Chapter 8 NURS3100 (Biological Basis)

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The nurse is teaching about effective administration of methylphenidate to the parents. What education given by the nurse is appropriate?

"Administer the drug early in the morning."

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."

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 serotonin in the body produces symptoms such as aggression, hostility, and compulsiveness."

The client presents to the mental health clinic with reports of fibromyalgia, migraines, and GI distress. The nurse talks about the different neurotransmitters and what each neurotransmitter does. How would you elaborate on the type of symptoms this client is demonstrating?

"Lack of serotonin in the body produces symptoms such as irritability, sleep disturbances, and compulsiveness."

A client has been discharged from the hospital with a prescription for lorazepam. Which instruction should the nurse provide to this client?

"Make sure that you don't drink any alcohol when you're taking this medication."

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?

"Molecules that control the opening/closing of ion channels"

A client diagnosed with bipolar disorder asks the nurse, "Why did I get this illness? I don't want to be sick." What response should the nurse provide to best answer the client's question?

"We don't fully understand the cause, but mental illnesses do seem to run in families."

Which client is most likely to benefit from treatment with an antiparkinsonism agent?

A client who has a medication-induced movement disorder

A nurse is teaching family members about the brain's connection to behaviors commonly seen in mental illnesses. How can the nurse best explain the term "neurotransmitter" to the family?

A molecular substance released in the brain.

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.

The body's first line of neurological defense against stressors involves what?

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

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

What part of the brain would be responsible for activities such as walking and dancing?

Cerebellum

Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells?

Chemically

A client is experiencing acute stress leading to the stimulation of increased gastric acid. In this situation, which body system uses acetylcholine as a neurotransmitter?

Cholinergic

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

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.

Contraindications Adverse reactions Indications for use Food and drug interactions

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 hippocampus

A client with diminished serotonin levels would likely experience which symptom?

Depression and impulsivity

A client has been diagnosed with Parkinson's disease. His symptoms of spasticity are related to a decrease in which neurotransmitter?

Dopamine

The nurse is educating the client and family members regarding schizophrenia. The nurse explains to them that schizophrenia is associated with an abnormality of which structure of the cerebrum?

Frontal lobe

A decrease in which neurotransmitter has been implicated in seizure disorders?

GABA

The nurse is teaching the client with anxiety about the mechanisms of benzodiazepines. Which is increased with this medication?

GABA

Which of the following is an inhibitory neurotransmitter?

GABA

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?

Hypothalamus

A client is returning from military service and has been diagnosed with post-traumatic stress disorder (PTSD). Dysfunction in which brain structure contributes to the rage and fear experienced in PTSD?

Hypothalamus

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?

Intramuscularly

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 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:

It may take a few weeks for the medication to become effective; activity will help to foster compliance.

Several neuroimaging techniques are available for researchers and practitioners. What value does this technology have in diagnosing disorders of the brain?

It provides data about the structures of the brain correlated with their activity.

Which correctly describes the primary effect of a selective serotonin reuptake inhibitor (SSRI) antidepressant drug?

Its ability to block the reuptake of serotonin

The hypothalamus affects the body primarily through which action?

Maintaining homeostasis

The brain stem consists of which structure?

Midbrain

Dietary modifications are most likely necessary when a client is being treated with which antidepressant?

Monoamine oxidase inhibitors (MAOIs)

Sensory deprivation in infancy and childhood can adversely affect brain development. Which characteristic of the brain is involved in this process?

Neuroplasticity

A client has a lithium level of 1.2 mEq/L. Which intervention by the nurse is indicated?

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?

Occipital

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

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

Serotonin

Which antidepressant drug is a preferred drug for clients at high risk of suicide?

Sertraline

In the discharge instructions for a client who is taking alprazolam, the nurse should include what?

Sudden cessation of alprazolam can cause rebound insomnia and nightmares.

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?

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 dislikes the weight gain associated with antipsychotic therapy.

Though the client does not exhibit any signs or symptoms of depression, a client's physician has prescribed a low dose of the antidepressant mirtazapine. What is the most likely rationale for the physician's action?

To make use of an off-label application of the medication (insomnia)

Which is the primary cholinergic neurotransmitter found in greatest concentration in the peripheral nervous system?

acetylcholine

A client is receiving clozapine. For which life-threatening disorder should the nurse be alert when assessing this client?

agranulocytosis

Two nursing students are giving a presentation on the limbic system. Which can they accurately include as actions of this brain structure?

behavior

In which way do neurons communicate through the use of synapses?

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?

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?

dopamine

Serotonin plays a role in which of these areas? Select all that apply.

emotion cognition sensory perceptions

Which neuropeptide suppresses pain and modulates mood and stress?

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

The function of the thalamus and the hypothalamus is to coordinate:

internal and external responses.

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.

limbic system

Which functions are controlled by the extrapyramidal motor system? Select all that apply.

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