hearing and emotional expression

1 Less anxiety Clonazepam belongs to the class of benzodiazepines, which are the most commonly used antianxiety agents. Reporting less anxiety is a desired outcome of this therapy. This drug would not affect the patient's appetite, sleep pattern, or auditory hallucinations.

Which documented change in patient behavior would suggest that prescribed clonazepam is working? 1 Less anxiety 2 Normal appetite 3 Improved sleep pattern 4 Reduced auditory hallucination

1 Less anxiety Clonazepam belongs to the class of benzodiazepines, which are the most commonly used antianxiety agents. Reporting less anxiety is a desired outcome of this therapy. This drug would not affect the patient's appetite, sleep pattern, or auditory hallucinations.

Which documented change in patient behavior would suggest that prescribed clonazepam is working? 1 Less anxiety 2 Normal appetite 3 Improved sleep pattern 4 Reduced auditory hallucinations

1 Sedation

Which effect would a psychotropic drug that enhances gamma-aminobutyric (GABA) receptor activity have on a patient? 1 Sedation 2 Pain relief 3 Stimulation of gastric secretion 4 Improvement of cognitive performance

2 A decrease in serotonin level A decreased serotonin level is highly associated with depression. Increased dopamine, increased norepinephrine, and decreased acetylcholine levels are not associated with depression.

Which event would be responsible for a patient's symptoms of profound depression based on the current understanding of neurotransmitters? 1 An increase in dopamine level 2 A decrease in serotonin level 3 An increase in norepinephrine level 4 A decrease in acetylcholine level

2 Positron emission tomography (PET) PET scans provide information about brain function. CT, MRI, and skull radiography provide information about brain structure, not function.

Which imaging technique can provide information about brain function? 1 Computed tomography (CT) 2 Positron emission tomography (PET) 3 Magnetic resonance imaging (MRI) 4 Skull radiography

4 Positron emission tomography (PET) 5 Single-photon emission computed tomography (SPECT) PET uses an injected radioactive substance (tracer) that travels to the brain and shows up as bright spots on the scan. Data collected by the detectors are relayed to a computer.

Which imaging technique requires an injection of a substance that is then traced to gather data regarding brain function? Select all that apply. One, some, or all responses may be correct. 1 Electroencephalography (EEG) 2 Computed tomography (CT) 3 Magnetic resonance imaging (MRI) 4 Positron emission tomography (PET) 5 Single-photon emission computed tomography (SPECT)

1 Increased dopamine Norepinephrine and dopamine are increased in schizophrenia. GABA is decreased in schizophrenia. Potassium and glutamate are not neurotransmitters associated with schizophrenia.

Which imbalance does the nurse know as likely attributed to schizophrenia? 1 Increased dopamine 2 Increased serum potassium 3 Increased gamma-aminobutyric acid (GABA) 4 Decreased number of glutamate receptors

2 "SGAs are capable of treating a larger variety of mental illnesses." 3 "It's used to identify the newer form of antipsychotic medications." 4 "SGAs produce fewer side effects than the first-generation formulations do." 5 "They contain a higher ratio of serotonin to dopamine than first-generation forms do."

Which information would the nurse include in response to a patient who asks why the prescribed medication is referred to as a second-generation antipsychotic (SGA)? Select all that apply. One, some, or all responses may be correct. 1 "Some SGAs may cause excessive salivation and diarrhea." 2 "SGAs are capable of treating a larger variety of mental illnesses." 3 "It's used to identify the newer form of antipsychotic medications." 4 "SGAs produce fewer side effects than the first-generation formulations do." 5 "They contain a higher ratio of serotonin to dopamine than first-generation forms do."

3 Assessing sitting, standing, and lying blood pressure daily Risperidone blocks alpha and histamine receptors and can cause orthostatic hypotension and sedation, which can lead to falls, so the nurse would monitor the patient's sitting, standing, and lying blood pressure daily.

Which intervention would the nurse include in the plan of care for a patient who is beginning a new prescription for risperidone? 1 Monitoring intake and output daily 2 Educating the patient about foods that contain tyramines 3 Assessing sitting, standing, and lying blood pressure daily 4 Administering the drug with food to reduce gastrointestinal irritation

2 Sodium level

Which laboratory values would be assessed for in a patient taking lithium? 1 Hematocrit 2 Sodium level 3 Hemoglobin 4 Anion gap

2 Temporal The temporal lobe connects to the limbic system to allow expression of emotions. Any injury to the temporal lobe would result in abnormally fluctuating emotions. This lobe is also responsible for language comprehension. The frontal lobe is chiefly responsible for initiating voluntary activities. The occipital lobe interprets visual images and stores visual memories. The parietal lobe is chiefly concerned with the perception of sensation.

Which lobe of the cerebral cortex is injured when a patient with a traumatic brain injury is demonstrating abnormally fluctuating emotions? 1 Frontal 2 Temporal 3 Occipital 4 Parietal

4 Lithium Lithium can cause disturbances in fluid balance in various body compartments. Sodium and potassium play a strong role in regulating fluid balance.

Which medication when administered calls for careful nursing assessment of fluid and electrolyte balance? 1 Fluvoxamine 2 Clozapine 3 Lamotrigine 4 Lithium

3 Magnetic resonance imaging (MRI) 1 Computed tomography (CT

Which neuroimaging technique demonstrates structural rather than functional problems? Select all that apply. One, some, or all responses may be correct. 1 Computed tomography (CT) 2 Electroencephalography (EEG) 3 Magnetic resonance imaging (MRI) 4 Positron emission tomography (PET) 5 Single-photon emission computed tomography (SPECT)

4 Gamma aminobutyric acid (GABA) The neurotransmitter GABA plays a role in modulating neuronal excitability and anxiety. Many antianxiety (anxiolytic) drugs increase the effectiveness of this neurotransmitter, primarily by increasing receptor responsiveness.

Which neurotransmitter is most closely related to anxiety? 1 Dopamine 2 Glutamate 3 Monoamine oxidase 4 Gamma aminobutyric acid (GABA)

4. GABA

Which neurotransmitter is most closely related to anxiety? 1 Dopamine 2 Glutamate 3 Monoamine oxidase 4 Gamma aminobutyric acid (GABA)

1. Dopamine 2. Norepinephrine 4. GABA

Which neurotransmitter is responsible for the hallucinations, anxiety, and altered thought processes by a patient who is experiencing a psychotic episode? Select all that apply. One, some, or all responses may be correct. 1 Dopamine (D2) 2 Norepinephrine 3 Serotonin (5-HT2) 4 Gamma aminobutyric acid (GABA) 5 Acetylcholine (ACh)

2 Norepinephrine, dopamine, and serotonin Norepinephrine, dopamine, and serotonin are all neurotransmitters involved in a diagnosis of depression. Acetylcholine is increased with depression rather than decreased, and GABA is associated with anxiety.

Which neurotransmitters are decreased with a diagnosis of depression? 1 Epinephrine, norepinephrine, and acetylcholine 2 Norepinephrine, dopamine, and serotonin 3 Acetylcholine, gamma-aminobutyric acid (GABA), and serotonin 4 GABA, dopamine, and epinephrine

1 Sleep hygiene measures for a 40-year-old patient diagnosed with major depressive disorder (MDD) The hypothalamus maintains homeostasis. It regulates temperature, blood pressure, perspiration, libido, hunger, thirst, and circadian rhythms, such as sleep and wakefulness, so improving sleep hygiene measures for a patient with MDD indicates a hypothalamus imbalance. Hypothalamus dysfunction is not associated with ODD, anorexia nervosa, or dementia.

Which nursing intervention would recognize an imbalance of a patient's hypothalamus? 1 Sleep hygiene measures for a 40-year-old patient diagnosed with major depressive disorder (MDD) 2 Limit setting for a 14-year-old patient diagnosed with oppositional defiance disorder (ODD) 3 Staff to accompany a 30-year-old patient diagnosed with anorexia nervosa to the bathroom 4 Frequent reorientation to time and place for a 79-year-old patient diagnosed with dementia

2 Monitoring for abnormal involuntary movements Risperidone has a high rate of extrapyramidal side effects (EPSs), even at doses only slightly higher than the effective dose, thus making it imperative to monitor for EPSs. Risperidone administration does not require monitoring blood levels, and it does not cause mania or memory changes

Which nursing intervention would the nurse take when administering risperidone? 1 Monitoring blood levels to avoid toxicity 2 Monitoring for abnormal involuntary movements 3 Observing for secondary mania 4 Observing for memory changes

2 Monitoring for abnormal involuntary movements Risperidone has a high rate of extrapyramidal side effects (EPSs), even at doses only slightly higher than the effective dose, thus making it imperative to monitor for EPSs. Risperidone administration does not require monitoring blood levels, and it does not cause mania or memory changes.

Which nursing intervention would the nurse take when administering risperidone? 1 Monitoring blood levels to avoid toxicity 2 Monitoring for abnormal involuntary movements 3 Observing for secondary mania 4 Observing for memory changes

4 Inhibiting the reuptake of norepinephrine and serotonin Originally termed tricyclic antidepressants (TCAs), these agents are more accurately called cyclic antidepressants(CAs) because newer members of this class have a four-ring structure

Which physiological response is caused by tricyclic antidepressants such as amitriptyline? 1 Inhibiting monoamine oxidase inhibitors that break down norepinephrine 2 Inhibiting nerve activity, which prevents overexcitability or stimulation 3 Blocking the reuptake of serotonin, which increases norepinephrine levels 4 Inhibiting the reuptake of norepinephrine and serotonin

2 Monitor blood pressure. 4 Reduce tyramine intake. 5 Do not take over-the-counter medication without provider approval.

Which priority teaching would the nurse include for a patient who is beginning therapy with a monoamine oxidase inhibitor (MAOI) medication? Select all that apply. One, some, or all responses may be correct. 1 Take the medication at bedtime. 2 Monitor blood pressure. 3 Report double vision. 4 Reduce tyramine intake. 5 Do not take over-the-counter medication without provider approval.

4 "The study will show how well the blood is flowing to active areas of your brain." fMRI is capable of providing a high-resolution, 3D-like cross-section of the brain. Such a view would allow an evaluation of blood flow to the ventricles, which is usually impaired in patients diagnosed with schizophrenia.

Which statement by the nurse best addresses a patient's concerns about the purpose of a functional magnetic resonance imaging study (fMRI) test in the diagnostic process for schizophrenia? 1 "It's a painless way to see inside the brain and view its structures." 2 "It's a series of cross-sectional pictures of the structure of your brain." 3 "This method reduces the brain's exposure to x-rays and radioactive isotopes." 4 "The study will show how well the blood is flowing to active areas of your brain."

3 Diazepam binds with gamma aminobutyric acid (GABA) receptors.

Which statement explains how the prescribed drug diazepam relieves anxiety? 1 Diazepam binds with alpha (α1) receptors. 2 Diazepam binds with serotonin (5HT1) receptors. 3 Diazepam binds with gamma aminobutyric acid (GABA) receptors. 4 Diazepam binds with dopamine (D2) receptors.

3 Diazepam binds with gamma aminobutyric acid (GABA) receptors. Diazepam belongs to the class of benzodiazepines. These drugs relieve anxiety by binding to GABA receptors. GABA is the major inhibitory neurotransmitter in the central nervous system. Therefore, blocking GABA receptors would prevent inhibition of the central nervous system and relieve anxiety. Diazepam does not bind with α1, 5HT1, or D2 receptors. Blocking α1 and 5HT1 receptors would cause depression. Blocking D2 receptors would relieve symptoms of schizophrenia, such as hallucinations and delusions.

Which statement explains how the prescribed drug diazepam relieves anxiety? 1 Diazepam binds with alpha (α1) receptors. 2 Diazepam binds with serotonin (5HT1) receptors. 3 Diazepam binds with gamma aminobutyric acid (GABA) receptors. 4 Diazepam binds with dopamine (D2) receptors.

4 A drug that inhibits norepinephrine activity The patient is extremely alert and is startled every time the nurse enters the room. This indicates that the patient has high levels of norepinephrine, which can create a feeling of hyperarousal; therefore, this patient should be prescribed a drug that inhibits norepinephrine activity, such as atomoxetine.

Which type of drug would the nurse most expect the health care provider to prescribe for a patient who reports being unable to sleep and is startled easily? 1 A drug that inhibits dopamine activity 2 A drug that inhibits histamine activity 3 A drug that inhibits substance P activity 4 A drug that inhibits norepinephrine activity

4 A drug that inhibits norepinephrine activity The patient is extremely alert and is startled every time the nurse enters the room. This indicates that the patient has high levels of norepinephrine, which can create a feeling of hyperarousal; therefore, this patient should be prescribed a drug that inhibits norepinephrine activity, such as atomoxetine. Dopamine is involved in fine-muscle movement and integration of emotions and thoughts, and it is inhibited by drugs such as amineptine. Histamine is involved in the inflammatory process and stimulates gastric secretion. It is inhibited by drugs such as fexofenadine. Substance P is associated with the modulation of pain sensation.

Which type of drug would the nurse most expect the health care provider to prescribe for a patient who reports being unable to sleep and is startled easily? 1 A drug that inhibits dopamine activity 2 A drug that inhibits histamine activity 3 A drug that inhibits substance P activity 4 A drug that inhibits norepinephrine activity

2 It prevents the destruction of norepinephrine.

hich statement explains the mechanism by which a tricyclic antidepressant helps relieve depression? 1 It prevents the destruction of monoamine oxidase. 2 It prevents the destruction of norepinephrine. 3 It stimulates the production of monoamine oxidase. 4 It stimulates the production of norepinephrine.