Question 1

The nurse wants to assess for disturbances in circadian rhythms in a patient admitted for depression.Which question best implements this assessment?

Accepted Answer

A)  "Do you ever see or hear things that others do not?"
B)  "Do you have problems with short-term memory?"
C)  "What are your worst and best times of day?"
D)  "How would you describe your thinking?" C

Question 2

A patient's spouse,who is a chemist,asks a nurse how serotonin reuptake inhibitors (SSRIs)lift depression.The nurse should explain that SSRIs:

Accepted Answer

A)  destroy increased amounts of neurotransmitters.
B)  make more serotonin available at the synaptic gap.
C)  increase production of acetylcholine and dopamine.
D)  block muscarinic and alpha1-norepinephrine receptors. A

Question 3

The spouse of a patient with schizophrenia asks,"Which neurotransmitters are more active when a person has schizophrenia?" The nurse should state,"The current thinking is that the thought disturbances are related to increased activity of: (Select all that apply. )

Accepted Answer

A)  GABA."
B)  substance P."
C)  histamine."
D)  dopamine."
E)  norepinephrine." D,E

Question 4

A patient begins therapy with a phenothiazine medication.What teaching should a nurse provide related to the drug's strong dopaminergic effect?

Accepted Answer

A)  Chew sugarless gum.
B)  Increase dietary fiber.
C)  Arise slowly from bed.
D)  Report muscle stiffness.

Question 5

A patient has delusions and hallucinations.Before beginning treatment with a psychotropic medication,the health care provider wants to rule out the presence of a brain tumor.For which test will a nurse need to prepare the patient?

Accepted Answer

A)  Cerebral arteriogram
B)  Computed tomography (CT) scan or magnetic resonance imaging (MRI) 
C)  Positron emission tomography (PET) or single photon emission computed tomography (SPECT) 
D)  Functional magnetic resonance imaging (fMRI)

Question 6

A nurse cares for patients taking various medications,including buspirone (BuSpar),haloperidol (Haldol),trazodone (Desyrel),and phenelzine (Nardil).The nurse will order a special diet for the patient taking:

Accepted Answer

A)  buspirone
B)  haloperidol
C)  trazodone
D)  phenelzine

Question 7

The therapeutic action of monoamine oxidase inhibitors (MAOIs)blocks neurotransmitter reuptake,causing:

Accepted Answer

A)  increased concentration of neurotransmitters in the synaptic gap
B)  decreased concentration of neurotransmitters in serum
C)  destruction of receptor sites
D)  limbic system stimulation

Question 8

A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to alpha? receptors because the patient may experience:

Accepted Answer

A)  increased psychotic symptoms
B)  severe appetite disturbance
C)  orthostatic hypotension
D)  hypertensive crisis

Question 9

A nurse should assess a patient taking a medication with anticholinergic properties for inhibited function of the:

Accepted Answer

A)  parasympathetic nervous system
B)  sympathetic nervous system
C)  reticular activating system
D)  medulla oblongata

Question 10

A nurse prepares to administer an antipsychotic medication to a patient with schizophrenia.Additional monitoring of the medication's effects and side effects will be most important if the patient is also diagnosed with which health problem? Select all that apply.

Accepted Answer

A)  Parkinson disease
B)  Graves disease
C)  Osteoarthritis
D)  Epilepsy
E)  Diabetes

Question 11

A patient has taken many conventional antipsychotic drugs over years.The health care provider,who is concerned about early signs of tardive dyskinesia,prescribes risperidone (Risperdal).A nurse planning care for this patient understands that atypical antipsychotics:

Accepted Answer

A)  are less costly.
B)  have higher potency.
C)  are more readily available.
D)  produce fewer motor side effects.

Question 12

A patient has dementia.The health care provider wants to make a differential diagnosis between Alzheimer disease and multiple infarctions.Which diagnostic procedure should a nurse expect to prepare the patient for first?

Accepted Answer

A)  Computed tomography (CT) scan
B)  Positron emission tomography (PET) scan
C)  Functional magnetic resonance imaging (fMRI) 
D)  Single-photon-emission computed tomography (SPECT) scan

Question 13

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion.A nurse can correctly analyze that these symptoms are related to which drug action?

Accepted Answer

A)  Anticholinergic effects
B)  Dopamine-blocking effects
C)  Endocrine-stimulating effects
D)  Ability to stimulate spinal nerves

Question 14

The parent of an adolescent with schizophrenia asks a nurse,"My child's doctor ordered a positron-emission tomography (PET)scan.What is that?" Select the nurse's best reply.

Accepted Answer

A)  "PET uses a magnetic field and gamma waves to identify problems areas in the brain.Does your teenager have any metal implants?"
B)  "It's a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred."
C)  "PET is a scan that passes an electrical current through the brain and shows brain wave activity.PET can help diagnose seizures."
D)  "PET is a special scan that shows blood flow and activity in the brain."

Question 15

A patient asks a nurse,"What are neurotransmitters? My doctor says mine are out of balance." The best reply would be:

Accepted Answer

A)  "You must feel relieved to know that your problem has a physical basis."
B)  "Neurotransmitters are chemicals that pass messages between brain cells."
C)  "It is a high-level concept to explain.You should ask the doctor to tell you more."
D)  "Neurotransmitters are substances we eat daily that influence memory and mood."

Question 16

The laboratory report for a patient taking clozapine (Clozaril)shows a white blood cell count of 3000 mm³ and a granulocyte count of 1500 mm³.The nurse should:

Accepted Answer

A)  report the laboratory results to the health care provider.
B)  give the next dose as prescribed.
C)  administer aspirin and force fluids.
D)  repeat the laboratory tests.

Question 17

A nurse can anticipate anticholinergic side effects will be likely when a patient is taking:

Accepted Answer

A)  lithium (Lithobid) 
B)  buspirone (BuSpar) 
C)  risperidone (Risperdal) 
D)  fluphenazine (Prolixin)

Question 18

A drug causes muscarinic-receptor blockade.A nurse will assess the patient for:

Accepted Answer

A)  dry mouth
B)  gynecomastia
C)  pseudoparkinsonism
D)  orthostatic hypotension

Question 19

A patient has symptoms of acute anxiety related to the death of a parent in an automobile accident 2 hours earlier.The nurse should prepare to teach the patient about a medication from which group?

Accepted Answer

A)  Tricyclic antidepressants
B)  Atypical antipsychotics
C)  Anticonvulsants
D)  Benzodiazepines

Question 20

On the basis of current knowledge of neurotransmitter effects,a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to:

Accepted Answer

A)  inhibit GABA production.
B)  increase dopamine sensitivity.
C)  decrease dopamine at receptor sites.
D)  prevent destruction of acetylcholine.

Exam 4: Biological Basis for Understanding Psychopharmacology