Mental Health Ch 8:Biologic Foundations of Psychiatric Nursing
A client is brought to the emergency department with reports of slurred speech, spasms, and jerky movements. The significant other shows the nurse a pill bottle and states that the client has been taking antipsychotic medications for "awhile". The nurse notices that an "improper dose" is ordered on the prescription bottle. How would the nurse explain what system is causing the movements? "Dysfunction of the corticospinal motor track may include masses such as strokes, subdural hemorrhage, abscesses and tumors" "Dysfunction of the pyramidal motor track can manifest plantar extension and hyperreflexia" " Dysfunction of the primary motor cortex can manifest in paralysis on the opposite side of the body" " Dysfunction of the extrapyramidal motor track can manifest serious neurologic symptoms including dystonia, pseudoparkinsonism, and akathisia"
" Dysfunction of the extrapyramidal motor track can manifest serious neurologic symptoms including dystonia, pseudoparkinsonism, and akathisia"
The anatomy instructor is discussing the central nervous system. A student asks where the cerebral cortex is located. What is the best answer? "It is located on the surface of the cerebrum." "It is located in the center of the cerebellum." "It is located at the base of the brain." "It is located between the left and right hemispheres of the brain."
"It is located on the surface of the cerebrum."
A client brings a spouse to the mental health clinic with reports that the spouse has been exhibiting a tendency to self-mutilate, experiences fits of intense rage, and is increasingly aggressive toward others. How should the nurse elaborate on the type of symptoms this client is demonstrating? "Lack of norepinephrine in the body produces symptoms such as obesity, fibromyalgia, and panic attacks." "Lack of histamine in the body produces symptoms such as anxiety, hypertension, and difficulty regulating body temperature." "Lack of dopamine in the body produces symptoms such as depression, fatigue, and lack of motivation." "Lack of serotonin in the body produces symptoms such as aggression, hostility, and compulsiveness."
"Lack of serotonin in the body produces symptoms such as aggression, hostility, and compulsiveness."
The nurse is assessing a client who suffered a head injury as a result of an altercation with two other individuals. The client has difficulty accurately recalling and reporting the events of the altercation and appears very emotional during the assessment. The nurse suspects which part of the brain received the greatest amount of injury? Cerebrum Cerebellum Medulla Amygdala
Amygdala
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.
The body's first line of neurological defense against stressors involves what? Norepinephrine Pituitary gland Arginine vasopressin Autonomic nervous system
Autonomic nervous system
A client diagnosed with a stroke is exhibiting expressive aphasia. Which area in the frontal lobe is responsible for the motor function of speech? Broca's area Wernicke's area Basal ganglia Limbic system
Broca's area
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 Pons Medulla Midbrain
Cerebellum
A client is having difficulty standing without assistance and is exhibiting swaying. The client has a history of falls. Which area of the brain is most likely affected? Cerebellum Hypothalamus Thalamus Hippocampus
Cerebellum
The client has difficulty with motor coordination and walks with an unsteady gait. Of the following brain structures, which is most likely affected in the client's brain? Cerebrum Medulla oblongata Hippocampus Cerebellum
Cerebellum
What part of the brain would be responsible for activities such as walking and dancing? Cerebellum Cerebrum Midbrain Brain stem
Cerebellum
Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells? Selectively Chemically Excitably Accessibly
Chemically
The client has seasonal affective disorder (SAD), in which depression parallels the shortening of the days during fall and winter. Which is most likely affected in the client? Circadian rhythm Hippocampus Medulla Cerebral cortex
Circadian rhythm
Which is the primary role of neurotransmitters? Excite the receptor cell located inside the synaptic cleft Inhibit the receptor cell found inside of glial cells Communicate information within the receptor cell Communicate information from one cell or cell group to another
Communicate information from one cell or cell group to another
A professional boxer has suffered several concussions while boxing. Since retirement, the client has experienced periods of depression and suffers from short-term memory loss. Which provides the best explanation for the neurological basis of the client's symptoms? Damage to the nucleus accumbeus Damage to the medulla Damage to the hippocampus Damage to the thalamus
Damage to the hippocampus
A client with diminished serotonin levels would likely experience which symptom? Fight-or-flight response Sleep disturbances Severe anxiety Depression and impulsivity
Depression and impulsivity
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
Abnormalities in which lobe is believed to be associated with schizophrenia? Frontal Occipital Temporal Parietal
Frontal
The nurse is teaching the client with anxiety about the mechanisms of benzodiazepines. Which is increased with this medication? Dopamine GABA Norepinephrine Epinephrine
GABA
The client cannot remember anything before an accident yesterday. Which brain structure might be injured? Hippocampus Midbrain Reticular formation Basal ganglia
Hippocampus
A client in the operating room goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The nurse knows that the area of the brain that regulates body temperature is what? Cerebellum Thalamus Hypothalamus Midbrain
Hypothalamus
Neuroplasticity influences psychiatric-mental health outcomes because it is or does what? Is the ability of nervous tissue to change structure and functioning in response to new experiences Determines a client's response to psychotropic medications Initiates the neuroendocrine-mediated physiologic events that prepare the body for fight or flight Is the process by which the information in RNA produces strings of amino acids
Is the ability of nervous tissue to change structure and functioning in response to new experiences
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 capses collusam. It has a temporal lobe. It has an occipital lobe.
It has a parietal lobe. It has a frontal lobe. It has a temporal lobe. It has an occipital lobe.
A nurse is formulating a teaching plan with the client and the client's family. The client has been newly diagnosed with depression, and the teaching plan includes medication, activities, and family support. For the client, the nurse knows that teaching is effective when the client and/or family state: Medication should be taken only when the client is feeling depressed and resists family activities. Medication should be taken on schedule only, and activities should be twice a week to prevent weight gain. Missed dosages should be taken right away, even when it is close to the next dose time, and activities should be increased. It may take a few weeks for the medication to become effective; activity will help to foster compliance.
It may take a few weeks for the medication to become effective; activity will help to foster compliance.
The brain stem consists of which structure? Midbrain Cerebellum Hypothalamus Thalamus
Midbrain
The physician orders a neurotransmitter for a client who has difficulty in regulating some chemicals in the brain. The nurse knows which is a neuromodulator? Neuropeptides Glutamate Dopamine GABA
Neuropeptides
Sensory deprivation in infancy and childhood can adversely affect brain development. Which characteristic of the brain is involved in this process? Neuroplasticity Reactive plasticity Adaptive plasticity Synaptic plasticity
Neuroplasticity
A nurse is teaching a patient about how impulses are transmitted and describes the factors that can impact this transmission. Which factor would the nurse most likely identify as increasing synaptic transmission? Reduction of chemicals Electrical impulse Calcium reaction Neurotransmitter
Neurotransmitter
A client has a lithium level of 1.2 mEq/L. Which intervention by the nurse is indicated? Call the physician for an increase in dosage. Do not give the next dose and call the physician. Increase fluid intake for the next week. No intervention is necessary at this time.
No intervention is necessary at this time.
A client is brought to the emergency room following a motor vehicle accident in which he sustained head trauma. The client is complaining of blindness in the left eye. The nurse would be correct in documenting this abnormal finding as corresponding to which of the following cerebral lobes? Temporal Occipital Parietal Frontal
Occipital
A client has been taking antidepressants for 2 years. The client tells the nurse that the medication no longer seems to be working. The nurse suspects that which situation is occurring? Refractoriness Supersensitivity Affinity Neurocircuitry
Refractoriness
After attending an anatomy and physiology review class on the nervous system, a group of nurses demonstrate understanding of the information when the group identifies which function as associated with the thalamus? Relays sensory information to the central nervous system Is responsible for voluntary movement Continually adjusts body temperature and heart rate Helps maintain red blood cell production
Relays sensory information to the central nervous system
After attending an anatomy and physiology review class on the nervous system, a group of nurses demonstrates an understanding of the information when the group identifies which function as associated with the thalamus? Relays sensory information to the central nervous system Is responsible for voluntary movement Continually adjusts body temperature and heart rate Helps maintain red blood cell production
Relays sensory information to the central nervous system
A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter? Serotonin Calcitonin Melatonin Parathyroid
Serotonin
Which antidepressant drug is a preferred drug for clients at high risk of suicide? Tranylcypromine Sertraline Imipramine Phenelzine
Sertraline
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? Autonomic nervous system Cardiovascular irregularity Sympathetic nervous system The release of dopamine
Sympathetic nervous system
A client is seen for frequent exacerbation of schizophrenia due to nonadherence to medication regimen. The nurse should assess for which common contributor to nonadherence? The client is symptom-free and therefore does not need to adhere to the medication regimen. The client cannot clearly see the instructions written on the prescription bottle. The client dislikes the weight gain associated with antipsychotic therapy. The client sells the antipsychotics to addicts in the neighborhood.
The client dislikes the weight gain associated with antipsychotic therapy.
Which is the primary cholinergic neurotransmitter found in greatest concentration in the peripheral nervous system? acetylcholine dopamine norepinephrine serotonin
acetylcholine
Two nursing students are giving a presentation on the limbic system. Which can they accurately include as actions of this brain structure? intellect engorgement suppression behavior
behavior
In which way do neurons communicate through the use of synapses? electrically excitatory chemically inhibitory
chemically
A nurse is reviewing the process of neuronal transmission. The nurse demonstrates understanding of this concept by identifying which part of the neuron as carring information into the neuron from other neurons? axon dendrite nucleus soma
dendrite
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 epinephrine dopamine serotonin
dopamine
Serotonin plays a role in which of these areas? Select all that apply. emotion cognition sensory perceptions breathing arterial blood pressure
emotion cognition sensory perceptions
Which neuropeptide suppresses pain and modulates mood and stress? endorphins melatonin substance P cholecystokinin
endorphins
A client taking an antipsychotic is exhibiting manifestations of neuroleptic malignant syndrome (NMS). Which area of the brain is involved with the increased temperature noted with NMS? hypothalamus thalamus amygdala hippocampus
hypothalamus
The function of the thalamus and the hypothalamus is to coordinate: internal and external responses. speech and communication. sensation. movement.
internal and external responses.
The most important reason that psychiatric nurses need to know about the brain is that ... it is the organ of the mind and governs all forms of human behavior. it is the center of all metabolic processes for drugs that are used for psychiatric disorders. it is responsible for the etiology of many mental disorders. it is the central location for transcription of genes related to behavior.
it is the organ of the mind and governs all forms of human behavior.
A nurse is instructing a client on taking lithium for bipolar disorder. The client will need to have blood draws every 2-3 days initially to determine what about the drug level? its rebound effect its efficacy its potency its half-life
its efficacy
The nurse is working with a client that has not been diagnosed yet. The client is aggressive, unable to control anger, and violent at times. The client was brought to the emergency deparment by local police. The nurse selects what system as the etiology for the clients' behavior? Classify the symptoms according to origin in the body. circulatory system peripheral nervous system limbic system endocrine system
limbic system
The nurse is working with a client that has not been diagnosed yet. The client is aggressive, unable to control anger, and violent at times. The client was brought to the emergency department by local police. The nurse selects what system as the etiology for the clients' behavior? Classify the symptoms according to origin in the body. circulatory system peripheral nervous system limbic system endocrine system
limbic system
Which functions are controlled by the extrapyramidal motor system? Select all that apply. muscle tone common reflexes automatic voluntary motor functioning memory Vision
muscle tone common reflexes automatic voluntary motor functioning
A client's medication history reveals the use of a medication that blocks the action of histamine. When assessing this client, which side effect would the nurse most likely assess? sedation hypertension weight loss diarrhea
sedation