Question 1

A nurse is teaching a medication class to a group of psychiatric clients. One of the students asks, "Why am I having so much more trouble learning now that I am 60 than I did when I was younger?" Which concept would the nurse integrate into the response?

A) The extrapyramidal motor system
B) The amygdala
C) Neuroplasticity
D) Psychoneuroimmunology

Neuroplasticity

Accepted Answer

Neuroplasticity is the brain's ability to change structure and function to compensate for a changing neuronal environment (Mohr & Mohr, 2001). With age, brains become less plastic, which explains why it is easier to learn a second language at the age of 5 years than at 55 years. The extrapyramidal motor system controls muscle tone, common reflexes, and automatic voluntary motor function. The amygdala provides an emotional component to memory and is involved in modulating aggression and sexuality. Psychoneuroimmunology involves the connection between the immune system and stress.

Question 2

When teaching a client about the brain, which area would a nurse identify when describing the part of the brain involved with verbal language function, including areas for both receptive and expressive speech?

A) Right hemisphere
B) Parietal lobe
C) Occipital lobe
D) Left hemisphere

Left hemisphere

Accepted Answer

The area of the brain involved with verbal language function, including areas for both receptive and expressive speech, is the left hemisphere. The right hemisphere provides input into receptive nonverbal communication, spatial orientation, and recognition. The parietal lobe is involved with coordinating visual and somatosensory information. The occipital lobe is primarily involved with vision.

Question 3

A nurse is developing a plan of care for a client experiencing expressive aphasia. The nurse incorporates knowledge that the client most likely has sustained damage to what area?&#10;A) The postcentral gyrus&#10;B) Broca's area&#10;C) Basal ganglia&#10;D) The hippocampus

Accepted Answer

The frontal lobe also 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. The postcentral gyrus, immediately behind the central sulcus, contains the primary somatosensory area. The basal ganglia are involved with motor functions and are associated with the learning and programming of behaviors/activities that are repetitive and that, done over time, become automatic. The hippocampus is involved in storing information, especially the emotions attached to a memory.

Question 4

A nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the client will have difficulty with which function?&#10;A) Smell&#10;B) Concept formation&#10;C) Receptive speech&#10;D) Hearing

Accepted Answer

Working memory is an important aspect of frontal lobe function. The nurse can anticipate that the client will have difficulty with concept formation, insight, judgment, and reasoning. The temporal lobes contain the primary auditory and olfactory areas. Wernicke's area, located at the posterior aspect of the superior temporal gyrus, is primarily responsible for receptive speech.

Question 5

A nurse is caring for a client who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the client will have difficulty with which activity?&#10;A) Perceiving motor input&#10;B) Calculating a math problem&#10;C) Seeing objects in front of the client&#10;D) Speaking fluently

Accepted Answer

A client who has experienced damage to the parietal lobes of the brain most likely will be unable to calculate a math problem. Damage to this area produces complex sensory deficits. The parietal lobes contribute to the ability to recognize objects by touch, calculate, write, draw, and organize spatial stimuli. Damage to the occipital lobe would lead to difficulty in vision, color vision, object and facial recognition, and the ability to perceive objects in motion. The frontal lobe, specifically Broca's area, would be involved if the client had difficulty speaking fluently.

Question 6

A client has been diagnosed with memory dysfunction associated with Alzheimer's disease. The nurse determines that damage to the client's brain includes deterioration of temporal lobe structures and the nerves of which area?

A) Basal ganglia
B) Limbic system
C) Frontal lobe
D) Hippocampus

Accepted Answer

Deterioration of the nerves of the hippocampus and other related temporal lobe structures are associated with Alzheimer's disease. The basal ganglia are involved with motor functions; the frontal lobe contains the primary motor area, Broca's area (for speech), personality, and working memory. The limbic system modulates basic emotions, needs, drives, and instinct.

Question 7

The nurse is caring for a hospitalized client who has been diagnosed with a disorder of the hypothalamus. When developing the client's plan of care, in which area would the nurse anticipate a problem?&#10;A) Sleep&#10;B) Constipation&#10;C) Speech&#10;D) Motor activity

Accepted Answer

Disorders of the hypothalamus produce common psychiatric symptoms such as sleep and appetite problems. The hypothalamus is not involved with bowel elimination, speech, or motor activity.

Question 8

A client who is scheduled to undergo a sleep-deprivation electroencephalogram (EEG) in the morning is experiencing moderate anxiety about the procedure. Based on an understanding of this test, which would the nurse avoid?

A) Explaining in depth what to expect during the upcoming procedure
B) Administering a benzodiazepine medication prescribed for anxiety
C) Taking a thorough history of the client's use of prescribed and illicit drugs
D) Giving the client a noncaffeinated beverage of choice

Accepted Answer

If a sleep-deprivation EEG is to be done, caffeine or other stimulants that might assist the client in staying awake should be withheld because they may change EEG patterns. In addition, many medications change the wave patterns on an EEG. For example, the benzodiazepine class of drugs increases the rapid and fast beta activity. Therefore, benzodiazepines should be avoided. Noncaffeinated beverages would be allowed. Explaining about the procedure would help to alleviate the client's anxiety. A thorough history about prescribed drug use would be important because it may reveal medications that could change the EEG wave patterns.

Question 9

A nursing instructor asks a student to explain the influence of chronobiology on depression. Which description would the student include when responding?&#10;A) The exact location of genes leads to identifying the gene responsible for causing depression.&#10;B) A break in the corpus callosum blocks information exchange between the right and left hemispheres.&#10;C) Damage to the posterior areas of the parietal lobe leads to altered discriminative sensory function.&#10;D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression.

Accepted Answer

Chronobiology involves the study and measure of time structures or biologic rhythms. Zeitgebers are specific events that function as time givers or synchronizers and that set biologic rhythms. Some theorists think that psychiatric disorders may result from one or more biologic rhythm dysfunctions. For example, depression may be, in part, a phase advance disorder, including early morning awakening and a decreased time of onset of REM sleep.

Question 10

When describing the various neurotransmitters, which would a nurse identify as the primary cholinergic neurotransmitter?&#10;A) Dopamine&#10;B) Acetylcholine&#10;C) Norepinephrine&#10;D) Serotonin

Accepted Answer

Acetylcholine is the primary cholinergic neurotransmitter. Biogenic amines include dopamine, norepinephrine, and serotonin.

Question 11

A nurse is reviewing the various neurotransmitters and their functions. The nurse demonstrates understanding by identifying which substance as a neuropeptide?&#10;A) Somatostatin&#10;B) Serotonin&#10;C) Glutamate&#10;D) Gamma-aminobutyric acid

Accepted Answer

The answer of A nurse is reviewing the various neurotransmitters...

Question 12

A nurse is assessing a client who is experiencing anxiety and observes increased sweating and goose flesh. The nurse understands that these symptoms are the result of which substance?&#10;A) Acetylcholine&#10;B) Norepinephrine&#10;C) Serotonin&#10;D) Histamine

Accepted Answer

The answer of A nurse is assessing a client who...

Question 13

A nurse is developing a plan of care for a client diagnosed with schizophrenia. The nurse integrates knowledge of this disorder, identifying which neurotransmitter as being primarily involved?&#10;A) Acetylcholine&#10;B) Dopamine&#10;C) Norepinephrine&#10;D) Serotonin

Accepted Answer

The answer of A nurse is developing a plan of...

Question 14

A group of students is reviewing information about neurotransmitter subtypes. The group demonstrates understanding of the information when they identify which neurotransmitter as having muscarinic and nicotinic receptors?

A) Serotonin
B) Gamma-aminobutyric acid (GABA)
C) Dopamine
D) Acetylcholine

Accepted Answer

The answer of A group of students is reviewing information...

Question 15

A psychiatric-mental health nurse is describing to a group of colleagues how information is gathered about the inheritance of mental disorders using population genetics. The nurse determines that additional discussion is needed when the group identifies which method as being used for evaluation?

A) Concordance rates of twins
B) Occurrence among first-degree relatives
C) Risk factor analysis
D) Adoption studies

Accepted Answer

The answer of A psychiatric-mental health nurse is describing to...

Question 16

A client is scheduled for a challenge test. Which information would a nurse include when explaining this test to the client?&#10;A) Intravenous administration of a substance to induce symptoms&#10;B) Application of electrodes to the scalp for monitoring&#10;C) Evaluation of electrical impulses recorded on graph paper&#10;D) Exposure to a flashing strobe light to elicit abnormal activity

Accepted Answer

The answer of A client is scheduled for a challenge...

Question 17

A client with depression tells a nurse, "I have a test that involves the recording of an electroencephalogram (EEG) throughout the night." The nurse most likely identifies this as what type of testing?

A) Sleep-deprivation EEG
B) Polysomnography
C) Evoked potentials
D) Functional magnetic resonance imaging

Accepted Answer

The answer of A client with depression tells a nurse,...

Question 18

A group of nurses is reviewing the role of serotonin in psychiatric disorders. The group demonstrates a need for additional study when they identify which disorder as being associated with its dysfunction?

A) Depression
B) Mania
C) Panic disorder
D) Schizophrenia

Accepted Answer

The answer of A group of nurses is reviewing the...

Question 19

When describing neuronal transmission, an instructor describes the area where the electrical intracellular signal becomes a chemical one. The instructor is describing what area?&#10;A) Soma&#10;B) Synaptic cleft&#10;C) Terminal&#10;D) Receptor site

Accepted Answer

The answer of When describing neuronal transmission, an instructor describes...

Question 20

A nurse is reading a journal article about psychoneuroimmunology. Which information would the nurse most likely find? Select all that apply.&#10;A) Neurotoxin's role in receptor site damage&#10;B) Hypothalamic-pituitary-thyroid axis disruption&#10;C) Static activity of T and B cells in response to stress&#10;D) Hypothalamic damage leading to immune dysfunction&#10;E) Interruption in the typical circadian rhythm cycle

Accepted Answer

The answer of A nurse is reading a journal article...

Deck 8: Biologic Foundations of Psychiatric Nursing