Chapter 6 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 6

Question 1

Type: MCSA

During an assessment, the nurse identifies that the client is having problems learning from the past, difficulty dressing self, and cannot recognize written words. What brain structure dysfunction is exhibited by the clients inability to recognize written words?

1. Frontal lobe dysfunction

2. Temporal lobe dysfunction

3. Parietal lobe dysfunction

4. Occipital lobe dysfunction

Correct Answer: 4

Rationale 1: The occipital lobe is involved in visual perception and recognition, language, and memory formation. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as mastery of visual and spatial balance, mathematical ability, and spelling. The frontal lobe has functional responsibilities for muscular movement and vegetative effects (slowing effects) on respiration and circulation.

Rationale 2: The occipital lobe is involved in visual perception and recognition, language, and memory formation. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as mastery of visual and spatial balance, mathematical ability, and spelling. The frontal lobe has functional responsibilities for muscular movement and vegetative effects (slowing effects) on respiration and circulation.

Rationale 3: The occipital lobe is involved in visual perception and recognition, language, and memory formation. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as mastery of visual and spatial balance, mathematical ability, and spelling. The frontal lobe has functional responsibilities for muscular movement and vegetative effects (slowing effects) on respiration and circulation.

Rationale 4: The occipital lobe is involved in visual perception and recognition, language, and memory formation. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as mastery of visual and spatial balance, mathematical ability, and spelling. The frontal lobe has functional responsibilities for muscular movement and vegetative effects (slowing effects) on respiration and circulation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe five neuroanatomic structures that affect thought, behavior, memory, understanding of consequences, and emotions.

Question 2

Type: MCSA

Clients with visual hallucinations are experiencing problems in their:

1. Temporal lobe

2. Occipital lobe

3. Right frontal lobe

4. Parietal lobe

Correct Answer: 2

Rationale 1: The occipital lobe is involved in interpretation of visual perception and recognition, language, and memory formation. The right frontal lobe has functional responsibilities for muscular movement on the left side of the body. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as a mastery of visual and spatial balance, mathematical ability, and spelling.

Rationale 2: The occipital lobe is involved in interpretation of visual perception and recognition, language, and memory formation. The right frontal lobe has functional responsibilities for muscular movement on the left side of the body. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as a mastery of visual and spatial balance, mathematical ability, and spelling.

Rationale 3: The occipital lobe is involved in interpretation of visual perception and recognition, language, and memory formation. The right frontal lobe has functional responsibilities for muscular movement on the left side of the body. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as a mastery of visual and spatial balance, mathematical ability, and spelling.

Rationale 4: The occipital lobe is involved in interpretation of visual perception and recognition, language, and memory formation. The right frontal lobe has functional responsibilities for muscular movement on the left side of the body. The temporal lobe is the emotional center and is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe facilitates complex motor and cognitive skills, such as a mastery of visual and spatial balance, mathematical ability, and spelling.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe five neuroanatomic structures that affect thought, behavior, memory, understanding of consequences, and emotions.

Question 3

Type: MCSA

The nurse is assessing the client for signs and symptoms of brain dysfunction. If the limbic system function is disrupted, you expect the client to have difficulty with:

1. Emotional responses.

2. Consciousness.

3. Vital life functions.

4. Auditory hallucinations.

Correct Answer: 1

Rationale 1: The limbic system, often referred to as the emotional brain, is believed to be responsible for the experience and expression of emotion, as well as memory, and some aspects of attention. Consciousness is modulated by the reticular activating system. Many vital life functions are controlled by the medulla oblongata. Auditory hallucinations would arise from disruptions in the cerebral cortex.

Rationale 2: The limbic system, often referred to as the emotional brain, is believed to be responsible for the experience and expression of emotion, as well as memory, and some aspects of attention. Consciousness is modulated by the reticular activating system. Many vital life functions are controlled by the medulla oblongata. Auditory hallucinations would arise from disruptions in the cerebral cortex.

Rationale 3: The limbic system, often referred to as the emotional brain, is believed to be responsible for the experience and expression of emotion, as well as memory, and some aspects of attention. Consciousness is modulated by the reticular activating system. Many vital life functions are controlled by the medulla oblongata. Auditory hallucinations would arise from disruptions in the cerebral cortex.

Rationale 4: The limbic system, often referred to as the emotional brain, is believed to be responsible for the experience and expression of emotion, as well as memory, and some aspects of attention. Consciousness is modulated by the reticular activating system. Many vital life functions are controlled by the medulla oblongata. Auditory hallucinations would arise from disruptions in the cerebral cortex.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe five neuroanatomic structures that affect thought, behavior, memory, understanding of consequences, and emotions.

Question 4

Type: MCSA

A client is admitted to the medical surgical unit with a brain tumor. The nurse can anticipate that a client with a tumor in the frontal lobes will have problems with:

1. Sensory functions.

2. The ability to think and plan.

3. Long-term memory.

4. Memory and judgment.

Correct Answer: 2

Rationale 1: The frontal lobe receives information from the limbic system that results in an effect on thinking, ability to plan, judgment, and understanding consequences of behavior. The temporal lobe is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe is involved with sensory functions. Memory is associated with the temporal and occipital lobes.

Rationale 2: The frontal lobe receives information from the limbic system that results in an effect on thinking, ability to plan, judgment, and understanding consequences of behavior. The temporal lobe is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe is involved with sensory functions. Memory is associated with the temporal and occipital lobes.

Rationale 3: The frontal lobe receives information from the limbic system that results in an effect on thinking, ability to plan, judgment, and understanding consequences of behavior. The temporal lobe is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe is involved with sensory functions. Memory is associated with the temporal and occipital lobes.

Rationale 4: The frontal lobe receives information from the limbic system that results in an effect on thinking, ability to plan, judgment, and understanding consequences of behavior. The temporal lobe is involved with memory, cognition, and understanding the acoustic aspects of language. The parietal lobe is involved with sensory functions. Memory is associated with the temporal and occipital lobes.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe five neuroanatomic structures that affect thought, behavior, memory, understanding of consequences, and emotions.

Question 5

Type: MCSA

A client is hospitalized for psychotic symptoms including auditory hallucinations and paranoid delusions. Based on an understanding of neurobiology, the nurse knows the psychotic symptoms arise from disruptions in which neurotransmitter?

1. Norepinephrine

2. Serotonin

3. Acetylcholine

4. Dopamine

Correct Answer: 4

Rationale 1: Dopamine disruptions are involved in psychosis. Serotonin and norepinephrine are associated with mood disorders. Acetylcholine is associated with dementia of the Alzheimers type.

Rationale 2: Dopamine disruptions are involved in psychosis. Serotonin and norepinephrine are associated with mood disorders. Acetylcholine is associated with dementia of the Alzheimers type.

Rationale 3: Dopamine disruptions are involved in psychosis. Serotonin and norepinephrine are associated with mood disorders. Acetylcholine is associated with dementia of the Alzheimers type.

Rationale 4: Dopamine disruptions are involved in psychosis. Serotonin and norepinephrine are associated with mood disorders. Acetylcholine is associated with dementia of the Alzheimers type.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Systematically compare and contrast alterations of the neuromessengers that occur in schizophrenia, bipolar disorder, and major depression.

Question 6

Type: MCSA

A client hospitalized for psychotic symptoms including auditory hallucinations and delusions of reference is prescribed a medication with a strong dopamine blocking action. The nurse teaches the client to recognize which symptom as a possible side effect of the medication?

1. Muscle stiffness

2. Constipation

3. Orthostatic intolerance

4. Dry mouth

Correct Answer: 1

Rationale 1: Dopamine is found in the basal ganglia and is responsible for control of complex movement. When these dopamine receptors are blocked, the client may experience muscle stiffness. A dry mouth and constipation are due to anticholinergic effects. Orthostatic intolerance is due to an antiadrenergic effect.

Rationale 2: Dopamine is found in the basal ganglia and is responsible for control of complex movement. When these dopamine receptors are blocked, the client may experience muscle stiffness. A dry mouth and constipation are due to anticholinergic effects. Orthostatic intolerance is due to an antiadrenergic effect.

Rationale 3: Dopamine is found in the basal ganglia and is responsible for control of complex movement. When these dopamine receptors are blocked, the client may experience muscle stiffness. A dry mouth and constipation are due to anticholinergic effects. Orthostatic intolerance is due to an antiadrenergic effect.

Rationale 4: Dopamine is found in the basal ganglia and is responsible for control of complex movement. When these dopamine receptors are blocked, the client may experience muscle stiffness. A dry mouth and constipation are due to anticholinergic effects. Orthostatic intolerance is due to an antiadrenergic effect.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Systematically compare and contrast alterations of the neuromessengers that occur in schizophrenia, bipolar disorder, and major depression.

Question 7

Type: MCSA

A nurse is teaching a client how selective serotonin reuptake inhibitor medications work. The client states I am depressed, why I should learn about serotonin is beyond me. The nurse should explain that:

1. Decreased serotonin will increase the clients energy levels.

2. Serotonin will help the client think more clearly.

3. Serotonin is associated with alterations in mood.

4. Increased serotonin will assist with sleep patterns.

Correct Answer: 3

Rationale 1: The client needs to understand that depression is associated with neurotransmitter changes in the brain. There is no indication that the client has problems with sleep, energy levels, or thinking.

Rationale 2: The client needs to understand that depression is associated with neurotransmitter changes in the brain. There is no indication that the client has problems with sleep, energy levels, or thinking.

Rationale 3: The client needs to understand that depression is associated with neurotransmitter changes in the brain. There is no indication that the client has problems with sleep, energy levels, or thinking.

Rationale 4: The client needs to understand that depression is associated with neurotransmitter changes in the brain. There is no indication that the client has problems with sleep, energy levels, or thinking.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Systematically compare and contrast alterations of the neuromessengers that occur in schizophrenia, bipolar disorder, and major depression.

Question 8

Type: MCSA

The advanced practice psychiatric nurse is preparing staff education on neurotransmitters. Which statement would be included in the teaching presentation?

1. There are two classes of neurotransmitters.

2. Each neurotransmitter functions in the same manner.

3. Neurotransmitters consistently act in either an excitatory or inhibitory manner.

4. Neurotransmitters and receptors do not vary in their affinity for each other.

Correct Answer: 3

Rationale 1: Neurotransmitters consistently have either an excitatory or inhibitory effect on the postsynaptic neuron. Each neurotransmitter functions in a unique manner. There are three classes of neurotransmitters. Neurotransmitters and receptors vary in their affinity for each other depending on the neurotransmitter involved.

Rationale 2: Neurotransmitters consistently have either an excitatory or inhibitory effect on the postsynaptic neuron. Each neurotransmitter functions in a unique manner. There are three classes of neurotransmitters. Neurotransmitters and receptors vary in their affinity for each other depending on the neurotransmitter involved.

Rationale 3: Neurotransmitters consistently have either an excitatory or inhibitory effect on the postsynaptic neuron. Each neurotransmitter functions in a unique manner. There are three classes of neurotransmitters. Neurotransmitters and receptors vary in their affinity for each other depending on the neurotransmitter involved.

Rationale 4: Neurotransmitters consistently have either an excitatory or inhibitory effect on the postsynaptic neuron. Each neurotransmitter functions in a unique manner. There are three classes of neurotransmitters. Neurotransmitters and receptors vary in their affinity for each other depending on the neurotransmitter involved.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Systematically compare and contrast alterations of the neuromessengers that occur in schizophrenia, bipolar disorder, and major depression.

Question 9

Type: MCSA

A client with a diagnosis of bipolar disorder asks the nurse what caused the illness. What should the nurse tell the client regarding the genetic transmission of bipolar disorder?

1. Bipolar disorder is caused by environmental factors.

2. There is no known cause for the development of bipolar disorder.

3. There appears to be a genetic link in the transmission of bipolar disease.

4. There is one single gene responsible for bipolar disorder.

Correct Answer: 3

Rationale 1: There appears to be about a 60% heritability factor in the transmission of bipolar disease. There is no single gene responsible for any mental disorder. The exact cause of bipolar disorder is not known, but there does appear to be heritability factors. The environment acts in concert with genotype for the expression of mental disorders.

Rationale 2: There appears to be about a 60% heritability factor in the transmission of bipolar disease. There is no single gene responsible for any mental disorder. The exact cause of bipolar disorder is not known, but there does appear to be heritability factors. The environment acts in concert with genotype for the expression of mental disorders.

Rationale 3: There appears to be about a 60% heritability factor in the transmission of bipolar disease. There is no single gene responsible for any mental disorder. The exact cause of bipolar disorder is not known, but there does appear to be heritability factors. The environment acts in concert with genotype for the expression of mental disorders.

Rationale 4: There appears to be about a 60% heritability factor in the transmission of bipolar disease. There is no single gene responsible for any mental disorder. The exact cause of bipolar disorder is not known, but there does appear to be heritability factors. The environment acts in concert with genotype for the expression of mental disorders.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Provide three examples of genetic contributions to mental disorders.

Question 10

Type: MCSA

The family of a client with a diagnosis of dementia of the Alzheimers type (DAT) has expressed concern that they may inherit the disorder. The nurse tells the family which of the following?

1. There appear to be genetic links in the development of early onset DAT.

2. There are no genetic links.

3. There is evidence to suggest increased cerebral blood flow causes DAT.

4. There is evidence to suggest massive neuronal death causes DAT.

Correct Answer: 1

Rationale 1: Heritability is well documented and accounts for approximately one-third of all cases of dementia of the Alzheimers type. Decreased cerebral blood flow is noted in the posterior temporoparietal regions. The causes of structural degeneration in the brains of clients with DAT are associated with amyloid-beta-derived diffusible ligands.

Rationale 2: Heritability is well documented and accounts for approximately one-third of all cases of dementia of the Alzheimers type. Decreased cerebral blood flow is noted in the posterior temporoparietal regions. The causes of structural degeneration in the brains of clients with DAT are associated with amyloid-beta-derived diffusible ligands.

Rationale 3: Heritability is well documented and accounts for approximately one-third of all cases of dementia of the Alzheimers type. Decreased cerebral blood flow is noted in the posterior temporoparietal regions. The causes of structural degeneration in the brains of clients with DAT are associated with amyloid-beta-derived diffusible ligands.

Rationale 4: Heritability is well documented and accounts for approximately one-third of all cases of dementia of the Alzheimers type. Decreased cerebral blood flow is noted in the posterior temporoparietal regions. The causes of structural degeneration in the brains of clients with DAT are associated with amyloid-beta-derived diffusible ligands.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Provide three examples of genetic contributions to mental disorders.

Question 11

Type: MCSA

The client with a diagnosis of major depression tells the nurse that multiple generations of women in her family also suffered from depression. She states I guess it is a family tradition to have problems dealing with stress. The nurse tells the client which of the following?

1. There is evidence to suggest that genotype is not influenced by stress.

2. There is probably a shared stressful environment.

3. Mood disorders do seem to have some basis in heredity among other contributing factors.

4. There is no evidence to suggest a familial occurrence of mood disorders.

Correct Answer: 3

Rationale 1: Genetics account for approximately 42% of heritability in meta-analysis studies. Environment does influence phenotype, but several generations of women will not share the same environment. A familial occurrence of mood disorders is suggested by genetic heritability rates. Genotype is expressed through the interaction with the environment, which includes stress.

Rationale 2: Genetics account for approximately 42% of heritability in meta-analysis studies. Environment does influence phenotype, but several generations of women will not share the same environment. A familial occurrence of mood disorders is suggested by genetic heritability rates. Genotype is expressed through the interaction with the environment, which includes stress.

Rationale 3: Genetics account for approximately 42% of heritability in meta-analysis studies. Environment does influence phenotype, but several generations of women will not share the same environment. A familial occurrence of mood disorders is suggested by genetic heritability rates. Genotype is expressed through the interaction with the environment, which includes stress.

Rationale 4: Genetics account for approximately 42% of heritability in meta-analysis studies. Environment does influence phenotype, but several generations of women will not share the same environment. A familial occurrence of mood disorders is suggested by genetic heritability rates. Genotype is expressed through the interaction with the environment, which includes stress.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Provide three examples of genetic contributions to mental disorders.

Question 12

Type: MCSA

An individual is subjected to chronic uncontrollable stress. What will be the effect on the clients neuroendocrine function?

1. Hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of substance P

2. Hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of dopamine

3. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of dopamine

4. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of substance P

Correct Answer: 4

Rationale 1: Substance P is neuropeptide thought to be released during physiologic and environmental stress. Substance P is thought to contribute to changes in the central nervous system that predispose individuals to anxiety and depression.

Rationale 2: Substance P is neuropeptide thought to be released during physiologic and environmental stress. Substance P is thought to contribute to changes in the central nervous system that predispose individuals to anxiety and depression.

Rationale 3: Substance P is neuropeptide thought to be released during physiologic and environmental stress. Substance P is thought to contribute to changes in the central nervous system that predispose individuals to anxiety and depression.

Rationale 4: Substance P is neuropeptide thought to be released during physiologic and environmental stress. Substance P is thought to contribute to changes in the central nervous system that predispose individuals to anxiety and depression.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Identify two ways in which the communication between the endocrine and immune systems affects a persons mood and behavior.

Question 13

Type: MCSA

The immune system is a complex system of cells, proteins, and functional systems. When the brain directly influences the immune system, this can be interpreted as what field of study?

1. Neuroendocrinology

2. Immunology

3. Psychoendocrinology

4. Psychoneuroimmunology

Correct Answer: 4

Rationale 1: Psychoneuroimmunology is the study of the links between thoughts, emotions, the nervous system, and the immune system. The interaction of the brain with the endocrine system is known as psychoendocrinology or neuroendocrinology. Immunology is the study of all aspects of the immune system.

Rationale 2: Psychoneuroimmunology is the study of the links between thoughts, emotions, the nervous system, and the immune system. The interaction of the brain with the endocrine system is known as psychoendocrinology or neuroendocrinology. Immunology is the study of all aspects of the immune system.

Rationale 3: Psychoneuroimmunology is the study of the links between thoughts, emotions, the nervous system, and the immune system. The interaction of the brain with the endocrine system is known as psychoendocrinology or neuroendocrinology. Immunology is the study of all aspects of the immune system.

Rationale 4: Psychoneuroimmunology is the study of the links between thoughts, emotions, the nervous system, and the immune system. The interaction of the brain with the endocrine system is known as psychoendocrinology or neuroendocrinology. Immunology is the study of all aspects of the immune system.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify two ways in which the communication between the endocrine and immune systems affects a persons mood and behavior.

Question 14

Type: MCSA

A client is administered the dexamethasone suppression test (DST), which attempts to assess the hypothalamic-pituitary-adrenal (HPA) axis. How will the results of the test be used?

1. To identify genetic predisposition

2. To diagnose psychiatric illness

3. To identify appropriate treatment

4. To identify pathology in the HPA axis function

Correct Answer: 4

Rationale 1: The results of the DST are not diagnostic of the illness, but suggest some pathology in the HPA axis function. The DST does not identify genetic predisposition or treatment options.

Rationale 2: The results of the DST are not diagnostic of the illness, but suggest some pathology in the HPA axis function. The DST does not identify genetic predisposition or treatment options.

Rationale 3: The results of the DST are not diagnostic of the illness, but suggest some pathology in the HPA axis function. The DST does not identify genetic predisposition or treatment options.

Rationale 4: The results of the DST are not diagnostic of the illness, but suggest some pathology in the HPA axis function. The DST does not identify genetic predisposition or treatment options.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify two ways in which the communication between the endocrine and immune systems affects a persons mood and behavior.

Question 15

Type: MCSA

Stress-related symptoms account for 60% of all primary care visits. What are the implications for practice?

1. An understanding of how stress influences disease will allow us to identify appropriate treatments.

2. An understanding of stress will allow us to teach clients stress reduction techniques.

3. An understanding of stress will allow us to identify integrative treatments.

4. An understanding of stress will allow us to identify clients at risk of mental illness.

Correct Answer: 1

Rationale 1: Practitioners in all specialties must have an understanding of why stress influences disease. Before clients at risk for mental illness can be identified, practitioners have to understand the etiology of how stress influences disease. This will allow implementation of appropriate treatments. Stress reduction is one of multiple treatment options and the goal is to utilize an integrative approach once an etiology is identified.

Rationale 2: Practitioners in all specialties must have an understanding of why stress influences disease. Before clients at risk for mental illness can be identified, practitioners have to understand the etiology of how stress influences disease. This will allow implementation of appropriate treatments. Stress reduction is one of multiple treatment options and the goal is to utilize an integrative approach once an etiology is identified.

Rationale 3: Practitioners in all specialties must have an understanding of why stress influences disease. Before clients at risk for mental illness can be identified, practitioners have to understand the etiology of how stress influences disease. This will allow implementation of appropriate treatments. Stress reduction is one of multiple treatment options and the goal is to utilize an integrative approach once an etiology is identified.

Rationale 4: Practitioners in all specialties must have an understanding of why stress influences disease. Before clients at risk for mental illness can be identified, practitioners have to understand the etiology of how stress influences disease. This will allow implementation of appropriate treatments. Stress reduction is one of multiple treatment options and the goal is to utilize an integrative approach once an etiology is identified.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Identify two ways in which the communication between the endocrine and immune systems affects a persons mood and behavior.

Question 16

Type: MCSA

The nurse is providing discharge instructions to a client diagnosed with an anxiety disorder. What will the nurse tell the client about the activity of the amino acid gamma-aminobutyric acid (GABA), benzodiazepines, and the effect on anxiety?

1. GABA is an inhibitory neurotransmitter.

2. GABA increases neuronal excitability.

3. GABA increases can be neurotoxic.

4. GABA is an excitatory neurotransmitter.

Correct Answer: 1

Rationale 1: GABA is an inhibitory neurotransmitter. When a neuron is stimulated, GABA decreases neuronal excitability. Benzodiazepines act by binding with GABA and benzodiazepine receptors to produce an antianxiety effect. An increase in GABA is not neurotoxic.

Rationale 2: GABA is an inhibitory neurotransmitter. When a neuron is stimulated, GABA decreases neuronal excitability. Benzodiazepines act by binding with GABA and benzodiazepine receptors to produce an antianxiety effect. An increase in GABA is not neurotoxic.

Rationale 3: GABA is an inhibitory neurotransmitter. When a neuron is stimulated, GABA decreases neuronal excitability. Benzodiazepines act by binding with GABA and benzodiazepine receptors to produce an antianxiety effect. An increase in GABA is not neurotoxic.

Rationale 4: GABA is an inhibitory neurotransmitter. When a neuron is stimulated, GABA decreases neuronal excitability. Benzodiazepines act by binding with GABA and benzodiazepine receptors to produce an anti-anxiety effect. An increase in GABA is not neurotoxic.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Explain how understanding the biologic contribution to emotional problems contributes to your nursing practice.

Question 17

Type: MCSA

During a medications management class, the nurse discusses the use of antipsychotic medications to treat psychosis. Which of the following statements indicate how these medications affect neurotransmitter activity?

1. Antipsychotics increase dopamine receptors.

2. Antipsychotics decrease the sensitivity of the receptor sites on the post-synaptic neuron.

3. Antipsychotics increase the amount of dopamine in the post-synaptic neuron.

4. Antipsychotics block dopamine receptors.

Correct Answer: 4

Rationale 1: The efficacy of antipsychotic drugs to treat psychosis is related to the medications ability to block dopamine receptors. Antipsychotic medications do not increase the amount of dopamine in the post-synaptic neuron or decrease the sensitivity of post-synaptic receptor sites.

Rationale 2: The efficacy of antipsychotic drugs to treat psychosis is related to the medications ability to block dopamine receptors. Antipsychotic medications do not increase the amount of dopamine in the post-synaptic neuron or decrease the sensitivity of post-synaptic receptor sites.

Rationale 3: The efficacy of antipsychotic drugs to treat psychosis is related to the medications ability to block dopamine receptors. Antipsychotic medications do not increase the amount of dopamine in the post-synaptic neuron or decrease the sensitivity of post-synaptic receptor sites.

Rationale 4: The efficacy of antipsychotic drugs to treat psychosis is related to the medications ability to block dopamine receptors. Antipsychotic medications do not increase the amount of dopamine in the post-synaptic neuron or decrease the sensitivity of post-synaptic receptor sites.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain how understanding the biologic contribution to emotional problems contributes to your nursing practice.

Question 18

Type: MCSA

A client with bipolar disorder tells the nurse, I am thinking of switching to an alternating day/night shift because it pays more and will give me more time with my children. The nurses reply should be based on the knowledge of which of the following?

1. The clients priority is steady employment.

2. The client should contact the nurse if prodromal symptoms of the bipolar disorder occur.

3. Disruptions in biologic rhythms can impact the clients bipolar disorder.

4. Biologic rhythms do not influence mood disorders.

Correct Answer: 3

Rationale 1: A stable work shift is essential to successful management of the bipolar disorder as irregular shift patterns could cause an exacerbation in the disorder. The client may not be able to maintain employment if there are exacerbations in the illness. Mood disorders often have a biologic rhythm component as evidenced by sleep pattern disturbances. It is prudent to maintain a consistent schedule to prevent the occurrence of mood changes as opposed to waiting for symptoms to occur.

Rationale 2: A stable work shift is essential to successful management of the bipolar disorder as irregular shift patterns could cause an exacerbation in the disorder. The client may not be able to maintain employment if there are exacerbations in the illness. Mood disorders often have a biologic rhythm component as evidenced by sleep pattern disturbances. It is prudent to maintain a consistent schedule to prevent the occurrence of mood changes as opposed to waiting for symptoms to occur.

Rationale 3: A stable work shift is essential to successful management of the bipolar disorder as irregular shift patterns could cause an exacerbation in the disorder. The client may not be able to maintain employment if there are exacerbations in the illness. Mood disorders often have a biologic rhythm component as evidenced by sleep pattern disturbances. It is prudent to maintain a consistent schedule to prevent the occurrence of mood changes as opposed to waiting for symptoms to occur.

Rationale 4: A stable work shift is essential to successful management of the bipolar disorder as irregular shift patterns could cause an exacerbation in the disorder. The client may not be able to maintain employment if there are exacerbations in the illness. Mood disorders often have a biologic rhythm component as evidenced by sleep pattern disturbances. It is prudent to maintain a consistent schedule to prevent the occurrence of mood changes as opposed to waiting for symptoms to occur.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how understanding the biologic contribution to emotional problems contributes to your nursing practice.

Question 19

Type: MCSA

The mother of a client diagnosed with schizophrenia is tearful and wonders aloud if she passed the illness on to her child, and if her grandchild will also develop the disease. The nurse should reply with which statement?

1. I see you are feeling upset. Do you want to talk?

2. Schizophrenia does have a strong genetic link, but at present there is no specific genetic test for it.

3. Your grandchild has nothing to worry about.

4. You and your child should volunteer for genetic research.

Correct Answer: 2

Rationale 1: Schizophrenia has an 80% chance of heritability. At present there is no specific genetic test available. Clients and families should be presented with information about the benefits of genetic research for future generations of people with schizophrenia. Telling the client there is nothing to worry about is false reassurance and is not therapeutic. Acknowledging the clients distress is appropriate, but the nurse must address the clients concerns directly.

Rationale 2: Schizophrenia has an 80% chance of heritability. At present there is no specific genetic test available. Clients and families should be presented with information about the benefits of genetic research for future generations of people with schizophrenia. Telling the client there is nothing to worry about is false reassurance and is not therapeutic. Acknowledging the clients distress is appropriate, but the nurse must address the clients concerns directly.

Rationale 3: Schizophrenia has an 80% chance of heritability. At present there is no specific genetic test available. Clients and families should be presented with information about the benefits of genetic research for future generations of people with schizophrenia. Telling the client there is nothing to worry about is false reassurance and is not therapeutic. Acknowledging the clients distress is appropriate, but the nurse must address the clients concerns directly.

Rationale 4: Schizophrenia has an 80% chance of heritability. At present there is no specific genetic test available. Clients and families should be presented with information about the benefits of genetic research for future generations of people with schizophrenia. Telling the client there is nothing to worry about is false reassurance and is not therapeutic. Acknowledging the clients distress is appropriate, but the nurse must address the clients concerns directly.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and families to teach the biologic implications of psychiatric illnesses.

Question 20

Type: MCSA

A client tells visiting family that a test was done to see how the clients brain was functioning. The family asks the nurse if there really is such a test. The nurse realizes that the client had which type of test?

1. Computerized tomography (CT)

2. Positron emission test (PET)

3. Single photon-emission computed tomography (SPECT)

4. Magnetic resonance imaging (MRI)

Correct Answer: 2

Rationale 1: A PET scan provides information about the metabolic functioning of the brain. CT, MRI, and SPECT are imaging techniques to examine the structure of the brain.

Rationale 2: A PET scan provides information about the metabolic functioning of the brain. CT, MRI, and SPECT are imaging techniques to examine the structure of the brain.

Rationale 3: A PET scan provides information about the metabolic functioning of the brain. CT, MRI, and SPECT are imaging techniques to examine the structure of the brain.

Rationale 4: A PET scan provides information about the metabolic functioning of the brain. CT, MRI, and SPECT are imaging techniques to examine the structure of the brain.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Partner with clients and families to teach the biologic implications of psychiatric illnesses.

Question 21

Type: MCSA

The nurse is working with a client and family. When planning care, the nurse will consider principles underlying psychobiological research including which of the following concepts?

1. Mental illness is primarily considered to be a consequence of environment.

2. The brain is unresponsive to the environment.

3. The brain is relatively unchangeable after birth.

4. Understanding the role of neurotransmitters in the formation of behavior is valuable to nursing care.

Correct Answer: 4

Rationale 1: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. Psychobiological knowledge should be incorporated into the nursing interventions and family teaching. The brain is a dynamic organ and is responsive to stimulation from the environment. Mental illness is most likely a combination of hereditary and environmental factors.

Rationale 2: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. Psychobiological knowledge should be incorporated into the nursing interventions and family teaching. The brain is a dynamic organ and is responsive to stimulation from the environment. Mental illness is most likely a combination of hereditary and environmental factors.

Rationale 3: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. Psychobiological knowledge should be incorporated into the nursing interventions and family teaching. The brain is a dynamic organ and is responsive to stimulation from the environment. Mental illness is most likely a combination of hereditary and environmental factors.

Rationale 4: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. Psychobiological knowledge should be incorporated into the nursing interventions and family teaching. The brain is a dynamic organ and is responsive to stimulation from the environment. Mental illness is most likely a combination of hereditary and environmental factors.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Partner with clients and families to teach the biologic implications of psychiatric illnesses.

Question 22

Type: MCSA

A member of the clients family tells the nurse that they dont understand the choice of electroconvulsive therapy (ECT) for their mothers depression. The family member states they are worried about the damage her brain will incur from the grand mal seizure. What will the nurse teach the family members about ECT?

1. Grand mal seizures are not life threatening.

2. They can withdraw consent at any time.

3. ECT is a safe and effective treatment option for depression.

4. The induced seizure lasts less than a minute.

Correct Answer: 3

Rationale 1: The priority information for the family is that ECT is a safe treatment option. The nurse can inform the family that ECT currently uses muscle relaxants and short-acting anesthetic agents during the procedure. The family should then be told that the ECT-induced seizure causes no tissue damage or neuronal cell loss. Most ECT clients report positive associations and relief from depression. And finally, the family should be informed that consent for the procedure is given by the client and the consent can be withdrawn at any time.

Rationale 2: The priority information for the family is that ECT is a safe treatment option. The nurse can inform the family that ECT currently uses muscle relaxants and short-acting anesthetic agents during the procedure. The family should then be told that the ECT-induced seizure causes no tissue damage or neuronal cell loss. Most ECT clients report positive associations and relief from depression. And finally, the family should be informed that consent for the procedure is given by the client and the consent can be withdrawn at any time.

Rationale 3: The priority information for the family is that ECT is a safe treatment option. The nurse can inform the family that ECT currently uses muscle relaxants and short-acting anesthetic agents during the procedure. The family should then be told that the ECT-induced seizure causes no tissue damage or neuronal cell loss. Most ECT clients report positive associations and relief from depression. And finally, the family should be informed that consent for the procedure is given by the client and the consent can be withdrawn at any time.

Rationale 4: The priority information for the family is that ECT is a safe treatment option. The nurse can inform the family that ECT currently uses muscle relaxants and short-acting anesthetic agents during the procedure. The family should then be told that the ECT-induced seizure causes no tissue damage or neuronal cell loss. Most ECT clients report positive associations and relief from depression. And finally, the family should be informed that consent for the procedure is given by the client and the consent can be withdrawn at any time.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and families to teach the biologic implications of psychiatric illnesses.

Question 23

Type: MCSA

When focusing on psychobiology, what is most important for the clients family to understand?

1. The clients symptoms

2. The underlying neurobiology of behavior

3. The clients medication regimen

4. The clients phenotype

Correct Answer: 2

Rationale 1: Understanding the neurobiology of the clients behavior will help the family comprehend the rationale for treatment. It also places the clients illness in the same context as any other medical disorder. The phenotype is the expression of the genotype. The family will have to understand the clients medication regimen, but should have an understanding of why the medications were selected. Symptoms should be discussed in terms of neurobiology.

Rationale 2: Understanding the neurobiology of the clients behavior will help the family comprehend the rationale for treatment. It also places the clients illness in the same context as any other medical disorder. The phenotype is the expression of the genotype. The family will have to understand the clients medication regimen, but should have an understanding of why the medications were selected. Symptoms should be discussed in terms of neurobiology.

Rationale 3: Understanding the neurobiology of the clients behavior will help the family comprehend the rationale for treatment. It also places the clients illness in the same context as any other medical disorder. The phenotype is the expression of the genotype. The family will have to understand the clients medication regimen, but should have an understanding of why the medications were selected. Symptoms should be discussed in terms of neurobiology.

Rationale 4: Understanding the neurobiology of the clients behavior will help the family comprehend the rationale for treatment. It also places the clients illness in the same context as any other medical disorder. The phenotype is the expression of the genotype. The family will have to understand the clients medication regimen, but should have an understanding of why the medications were selected. Symptoms should be discussed in terms of neurobiology.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and families to teach the biologic implications of psychiatric illnesses.

Question 24

Type: MCSA

The nurse and a client are discussing the diagnosis of depression. The client asks, Where in my brain does the depression come from? The nurse is aware that:

1. The occipital lobe governs perceptions of events, judging them as positive or negative.

2. The parietal lobe has been linked to depression.

3. The limbic system is thought to be the emotional center of the brain.

4. The medulla regulates key biological and psychological activities.

Correct Answer: 3

Rationale 1: The limbic system is thought to be the emotional center of the brain. The parietal lobe has not been linked to depression. The medulla does regulate key biological activities, but not psychological activities. The frontal lobe, not the occipital lobe, governs perceptions of events, judging them as positive or negative.

Rationale 2: The limbic system is thought to be the emotional center of the brain. The parietal lobe has not been linked to depression. The medulla does regulate key biological activities, but not psychological activities. The frontal lobe, not the occipital lobe, governs perceptions of events, judging them as positive or negative.

Rationale 3: The limbic system is thought to be the emotional center of the brain. The parietal lobe has not been linked to depression. The medulla does regulate key biological activities, but not psychological activities. The frontal lobe, not the occipital lobe, governs perceptions of events, judging them as positive or negative.

Rationale 4: The limbic system is thought to be the emotional center of the brain. The parietal lobe has not been linked to depression. The medulla does regulate key biological activities, but not psychological activities. The frontal lobe, not the occipital lobe, governs perceptions of events, judging them as positive or negative.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Partner with clients and families to teach the biologic implications of psychiatric illnesses.

Question 25

Type: MCSA

A new nurse in a psychiatric program tells the charge nurse Im not sure I feel safe working with all of these crazy people. Select the best reply by the charge nurse.

1. Dont worry, youll get used to it.

2. Believe me, it is not safe to work with some of these clients.

3. Maybe you should consider transferring to a medical-surgical floor.

4. It sounds like you need to discuss your feelings with the clinical supervisor.

Correct Answer: 4

Rationale 1: Developing self-awareness of ones own dualistic issues is essential to providing professional, competent, and quality care. Dismissing these concerns, agreeing with them, or advising a transfer are not strategies that will promote the new nurses self-awareness.

Rationale 2: Developing self-awareness of ones own dualistic issues is essential to providing professional, competent, and quality care. Dismissing these concerns, agreeing with them, or advising a transfer are not strategies that will promote the new nurses self-awareness.

Rationale 3: Developing self-awareness of ones own dualistic issues is essential to providing professional, competent, and quality care. Dismissing these concerns, agreeing with them, or advising a transfer are not strategies that will promote the new nurses self-awareness.

Rationale 4: Developing self-awareness of ones own dualistic issues is essential to providing professional, competent, and quality care. Dismissing these concerns, agreeing with them, or advising a transfer are not strategies that will promote the new nurses self-awareness.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Analyze how your own personal feelings, opinions, or beliefs about psychobiology can enhance or diminish your ability to be a support person and advocate for clients and their families.

Question 26

Type: MCSA

An involuntary client being treated for an acute exacerbation of paranoid schizophrenia refuses the morning dose of medication. The nurse is frustrated and wonders if the client will ever develop insight. What aspects of psychobiology could help reframe the clients behavior for the nurse?

1. The client is not responsible for the behavior.

2. Adhering to the clients medication regimen is a priority to the nursing care.

3. The frontal and parietal lobe involvement in schizophrenia can cause an unawareness of the illness or the need to take medications.

4. The clients brain chemistry is altered and medications will help.

Correct Answer: 3

Rationale 1: Acknowledging the psychobiology aspects of the clients illness will explain why it is not possible for the client to maintain insight during the exacerbation of the illness. Knowing that the clients illness will respond to medications does not address the nurses frustration. It is important to know why the client is not responsible for his behavior.

Rationale 2: Acknowledging the psychobiology aspects of the clients illness will explain why it is not possible for the client to maintain insight during the exacerbation of the illness. Knowing that the clients illness will respond to medications does not address the nurses frustration. It is important to know why the client is not responsible for his behavior.

Rationale 3: Acknowledging the psychobiology aspects of the clients illness will explain why it is not possible for the client to maintain insight during the exacerbation of the illness. Knowing that the clients illness will respond to medications does not address the nurses frustration. It is important to know why the client is not responsible for his behavior.

Rationale 4: Acknowledging the psychobiology aspects of the clients illness will explain why it is not possible for the client to maintain insight during the exacerbation of the illness. Knowing that the clients illness will respond to medications does not address the nurses frustration. It is important to know why the client is not responsible for his behavior.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Analyze how your own personal feelings, opinions, or beliefs about psychobiology can enhance or diminish your ability to be a support person and advocate for clients and their families.

Question 27

Type: MCSA

A client who presents in the psychiatric unit tells the admitting nurse that he or she is very depressed and is having a hard time staying clean and sober. Which of the following describes the psychobiology of his or her illness?

1. Depression or other mental illness should be treated with compatible medications.

2. Depression or other mental illnesses are symptoms of the substance abuse.

3. There is heritability and predisposition to alcohol dependence as well as complex environmental influences.

4. Depression or other mental illnesses is an expected outcome of substance abuse recovery.

Correct Answer: 3

Rationale 1: Four to five percent of people in Western societies have difficulty with alcohol dependence and the relapse rate is 5080% in a year. The psychobiology of alcohol dependence includes an understanding of the environmental and genetic contributions. Depression and other mental illness should be treated along with the alcohol dependence. Melancholy and despair may occur from time to time as a natural part of recovery, but depression or other mental illnesses are not expected outcomes of recovery.

Rationale 2: Four to five percent of people in Western societies have difficulty with alcohol dependence and the relapse rate is 5080% in a year. The psychobiology of alcohol dependence includes an understanding of the environmental and genetic contributions. Depression and other mental illness should be treated along with the alcohol dependence. Melancholy and despair may occur from time to time as a natural part of recovery, but depression or other mental illnesses are not expected outcomes of recovery.

Rationale 3: Four to five percent of people in Western societies have difficulty with alcohol dependence and the relapse rate is 5080% in a year. The psychobiology of alcohol dependence includes an understanding of the environmental and genetic contributions. Depression and other mental illness should be treated along with the alcohol dependence. Melancholy and despair may occur from time to time as a natural part of recovery, but depression or other mental illnesses are not expected outcomes of recovery.

Rationale 4: Four to five percent of people in Western societies have difficulty with alcohol dependence and the relapse rate is 5080% in a year. The psychobiology of alcohol dependence includes an understanding of the environmental and genetic contributions. Depression and other mental illness should be treated along with the alcohol dependence. Melancholy and despair may occur from time to time as a natural part of recovery, but depression or other mental illnesses are not expected outcomes of recovery.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Analyze how your own personal feelings, opinions, or beliefs about psychobiology can enhance or diminish your ability to be a support person and advocate for clients and their families.

Question 28

Type: MCSA

Which statement describes the benefits of integrating psychobiology into nursing care?

1. A psychobiologic approach enables the nurse to modify assessments, diagnoses, interventions, and evaluations of clients response patterns.

2. A psychobiologic approach is not compatible with the nursing process.

3. A psychobiologic approach will provide a theoretical framework from which to practice.

4. A psychobiologic approach is utilized only by physicians.

Correct Answer: 1

Rationale 1: If the comprehensive nursing assessment, interpretation of the assessment, client teaching, and evaluation of the intervention are based on knowledge of the biologic, cognitive, and behavioral factors that affect the client, the client has a greater opportunity for successful reduction of symptoms. Nurses use a variety of theoretical frameworks and the nursing process to guide care. A psychobiologic approach is compatible with the nursing process. Nurses and physicians practice from a psychobiological perspective using the nursing process.

Rationale 2: If the comprehensive nursing assessment, interpretation of the assessment, client teaching, and evaluation of the intervention are based on knowledge of the biologic, cognitive, and behavioral factors that affect the client, the client has a greater opportunity for successful reduction of symptoms. Nurses use a variety of theoretical frameworks and the nursing process to guide care. A psychobiologic approach is compatible with the nursing process. Nurses and physicians practice from a psychobiological perspective using the nursing process.

Rationale 3: If the comprehensive nursing assessment, interpretation of the assessment, client teaching, and evaluation of the intervention are based on knowledge of the biologic, cognitive, and behavioral factors that affect the client, the client has a greater opportunity for successful reduction of symptoms. Nurses use a variety of theoretical frameworks and the nursing process to guide care. A psychobiologic approach is compatible with the nursing process. Nurses and physicians practice from a psychobiological perspective using the nursing process.

Rationale 4: If the comprehensive nursing assessment, interpretation of the assessment, client teaching, and evaluation of the intervention are based on knowledge of the biologic, cognitive, and behavioral factors that affect the client, the client has a greater opportunity for successful reduction of symptoms. Nurses use a variety of theoretical frameworks and the nursing process to guide care. A psychobiologic approach is compatible with the nursing process. Nurses and physicians practice from a psychobiological perspective using the nursing process.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Analyze how your own personal feelings, opinions, or beliefs about psychobiology can enhance or diminish your ability to be a support person and advocate for clients and their families.

Question 29

Type: MCSA

The nurse is learning how to reduce the stigma associated with substance dependence. What knowledge of psychobiology will help reduce the stigma?

1. Clients with alcohol dependence cannot be held accountable for their actions.

2. Relapse is a common feature of substance abuse.

3. There is heritability and predisposition to alcohol dependence as well as complex environmental influences.

4. Alcoholics Anonymous is an accepted treatment approach.

Correct Answer: 3

Rationale 1: Knowing the psychobiological aspects of heritability and predisposition to alcohol dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Rationale 2: Knowing the psychobiological aspects of heritability and predisposition to alcohol dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Rationale 3: Knowing the psychobiological aspects of heritability and predisposition to alcohol dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Rationale 4: Knowing the psychobiological aspects of heritability and predisposition to alcohol dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Analyze how your own personal feelings, opinions, or beliefs about psychobiology can enhance or diminish your ability to be a support person and advocate for clients and their families.

Question 30

Type: MCSA

The nurse expresses ambivalence about the use of electroconvulsive therapy (ECT). How can this attitude influence client care?

1. This attitude may be communicated to the client and the family, thus hindering the nursing care.

2. The client may be unaware of the nurses attitude.

3. The nurses attitude may spread to other staff members.

4. The nurses ambivalence will have no effect as long as the nurse is professional.

Correct Answer: 1

Rationale 1: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. It is important to consider how treatment outcomes are potentially influenced by both the style and the knowledge incorporated into nursing interventions. The nurses attitude may be conveyed to the client through nonverbal communication. Other staff members may be influenced by ambivalent attitudes.

Rationale 2: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. It is important to consider how treatment outcomes are potentially influenced by both the style and the knowledge incorporated into nursing interventions. The nurses attitude may be conveyed to the client through nonverbal communication. Other staff members may be influenced by ambivalent attitudes.

Rationale 3: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. It is important to consider how treatment outcomes are potentially influenced by both the style and the knowledge incorporated into nursing interventions. The nurses attitude may be conveyed to the client through nonverbal communication. Other staff members may be influenced by ambivalent attitudes.

Rationale 4: The nurses attitude about the underlying neurobiology of behavior can influence therapeutic outcomes. It is important to consider how treatment outcomes are potentially influenced by both the style and the knowledge incorporated into nursing interventions. The nurses attitude may be conveyed to the client through nonverbal communication. Other staff members may be influenced by ambivalent attitudes.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Analyze how your own personal feelings, opinions, or beliefs about psychobiology can enhance or diminish your ability to be a support person and advocate for clients and their families.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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