Psych/Mental Health Chapter 6

The body's first line of neurological defense against stressors involves what? Norepinephrine Pituitary gland Arginine vasopressin Autonomic nervous system

Autonomic nervous system Explanation: The neural response of the Autonomic nervous system is instantaneous; it is the body's first line of defense against stressors.

The nurse provides care for a client who is diagnosed with Addison disease. Which question should the nurse ask the client to monitor for psychosocial symptoms? Select all that apply. "Are you experiencing fatigue?" "Do you crave salt with your meals?" "Do you have difficulty concentrating?" "Do you experience feelings of depression?" "Are you experiencing a decreased appetite?"

Correct response: "Are you experiencing fatigue?" "Do you have difficulty concentrating?" "Do you experience feelings of depression?" Explanation: Addison disease (i.e., hypoadrenalism) produces psychosocial symptoms including apathy, depression, fatigue, and occasionally psychosis. Based on these symptoms, the nurse asks questions related to fatigue, psychosis (e.g., difficulty concentrating), and depression. Craving salt with meals and a decreased appetite are physiologic symptoms of Addison disease; therefore, these questions are not included when monitoring for psychosocial symptoms related to this disease process.

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

Correct response: Dopamine Explanation: 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.

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

GABA

The hypothalamus affects the body primarily through which action? Maintaining homeostasis Processing sensory input Secreting melatonin Integrating motor activities

Maintaining homeostasis

The brain stem consists of which structure? Midbrain Cerebellum Hypothalamus Thalamus

Midbrain Explanation: The brain stem consists of the midbrain, pons, and medulla.

Which lobe of the brain assists in spatial perception? Frontal Temporal Parietal Occipital

Parietal

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

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

Correct response: Broca's area Explanation: The frontal lobe contains Broca's area, which controls the motor function of speech. Damage to Broca's area produces expressive aphasia, or difficulty with the motor movements of speech. Wernicke's area is primarily responsible for receptive speech. The basal ganglia are involved with motor functions and association in both the learning and the programming of behavior or activities that are repetitive and, when done over time, become automatic. Basic emotions, needs, drives, and instinct begin and are modulated in the limbic system.

Abnormalities in which lobe is believed to be associated with schizophrenia? Frontal Occipital Temporal Parietal

Frontal

In which way do neurons communicate through the use of synapses? indirectly excitatorily electrochemically inhibitorily

electrochemically

The function of the thalamus and the hypothalamus is to coordinate: internal and external responses. speech and communication. sensation. movement.

internal and external responses.

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 nurse prepares an in-service for psychiatric-mental health nurses regarding the role of neurotransmitters in many mental health disorders. Which statement should the nurse include in the seminar? "Low activity of dopamine is associated with schizophrenia." "Fluoxetine decreases serotonin levels and so is effective to treat depression." "Abnormalities of dopamine activity may cause substance use disorders." "Norepinephrine plays a role in the physical symptoms caused by depression."

"Abnormalities of dopamine activity may cause substance use disorders."

The nurse provides care to a client who is diagnosed with hypothyroidism. Which question should the nurse include in the psychosocial health history interview based on the medical diagnosis? "Do you have a history of anxiety?" "Do you have a history of insomnia?" "Do you have a history of schizophrenia?" "Do you have a history of bipolar disorder?"

"Do you have a history of anxiety?" Explanation: Clients who have a medical diagnosis of hypothyroidism often experience depression or anxiety as psychosocial comorbidities; therefore, the question the nurse asks is "Do you have a history of anxiety?" Insomnia, schizophrenia, and bipolar disorder are not psychosocial comorbidities associated with hypothyroidism.

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." The cerebral cortex is on the surface of the cerebrum. It contains motor neurons, which are responsible for movement, and sensory neurons, which receive impulses from peripheral sensory neurons located throughout the body.

The nurse provides a client education regarding the role of serotonin within the body. Which statement by the nurse regarding this role is accurate? "Serotonin is primarily an inhibitory neurotransmitter within the brain." "Serotonin is derived from melatonin, thus playing a role in mood changes." "Serotonin concentrations decrease during rapid eye movement (REM) sleep." "Serotonin is shunted to the cranial blood vessels by some migraine medications."

"Serotonin concentrations decrease during rapid eye movement (REM) sleep." Melatonin is derived from serotonin, not vice versa.

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? "People who develop mental illnesses often had very traumatic childhood experiences." "There is some evidence that contracting a virus during childhood can lead to mental disorders." "Sometimes people with mental illness have an overactive immune system." "We don't fully understand the cause, but mental illnesses do seem to run in families."

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

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 nurse is preparing a client for a functional magnetic resonance imaging (fMRI) scan. When describing this procedure, which information would be most appropriate for the nurse to include? "You'll have electrodes placed on your scalp to measure the electrical activity." "While you're asleep, a machine will look at your brain's activity." "You'll have images taken of your brain to look at the blood flow through it." "You'll be given some stimulus and your brain's activity will be monitored."

"You'll have images taken of your brain to look at the blood flow through it." A functional MRI (fMRI) creates functional images that rely on the properties of oxygenated and deoxygenated hemoglobin to see images of changes in blood flow. An electroencephalogram involves the use of electrodes applied to the scalp to evaluate the electrical activity of the brain. Polysomnography is a procedure done while sleeping that looks at the brain's activity. Evoked potentials (EPs) measure changes in electrical activity of the brain in specific regions as a response to a given stimulus.

Which component is included in a neuron? A glial cell, nucleus, organelles, dendrites, and axons A glial cell, nucleus, dendrites, and synapses A cell body, nucleus, organelles, dendrites, and axons A cell body, nucleus, axon, and synapses

A cell body, nucleus, organelles, dendrites, and axons

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 hormone in the brain. A molecular substance released in the brain. A specific location in the brain. A nerve that transmits impulses in the brain.

A molecular substance released in the brain

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

What part of the brain would be responsible for activities such as walking and dancing? Cerebellum Cerebrum Midbrain Brain stem

Cerebellum Explanation: The cerebellum, which is located behind and below the cerebrum, controls and coordinates muscle movement integral to physical activities such as walking and dancing. Cerebrum, midbrain, and brain stem are incorrect.

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 The cerebellum controls and guides movements, as well as maintains muscle tone. The cerebrum is composed of the frontal, parietal, occipital, and temporal regions and contributes to intellectual function, including learning, judgment, reasoning, and memory. The medulla oblongata controls respiration, gastrointestinal motility, and circulation. The hippocampus is part of the limbic system.

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

The nurse is assessing a client who may be a candidate for light therapy. Which question(s) should the nurse include in the assessment to determine eligibility? Select all that apply. "Do you feel fatigued?" "Do you have feelings of depression?" "Do you experience feelings of anxiety?" "Do you overeat even when you are not hungry?" "Do you experience excessive daytime sleepiness?"

Correct response: "Do you feel fatigued?" "Do you have feelings of depression?" "Do you overeat even when you are not hungry?" "Do you experience excessive daytime sleepiness?" Exposure to specific artificial light often relieves symptoms of fatigue, overeating, hypersomnia, and depression. Based on this information, the questions regarding fatigue, depression, overeating, and hypersomnia (i.e., excessive daytime sleepiness) are important to determine eligibility for light therapy.

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."

Correct response: "Lack of serotonin in the body produces symptoms such as aggression, hostility, and compulsiveness." Explanation: Serotonin plays a role in emotions, cognition, sensory perceptions, and essential biologic functions such as sleep and appetite. Serotonin also controls food intake, irritability, sleep and wakefulness, compulsiveness, temperature regulation, pain control, sexual behaviors, and regulation of emotions. Norepinephrine, histamine, and dopamine are not correct. Lack of norepinephrine may lead to conditions such as attention deficit hyperactivity disorder, depression, and hypotension. Lack of histamine means dopamine levels will be elevated and this may result in anxiety, paranoia, being suspicious, and hallucinations. Lack of dopamine may lead to imbalance difficulties, speech problems, and postural changes.

A client states to the nurse, "I have been on so many antidepressants over the years. They work well for a while but never long term. I don't understand why this is happening?" Which response by the nurse is accurate? "There really is no reason for this. I understand that it is frustrating." "Some drugs can negatively affect receptors, which affects effectiveness." "Your therapist documented that you don't take your medications as prescribed." "Are you taking your medication with food? You must take it exactly as prescribed."

Correct response: "Some drugs can negatively affect receptors, which affects effectiveness." Explanation: Drugs can affect the sensitivity of the receptor by altering the strength of attraction of a receptor for the neurotransmitter, by changing the efficiency with which the receptor activity translates the message inside the receiving cell, or by decreasing over time the number of receptors. These mechanisms may account for the loss of effectiveness of a given medication. Telling the client there is no reason for the decreased effectiveness is not accurate. Although it is important to take medications as prescribed, this response is not therapeutic and does not accurately address the client's question.

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 Dopaminergic GABA-ergic Noradrenergic

Correct response: Cholinergic Explanation: The cholinergic system uses acetylcholine as a neurotransmitter. The dopaminergic system uses dopamine as its neurotransmitter. The GABA-ergic system uses GABA as its neurotransmitter. The noradrenergic system uses norepinephrine as its neurotransmitter.

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

Correct response: Damage to the hippocampus Explanation: Damage to the hippocampus causes short-term memory loss and lack of motivation. Damage of the nucleus accumbeus does not cause memory loss. Damage to the thalamus results in obsessive-compulsive behavior or decreased ability to experience pleasure. Damage to the medulla affects circulation and respiration.

Which of the following is an inhibitory neurotransmitter? Dopamine GABA Norepinephrine Epinephrine

Correct response: GABA Explanation: GABA is an inhibitory neurotransmitter that controls sleep and wakefulness, temperature regulation, and regulation of emotions. Dopamine, norepinephrine, and epinephrine are excitatory neurotransmitters.

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.

Correct response: It has a parietal lobe. It has a frontal lobe. It has a temporal lobe. It has an occipital lobe. Explanation: The brain is divided into three parts: the cerebrum, the cerebellum, and the brain stem. The cerebrum consists of two hemispheres connected by the corpus callosum, a band of white fibers that acts as a bridge for transmitting impulses between the left and right hemispheres. Each hemisphere has four lobes: frontal, parietal, temporal, and occipital.

The nurse prepares a seminar for practicing psychiatric-mental health professionals regarding gut microbiota related to psychoneuroimmunology. Which mental health condition should the nurse include during the presentation? Select all that apply. anxiety depression schizophrenia Alzheimer disease autism spectrum disorder

Correct response: anxiety depression Alzheimer disease autism spectrum disorder Explanation: The gut microbiota is the complex bacterial community located in the gastrointestinal tract. Recent research shows that not only is gut microbiota essential for maintaining metabolic and immune health but also it influences brain development, neurogenesis, and interacts with the enteric nervous system (ENS) and central nervous system (CNS). There is evidence that the gut microbiota has a role in depression, anxiety, Alzheimer disease, and autism spectrum disorder; therefore, these are included in the presentation. Gut microbiota does not appear to play a role is schizophrenia.

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

Correct response: behavior Explanation: This part of the brain seems to be largely responsible for the human aspect of brain function. Drug therapy aimed at alleviating emotional disorders, such as depression and anxiety, often involves attempting to alter the levels of epinephrine, norepinephrine, and serotonin.

Which statement best reflects the role of the psychiatric-mental health nurse in the provision of client care? determining the pharmacologic treatment based on the client's symptoms monitoring for adverse reactions related to the client's prescribed treatment connecting the symptomatology with the rationale for the client's treatment providing education related to the alterations in the client's brain functioning

Correct response: connecting the symptomatology with the rationale for the client's treatment Explanation: Psychiatric-mental health nurses must be able to make the connection among (1) clients' psychiatric symptoms, (2) the probable alterations in brain functioning linked to those symptoms, and (3) the rationale for treatment and care practices. Based on this information, the statement that best reflects the role of these nurses is connecting the symptomatology with the rationale for the client's treatment. It is outside of the scope of practice for the nurse to determine the pharmacologic treatment based on the client's symptoms. Although monitoring for adverse reactions and providing education is within the role of the practicing nurse, these are not the best statements that reflect the role of the psychiatric-mental health nurse in the provision of client care.

Norepinephrine has been shown to play a role in a person's mood and ability to concentrate. Which are disease processes seen with low levels of norepinephrine? Select all that apply. schizophrenia depression ADHD hypertension psychosis

Correct response: depression ADHD

Serotonin plays a role in which of these areas? Select all that apply. emotion cognition sensory perceptions breathing arterial blood pressure

Correct response: emotion cognition sensory perceptions Explanation: Serotonin plays a role in emotions, cognition, sensory perceptions, and essential body functions, such as sleep and appetite. It is also involved in control of food intake, hormone secretion, sexual behavior, thermoregulation, and cardiovascular regulation. It does not have a role in breathing or arterial blood pressure.

A nurse is attending a review class on the neurologic basis of psychiatric disorders. The class also includes a review of the anatomy and physiology of the neurological system. The nurse demonstrates understanding of the information by identifying which structures as components of the brain stem? (Select all that apply.) midbrain pons medulla cerebellum occipital lobes

Correct response: midbrain pons medulla

Which functions are controlled by the extrapyramidal motor system? Select all that apply. muscle tone common reflexes automatic voluntary motor functioning memory Vision

Correct response: muscle tone common reflexes automatic voluntary motor functioning

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

Concordance rates for schizophrenia in monozygotic twins are only 50%. Which statement best explains this phenomenon? Genetic predisposition to disease may result in disease in one person but not in another. One twin is more vulnerable. Environmental experiences affect gene expression. The genetic pathway responsible for vulnerability is present in one twin but not the other.

Environmental experiences affect gene expression. While human genes play an enormous role in certain pathologies, the pathophysiology of psychiatric disorders, like all disorders, depends on a complex interaction of genetic factors and environmental factors. These genetic and environmental factors also affect the brain's development and subsequent function.

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? Parietal lobes Frontal lobe Occipital lobe Temporal lobes

Frontal lobe

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? Parietal lobes Frontal lobe Occipital lobe Temporal lobes

Frontal lobe Explanation: Abnormalities in the frontal lobes are associated with schizophrenia, attention deficit hyperactivity disorder (ADHD), and dementia. The parietal lobes interpret sensations of taste and touch and assist in spatial orientation. The temporal lobes are centers for the senses of smell and hearing and for memory and emotional expression. The occipital lobe assists in coordinating language generation and visual interpretation, such as depth perception.

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

GABA Explanation: GABA is the major inhibitory neurotransmitter in the brain and has been found to modulate other neurotransmitter systems rather than to provide a direct stimulus. Dopamine, norepinephrine, and epinephrine are excitatory neurotransmitters.

A decrease in which neurotransmitter has been implicated in seizure disorders? GABA serotonin dopamine epinephrine

GABA Explanation: Decreased GABA activity is involved in the development of seizure disorders. Serotonin, dopamine, and epinephrine are not decreased in people diagnosed with seizure disorders

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

Hippocampus Explanation: 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.

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? Basal ganglia Pons Corpus callosum Hypothalamus

Hypothalamus Explanation: The hypothalamus is a part of the limbic system, which is sometimes called the emotional brain. The hypothalamus is involved in impulsive behavior associated with feelings of anger, rage, or excitement. The pons connects the cerebellum and the brainstem. The basal ganglia initiates motor function. The corpus callosum is the pathway that connects the two hemispheres of the brain.

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 Explanation: The brain's ability to develop and alter in response to experience is known as neuroplasticity. This means that the brain adapts to new conditions during its maturation and during its constant interaction with its environment. This also means that, to some degree, humans can create their own brains by exposing them to certain experiences.

The structure of the brain associated with emotional control, memory, and learning is what? Basal ganglia Brainstem Limbic system Cerebellum

Limbic system Explanation: The limbic system controls emotions, memory, and learning. The basal ganglia initiate and control voluntary motor activities and muscle tone. The brainstem controls respiration, gastrointestinal motility, circulation, and sleep and wakefulness, and directs visual and auditory reflexes. The cerebellum controls and guides movements and maintains muscle tone.

Imbalances in neurotransmitters contribute to the development of mental disorders. Norepinephrine imbalance is implicated in which of the following disorders? Schizophrenia Mood disorders Dementia Generalized anxiety disorder

Mood disorders Explanation: Norepinephrine is implicated in mood disorders. Dopamine is implicated in schizophrenia; gamma-aminobutyric acid (GABA) is implicated in dementia, schizophrenia, and anxiety disorders AND SEIZURES; and high levels of serotonin are implicated in anxiety disorders.

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 Explanation: Neuroplasticity is the brain's ability to develop and alter in response to experiences with various stimuli

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 Explanation: As the electrical action potential reaches the ends of the axons, called terminals, calcium ion channels are opened, allowing an influx of Ca++ ions into the neuron. This increase in calcium stimulates the release of neurotransmitters into the synapse. Rapid signaling among neurons requires a ready supply of neurotransmitter. These neurotransmitters are stored in small vesicles grouped near the cell membrane at the end of the axon. When stimulated, the vesicles containing the neurotransmitter fuse with the cell membrane, and the neurotransmitter is released into the synapse. The neurotransmitter then crosses the synaptic cleft to a receptor site on the postsynaptic neuron and stimulates adjacent neurons.

The instructor is discussing neurotransmitters with the prenursing anatomy and physiology class. What would the instructor tell the students is a catecholamine that is classed as a hormone when it is released from the adrenal medulla? Ephedrine Norepinephrine Dopamine Acetylcholine

Norepinephrine Explanation: Norepinephrine and epinephrine are catecholamines, which are released by nerves in the sympathetic branch of the autonomic nervous system and are classified as hormones when they are released from cells in the adrenal medulla.

A psychiatric-mental health nurse is attending a continuing education program on neurotransmitters and psychiatric disorders. The nurse demonstrates understanding of the information by identifying which neurotransmitter as being heavily concentrated in the terminal sites of sympathetic nerves? Norepinephrine Dopamine Serotonin Acetylcholine

Norepinephrine Explanation: Norepinephrine is an excitatory neurochemical that plays a major role in generating and maintaining mood states

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 neuroimaging technique used to examine brain functioning, including glucose metabolism, blood flow, and neurotransmitter-receptor activity, is known as what? Magnetic resonance imaging (MRI) Electroencephalogram (EEG) Ultrasonography Positron emission tomography (PET) scan

Positron emission tomography (PET) scan Explanation: The positron emission tomography (PET) scan is used to examine brain functioning, including glucose metabolism, blood flow, and neurotransmitter-receptor activity. Magnetic resonance imaging (MRI) can detect demyelinization.

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 Explanation: Refractoriness means the desensitization of cells to a drug over time. Also called downregulation, refractoriness generally occurs when agonists continually stimulate cells. The resultant repeated exposure of cells to the same concentration of the drug causes the drug to have diminished effectiveness. Affinity refers to the strength of attraction to the receptor; supersensitivity refers to a greater than usual response to the neurotransmitter. Neurocircuitry refers to the complex neural functional networks that link the brain structures such as the prefrontal cortex, striatum, hippocampus, and amygdala.

A nurse is reviewing the function of the sympathetic nervous system and how the body responds to sympathetic stimulation. The nurse demonstrates understanding of the information by identifying which event as a sympathetic response of the lungs? Relaxation of bronchial muscles Secretion from the bronchial glands Bronchoconstriction Dilation of blood vessels

Relaxation of bronchial muscles

After attending an anatomy and physiology review class on the nervous system, a group of nurses demonstrate understanding of the information whe 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 Explanation: Sometimes called the "relay-switching center of the brain," the thalamus functions as a regulatory structure to relay all sensory information, except smell, sent to the CNS from the PNS. From the thalamus, the sensory information is relayed mostly to the cerebral cortex. The thalamus relays and regulates by filtering incoming information and determining what to pass on or not pass on to the cortex. In this fashion, the thalamus prevents the cortex from becoming overloaded with sensory stimulus. It is not responsible for voluntary movement, adjusting body temperature and heart rate, or maintaining red blood cell production.

A nurse is reviewing the role of neurotransmitters with mental illnesses. The nurse would identify Increased levels of which neurotransmitter as being primarily involved with mania? Serotonin Dopamine Melatonin Acetylcholine

Serotonin Whereas depression and insomnia have been associated with decreased levels of 5-HT, mania has been associated with increased 5-HT. Increased levels of dopamine are associated with schizophrenia.

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 34-year-old woman is three months postpartum and being treated for mild depression following the birth of her child. She states that she misses her career and was not ready to become a full-time mother. Her husband tries to help her, but she admits that she resents the time she still has to devote to the baby. The infant looks well fed and cared for, but the mother clearly seems burdened by the child. Basing her plan of care on concepts about brain development and neuroplasticity, the nurse identifies which of the following goals as most critical? The client will receive physical and emotional support from her husband. The client will resume her job on a part-time basis. The client will develop an attachment with the infant. The client will use daycare or other services to allow her more time to herself.

The client will develop an attachment with the infant. Explanation: Neuroplasticity means that the brain adapts to new conditions during its constant interaction with the environment. Our brains continue to grow connections, and exposure to new learning results in brain changes, even into advanced old age. The mother can learn to embrace her new role as mother and develop an attachment with the infant.

A psychiatric-mental health nurse practitioner is conducting a review class for a group of nurses about emerging fields of study in psychiatric-mental health care. The nurse is describing the field of chronobiology and events that synchronize and set biologic rhythms. The nurse practitioner is correct in using which term to denote the synchronizing events? Sensitivity Zeitgeber Affinity Neuroplasticity

Zeitgeber

Which is the primary cholinergic neurotransmitter found in greatest concentration in the peripheral nervous system? acetylcholine dopamine norepinephrine serotonin

acetylcholine Explanation: Acetylcholine is the primary cholinergic neurotransmitter. Dopamine is an excitatory neurotransmitter found in distinct regions of the central nervous system and is involved in cognition, motor, and neuroendocrine functions. Norepinephrine is an excitatory neurochemical that plays a major role in generating and maintaining mood states. Serotonin plays a role in emotions, cognition, sensory perceptions, and essential biologic functions.

Neurotransmitters are small molecules that exert their actions through specific proteins, called receptors, embedded in the postsynaptic membrane. Where are neurotransmitters synthesized? dendrite terminal presynaptic junction postsynaptic junction axon terminal

axon terminal

The nurse provides care to a client who experiences severe anxiety that borders on panic disorder. Which laboratory test should the nurse discuss with the client's health care provider for diagnostic purposes? challenge test thyroid studies hepatic enzymes serum electrolytes

challenge test

A nurse is reviewing the process of neuronal transmission. The nurse demonstrates understanding of this concept by identifying which part of the neuron as carrying information into the neuron from other neurons? axon dendrite nucleus soma

dendrite Explanation: Dendrites route information to the nerve and axons carry information from a nerve to be transmitted to effector cells, which are found in muscles, glands, or another nerve

Which neuropeptide suppresses pain and modulates mood and stress? endorphins melatonin substance P cholecystokinin

endorphins

The nurse provides care to a client who is diagnosed with schizophrenia. A family member asks the nurse, "I don't know how she tolerates wearing that winter coat in the middle of the summer!" Which structure of the limbic system should the nurse base the response? thalamus amygdala hippocampus hypothalamus

hypothalamus Explanation: Deregulation of the hypothalamus can be manifested in symptoms of certain psychiatric disorders. For example, in schizophrenia, clients often wear heavy coats during the hot summer months and do not appear hot. Before the role of the hypothalamus in schizophrenia was understood, psychological reasons were used to explain such symptoms. Now it is increasingly clear that such a symptom relates to deregulation of the hypothalamus's normal role in temperature regulation and is a biologically based symptom. The other structures of the limbic system are not appropriate to use a basis for the response.

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 Explanation: Body temperature is regulated by the hypothalamus.

The nurse provides care to a client who is diagnosed with bipolar disorder. The client reports fatigue, being sensitive to cold, constipation, and weight gain. When applying concepts associated with psychoneuroimmunology, which disorder should the nurse include in this client's plan of care? hypothyroidism hyperthyroidism Type 1 diabetes mellitus Type 2 diabetes mellitus

hypothyroidism Explanation: Normal functioning of the endocrine system is often disturbed in people with psychiatric disorders. For example, thyroid functioning is often low in those with bipolar disorder, and people with schizophrenia have a higher incidence of diabetes.

The nurse prepares educational material regarding psychoneuroimmunology (PNI) for clients diagnosed with mental health disorders. Which body system should the nurse include when discussing client behaviors, thoughts, and feelings? Select all that apply. immune system nervous system endocrine system respiratory system cardiovascular system

immune system nervous system endocrine system Explanation: Psychoneuroimmunology (PNI) examines the relationships among the immune system, nervous system, and endocrine system and our behaviors, thoughts, and feelings. The respiratory and cardiovascular systems are not examined with PNI.

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.

The nurse provides care to a client who presents to the emergency department (ED) with symptoms indicative of a traumatic brain injury (TBI). The client states, "I am unable to see anything. I think I am blind now!" Which area of the cerebrum should the nurse suspect the TBI affected based on the client's statement? frontal lobe parietal lobe occipital lobe temporal lobe

occipital lobe The primary visual area is in the most posterior aspect of the occipital lobes. Damage to this area results in a condition called cortical blindness. In other words, the retina and optic nerve remain intact, but the individual cannot see.

The nurse provides care to a client who has a history of traumatic brain injury (TBI). The client's medical record indicates damage to the parietal lobe. Which finding should the nurse anticipate on assessment of this client? receptive aphasia expressive aphasia impulse control issues spatial relationship neglect

spatial relationship neglect The posterior areas of the parietal lobe appear to coordinate visual and somatosensory information. Damage to this area produces complex sensory deficits, including neglect of contralateral sensory stimuli and spatial relationships

A client has developed deficits involving the senses of smell and hearing. The nurse would correlate this sensory dysfunction with which cerebral lobe? temporal parietal frontal occipital

temporal Explanation: The temporal lobes contain the primary auditory and olfactory areas. The parietal lobes contribute to the ability to recognize objects by touch, calculate, write, recognize fingers of the opposite hands, draw, and organize spatial directions, such as how to travel to familiar places. The frontal lobes are thought to contain the highest or most complex aspects of cortical functioning, which collectively make up a large part of personality. The occipital lobes are involved in many aspects of visual integration of information, including color vision, object and facial recognition, and the ability to perceive objects in motion.