Question 1

A patient has begun experiencing dysfunction of the hypothalamus.What nursing interventions will the nurse include in the patient's plan of care? Select all that apply.

Accepted Answer

The hypothalamus is responsible for regulation of sleep-rest patterns,body temperature,and physical drives of hunger.Social appropriateness and blood pressure is not controlled by the hypothalamus.

Question 2

A patient with chronic schizophrenia had a stroke involving the hippocampus.The patient will be discharged on low doses of haloperidol.The nurse will need to individualize the patient's medication teaching by:

Accepted Answer

The hippocampus plays a major role in short-term memory and,hence,in learning.Taking the medication as prescribed and providing the education at a time when the patient is calm and relaxed is information or considerations that all patients should be given.The medication does not necessarily need to be crushed or dissolved since the stroke would not have caused difficulty with swallowing.

Question 3

A patient whose symptoms of mild depression have been managed with antidepressants is concerned about the affect of accepting a promotion that will require working the night shift.What will be the basis of the response the nurse gives to address the patient's concern?

Accepted Answer

Many psychiatric and medical disorders occur more frequently or are exacerbated when sleep patterns and biologic rhythms are disrupted.While the remaining options contain true information regarding the management of depression that is a result of sleep disruption,they do not effectively address the patient's concern.

Question 4

A patient has experienced a stroke (cerebral vascular accident)that has resulted in damage to the Broca area.Which evaluation does the nurse conduct to reinforce this diagnosis?

Accepted Answer

Accidents or strokes that damage Broca's area may result in the inability to speak (i.e.,motor aphasia).Fine motor skills,blood pressure control,and muscle strength are not controlled by the Broca area of the left frontal lobe.

Question 5

What assessment data would reinforce the diagnosis of temporal lobe injury in patient who experienced head trauma? Select all that apply.

Accepted Answer

The temporal lobe is involved with memory as well as increased sexual focus and altered emotional responses.Personality and intellectual function is not centered in the temporal lobe.

Question 6

The nurse is preparing a patient for a positron emission tomography (PET)scan.Which instructions will the nurse include? Select all that apply.

Accepted Answer

Appropriate patient preparation for a PET scan would include information regarding the time interval between injection of the isotope and the actual scan,the fact that steps will be taken to minimize the effects of sights and sounds during the scan,lying still is critical to achieving a quality image,and that being asleep during the scan will alter the results.It is not necessary to fast before or during the scan.

Question 7

The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor.The nurse's answer will be based on information that the therapeutic action of psychotropic drugs is the result of their effect on:

Accepted Answer

Medications used to treat psychiatric disorders operate in and around the synaptic cleft and have action at the neurotransmitter level,especially in the case of schizophrenia,on dopamine.The Wernicke's area,dendrite function,or the sensitivity of the peripheral nervous system are not relevant to either schizophrenia or psychotropic medications.

Question 8

The physician tells the nurse,"The medication I'm prescribing for the patient enhances the g-aminobutyric acid (GABA)system." Which patient behavior will provide evidence that the medication therapy is successful?

Accepted Answer

GABA is the principle inhibitory neurotransmitter.The medication should provide an antianxiety effect.Alertness,psychotic behaviors,and mood elevation are not generally affected by g-aminobutyric acid.

Question 9

The wife of a patient with paranoid schizophrenia tells the nurse,"I've learned that my husband has several close relatives with the same disorder.Does this problem run in families?" The response based on recent discoveries in the field of genetics would be:

Accepted Answer

Familial tendencies appear with several psychiatric disorders including schizophrenia.To insinuate that the children are at such risk would not be supported by research.

Question 10

There remains a stigma attached to psychiatric illnesses.The psychiatric nurse makes the greatest impact on this sociological problem when:

Accepted Answer

Much of the stigma attached to psychiatric illness is due to a lack of understanding of the biologic basis of these disorders.Therefore,effective patient,family,and public teaching is an important function of the role of the psychiatric mental health nurse.While the remaining options are appropriate,they are not directed towards eliminating social stigma but rather empowering the patient.

Question 11

A patient asks the nurse,"My wife has breast cancer.Could it be caused by her chronic depression?" Which response is supported by research data?

Accepted Answer

Research indicates that stress causes a release of corticotropin-releasing factors that suppress the immune system.Studies indicate that psychiatric disorders such as mood disorders are sometimes associated with decreased functioning of the immune system.Research does not support a connection between many cancers and stress.There is a significant amount of research about stress and the body.Research has shown that there are some connections between stress and physical disease.

Question 12

A patient with depression mentions to the nurse,"My mother says depression is a chemical disorder.What does she mean?" The nurse's response is based on the theory that depression primarily involves which of the following neurotransmitters?

Accepted Answer

One possible cause of depression is thought to involve one or more neurotransmitters.Serotonin and norepinephrine have been found to be important in the regulation of depression.There is no research to support that the other options play a significant role in the development of depression.

Question 13

A patient with schizophrenia is described as "having difficulty with executive functions." What patient dysfunction can the nurse expect to assess behaviorally? Select all that apply.

Accepted Answer

Executive functions include reasoning,planning,prioritizing,sequencing behavior,insight,flexibility,judgment,focusing on tasks,responding to social cues,and attending in appropriate ways to incoming stimuli.Memory is not considered an executive function and risk for harm to self and others is not generally a diagnosis appropriate for such a patient.

Question 14

The nurse is discouraged because the patient exhibiting negative symptoms of schizophrenia has shown no improvement with the planned interventions to reduce the symptoms.The mentor's remark that helps place the problem in perspective is:

Accepted Answer

A complex disorder,such as schizophrenia,most likely has multiple contributing factors,including genetic predisposition,prenatal development,and the environment.Nurse frustration can be alleviated by helping the nurse realize that negative symptoms may be the result of actual brain dysfunction,rather than psychologically determined behaviors; thus the remaining options are not appropriate since they do not address the complexity of the problem.

Question 15

The patient's family asks whether a diagnosis of Parkinson's disease creates an increased risk for any mental health issues.What question would the nurse ask to assess for such a comorbid condition?

Accepted Answer

Serotonin and its close chemical relatives,dopamine and norepinephrine,are the neurotransmitters that are most widely involved in various forms of depression.Most researchers agree that the immediate cause of parkinsonism is a deficiency of dopamine and so a patient with Parkinson's disease should be monitored for depression,The other mental health disorders (bipolar disorder,hallucinations,and obsessive compulsive disorder)have not been connected to Parkinson's disease.

Question 16

At admission,the nurse learns that some time ago the patient had an infarct in the right cerebral cortex.During assessment,the nurse would expect to find that the patient:

Accepted Answer

The cerebral hemispheres are responsible for functions such as control of muscles.The right hemisphere mainly controls the motor and sensory functions on the left side of the body.Damage to the right side would result in impaired function on the left side of the body.The motor cortex controls voluntary motor activity.Broca's area controls motor speech.Cognitive functions are attributed to the association cortex.The right side of the body's motor activity is controlled by the left cerebral cortex.

Question 17

A student nurse mutters that it seems entirely unnecessary to have to struggle with understanding the anatomy and physiology of the neurologic system.The mentor would base a response on the understanding that it is:

Accepted Answer

Nurses must understand that many symptoms of psychiatric disorders have a neurologic basis,although the symptoms are manifested behaviorally.This understanding facilitates effective care planning.The foundation of knowledge is not used exclusively by advanced practice psychiatric nurses nor is it relevant for only behavior therapies or brain trauma since dealing with the results of normal and abnormal brain function is a responsibility of all nurses providing all types of care to the psychiatric patient.

Question 18

A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs.Of the aspects of functioning listed,which will the nurse identify as a focus of nursing intervention?

Accepted Answer

The parietal lobe is responsible for associating and processing sensory information that allows for functions such as following directions on a map,reading a clock,dressing self,keeping appointments,and distinguishing right from left.Emotional expression is associated with frontal lobe function.Detecting auditory stimuli is a temporal lobe function.Receiving visual images is related to occipital lobe function.

Question 19

The unit physicians have ordered magnetic resonance imaging (MRI)tests for the following patients.For which patients would the nurse decline to make test arrangements without further discussion with the physician? Select all that apply.

Accepted Answer

Patients with claustrophobia are often unable to complete this type of study,because the MRI machine is enclosed,and patients are required to remain motionless.Metal implants are contraindications for MRIs since metal affects the scan.Breastfeeding,iodine sensitivity,and neuroleptic medication therapy are not contraindications for an MRI.

Question 20

Which explanation for the prescription of donepezil (Aricept)would the nurse provide for a patient in the early stage of Alzheimer's disease?

Accepted Answer

Decreased levels of acetylcholine are thought to produce many of the behavioral symptoms of Alzheimer's disease.The inhibiting action the drug has on cholinesterase will slow down the breakdown of acetylcholine and so delay the onset of symptoms.The other neurotransmitters (GABA,dopamine,and serotonin)are not currently believed to play a role in Alzheimer's disease.

Quiz 6: Neurobiology in Mental Health and Mental Disorder