Chapter 1 Flashcards
A patient with depression mentions to the nurse, My mother says depression is a chemical disorder. What does she mean? The nurses response is based on the theory that depression primarily involves which of the following neurotransmitters?
Serotonin and norepinephrine
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?
Asking the patient to recite the alphabet
The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor. The nurses answer will be based on information that the therapeutic action of psychotropic drugs is the result of their effect on:
The regulation of neurotransmitters especially dopamine
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:
Necessary for planning psychiatric care for all patients especially those experiencing psychiatric disorders
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?
Stress does cause the release of factors that suppress the immune system.
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?
Processing associations
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:
Is unable to effectively hold a spoon in the left hand
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 patients medication teaching by:
Including the patients caregiver in the education
The physician tells the nurse, The medication Im prescribing for the patient enhances the g-aminobutyric acid (GABA) system. Which patient behavior will provide evidence that the medication therapy is successful?
The patient reports that, I dont feel as anxious as I did a couple of days ago.
The patients family asks whether a diagnosis of Parkinsons disease creates an increased risk for any mental health issues. What question would the nurse ask to assess for such a comorbid condition?
Has your father exhibited any signs of depression?
Which explanation for the prescription of donepezil (Aricept) would the nurse provide for a patient in the early stage of Alzheimers disease?
The acetylcholine deficiency will be managed by inhibiting cholinesterase.
There remains a stigma attached to psychiatric illnesses. The psychiatric nurse makes the greatest impact on this sociological problem when:
Providing educational programming for patients and the public
The wife of a patient with paranoid schizophrenia tells the nurse, Ive 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:
Research tends to support a familiar tendency to schizophrenia.
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 patients concern?
The interruption in normal wake-sleep patterns can influence mood disorders.
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 mentors remark that helps place the problem in perspective is:
Negative symptoms have been associated with genetic pathology.
What assessment data would reinforce the diagnosis of temporal lobe injury in patient who experienced head trauma? Select all that apply.
a. Inability to balance a checkbook
b. Uncharacteristically aggressive
c. Affect fluctuates dramatically
d. Increased interest in sexual behaviors
e. Difficulty remembering the names of family members
C, D, E
A patient has begun experiencing dysfunction of the hypothalamus. What nursing interventions will the nurse include in the patients plan of care? Select all that apply.
a. Reinforcing clear physical boundaries
b. Assisting the patient with completing daily menus
c. Learning about healthy sleep hygiene habits
d. Monitoring and recording temperature every 4 hours
e. Monitoring and recording blood pressure every 4 hours
B, C, D
The nurse is preparing a patient for a positron emission tomography (PET) scan. Which instructions will the nurse include? Select all that apply.
a. There will likely be a 30 to 45 minute wait between the injection and the beginning of the scan.
b. A blindfold and earplugs may be used to help decrease reaction to the environment during the scan.
c. Make every attempt to lie still during the scan because movement will affect the imaging produced.
d. No food or fluids are to be ingested for at least 8 full hours before the scan and none during the scan.
e. Staying awake during the scan is important since the results are altered when the patient is in any phase of the sleep state.
A, B, C, E
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.
a. Invades the personal space of others frequently
b. Consistently fails to bring money when going to buy snacks
c. Cannot remember the names of staff who often provide care
d. Requires repeated reinforcement on how to make a sandwich
e. Frequently speaks of hurting himself or of hurting other patients
A, B, D
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.
a. A patient who is claustrophobic
b. A patient who is breastfeeding
c. A patient who has an allergy to iodine
d. A patient who had a total knee replacement
e. A patient who is taking a neuroleptic medication
A, D
