Deck 5: Biological Context of Psychiatric Nursing Care

Question 1

The spouse of a patient recently diagnosed with cancer asks,"What do you think about the relationship of stress and the development of cancer? My spouse has been under a huge amount of stress at work,and now they've diagnosed cancer." The answer that best reflects the current thinking about psychoneuroimmunology is:

A) "It's thought that the immune system is negatively affected by high stress."
B) "The research hasn't been focused directly on the link between cancer and stress."
C) "Your spouse's situation may reflect a coincidence. There is little concrete evidence that stress makes one prone to physical illness."
D) "Grief and depression are known to cause physical illness, but other types of stress have not been implicated as illness producers."

Answer 1

"It's thought that the immune system is negatively affected by high stress."

Question 2

A genetic counselor is called to see patients with genetic questions or concerns.With which patient would it be most appropriate for the counselor to speak?

A) A pregnant patient with sickle cell anemia
B) A patient who has made a recent suicide attempt
C) A patient prescribed the most drugs for the treatment of chronic disorders
D) A patient with schizophrenia who had multiple hospital admissions in the last year

Answer 2

A pregnant patient with sickle cell anemia

Question 3

Which neurotransmitter is located only in the brain,particularly in the raphe nuclei of the brainstem,and is implicated in depression?

A) Norepinephrine
B) Acetylcholine
C) Dopamine
D) Serotonin

Answer 3

Serotonin

Question 4

A patient mentions,"My doctor told me I was going to have a PET scan that would show where my brain has bright spots.Does that mean I'm getting an electrical jolt like in electroconvulsive therapy (ECT)?" The best reply would be:

A) "PET scans and ECT treatments are entirely different."
B) "A PET scan is a diagnostic test, and an ECT treatment is a form of therapy."
C) "A PET scan involves a substance, not electricity, that travels to the brain and produces a bright spot where the brain is active."
D) "PET scans show us the electrical activity of the brain in the form of light bands."

Question 5

A nurse explains to a patient undergoing diagnostic testing which brain imaging technique measures brain structure?

A) Computed tomography (CT)
B) Positron emission tomography (PET)
C) Brain electrical activity mapping (BEAM)
D) Single-photon emission computed tomography (SPECT)

Question 6

A patient demonstrates disoriented thinking and irrational ideas.A nurse can anticipate that a PET scan would most likely show dysfunction in the brain's _____ lobe.

A) frontal
B) parietal
C) occipital
D) temporal

Question 7

What part of the brain is responsible for regulating pituitary hormones and is known to regulate the body's temperature?

A) Thalamus
B) Cerebellum
C) Limbic system
D) Hypothalamus

Question 8

The function of the limbic system is to:

A) regulate emotional behavior.
B) perform abstract reasoning.
C) facilitate critical decision making.
D) coordinate stress-related responses.

Question 9

When a patient asks the nurse,"What are neurotransmitters?" The nurse replies that neurotransmitters are:

A) "the chemical messengers that cause brain cells to turn on or off."
B) "small clumps of cells that alert the other brain cells to receive messages."
C) "tiny areas of the brain that are responsible for controlling our emotions."
D) "weblike structures that provide connections among various parts of the brain."

Question 10

A patient diagnosed with depression tells a nurse,"I don't feel rested.It's as though I didn't sleep at all." Comments by night shift staff show that the patient slept through most of the night.How can these two observations be reconciled?

A) The patient is considered the more accurate reporter.
B) The staff observations are more objective than the patient's statement.
C) Studies show that people with depression have disturbed sleep cycles that can result in sleep deprivation.
D) People with depression characteristically underreport sleep satisfaction because of cognition flaws.

Question 11

A patient tells a nurse,"My doctor thinks my problem is serious but it can be treated with medications.Does that mean I'll always have to be treated with drugs?" The nurse replies:

A) "How would you feel about being on medications for a lifetime?"
B) "What concerns do you have about having a serious mental disorder?"
C) "Did your doctor suggest your problem was related to neurotransmitter problems?"
D) "What do you know about this condition that the doctor is preparing to treat with medications?"

Question 12

A patient tells a nurse,"My doctor says my problem may be with the neurotransmitters in my brain but I don't understand what that means." The nurse responds:

A) "Let's begin with exploring what your doctor has told you about your problem."
B) "We should start with a discussion about any concerns you have about having a neurotransmitter disorder."
C) "First let me say that neurotransmitter problems can usually be treated or cured with medication therapy."
D) "What you need to understand is that neurotransmitters are chemical messengers in the brain responsible for brain communication."

Question 13

Pharmacogenetics will eventually allow researchers to do which of the following?

A) Remove the genes that cause illness.
B) Allow the design of custom drugs.
C) Develop foods that fight disease.
D) Splice genes to improve health.

Question 14

The objective information that has helped mental health professionals understand that schizophrenia has a biological component has been obtained primarily from which of the following?

A) Genetic studies
B) Patient histories
C) Comparisons of blood chemistries
D) Magnetic resonance imaging (MRI) studies

Question 15

A couple tells a nurse that they are concerned about having children because there is bipolar disorder in first-degree relatives of each of them.What advice should the nurse give?

A) "Do not have children."
B) "Seek genetic counseling."
C) "Do as your conscience dictates."
D) "Bipolar disorder is not hereditary."

Question 16

A patient states,"I'm going to have a positron emission tomography (PET) scan.What are the doctors going to learn from it?" The best reply would be that they focus on:

A) "identifying structures like tumors and scars."
B) "highlighting activity in various portions of the brain."
C) "outlining the structures of the brain more clearly."
D) "providing data to support new treatment modalities."

Question 17

Which neurotransmitter is involved in the movement disorders seen in Parkinson disease and in the deficits seen in schizophrenia and other psychoses?

A) Dopamine
B) Melatonin
C) Serotonin
D) Norepinephrine

Question 18

A patient's spouse asks a nurse,"Why are they wasting money doing all these tests on my spouse? The hallucinations and delusions make the mental illness obvious!" The best reply would be:

A) "Don't be upset. We are using the most modern approach to caring for your spouse."
B) "I know you must be worried about costs, but having these tests is very necessary."
C) "Physical illnesses can cause psychiatric symptoms. We must be sure of what we are treating."
D) "I think that you are upset about your spouse's illness and not thinking clearly. To avoid harm, physical illness must be ruled out."

Question 19

A patient tells a nurse,"My daughter is pregnant with our first grandchild and my son-in-law has a sibling with cystic fibrosis.Is there a chance the baby might have this disease?" Which response is best?

A) "This is not an inherited disorder."
B) "You should speak to a genetic counselor."
C) "Science has not yet developed gene testing for this disease."
D) "There are new treatments for this illness that are readily available."

Question 20

Which part of the brain is responsible for fine motor coordination?

A) Medulla
B) Thalamus
C) Cerebellum
D) Temporal lobe

Question 21

A patient with a history of depression reports not feeling well rested in recent weeks.Before making the assumption that the complaint is related to depression,a nurse should investigate whether the patient has had any recent changes in:

A) work schedule that affect the hours of sleep.
B) vacations taken within the same time zone.
C) fluid intake with reduced overall intake of water.
D) food intake with decreased intake of heavy foods before bedtime.

Question 22

A depressed patient scheduled for an MRI asks about the purpose of the test and whether it will hurt.The response would include that the test: (Select all that apply.)

A) takes a picture of the brain.
B) is used to diagnose mental illness.
C) should not produce any physical pain.
D) may be uncomfortable if tight spaces bother you.
E) machinery produces loud noises while the test is being conducted.

Question 23

A family member asks a mental health nurse,"I am reading a lot of information about gene therapy in the news lately.Will gene therapy be able to help my spouse,who has schizophrenia?" Which response by the nurse is best?

A) "Gene therapy for schizophrenia is common in Europe but has not yet become popular in the United States."
B) "Gene therapy for schizophrenia is available, but the high cost prohibits most people from taking advantage of it."
C) "Gene therapy is still an experimental field and is not likely to be used to treat mental health disorders in the near future."
D) "Gene therapy has already shown promise in treating schizophrenia, but not enough large-scale studies have been carried out to date."