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?
- A. Cerebral arteriogram
- B. Functional magnetic resonance imaging (fMRI)
- C. Computed tomography (CT) scan or magnetic resonance imaging (MRI)
- D. Positron emission tomography (PET) or single-photon emission computed tomography (SPECT)
Correct Answer: C
Rationale: A CT scan and an MRI visualize neoplasms and other structural abnormalities. A PET scan, SPECT scan, and fMRI, which give information about brain function, are not indicated. An arteriogram would not be appropriate.
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The spouse of a patient diagnosed with schizophrenia asks, 'Which neurotransmitters are more active when a person has schizophrenia?' The nurse's response will focus on which neurotransmitters? (Select all that apply.)
- A. GABA
- B. Substance P
- C. Histamine
- D. Dopamine
- E. Norepinephrine
Correct Answer: D,E
Rationale: Dopamine plays a role in the integration of thoughts and emotions, and excess dopamine is implicated in the thought disturbances of schizophrenia. Increased activity of norepinephrine also occurs. Substance P is most related to the pain experience. Histamine decrease is associated with depression. Increased GABA is associated with anxiety reduction.
A nurse prepares to administer an antipsychotic medication to a patient diagnosed 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.)
- A. Parkinson disease
- B. Graves' disease
- C. Osteoarthritis
- D. Epilepsy
- E. Diabetes
Correct Answer: A,D,E
Rationale: Antipsychotic medications may produce weight gain, which complicates the care of a patient with diabetes, or lowers the seizure threshold (or both), which complicates the care of a patient with epilepsy. Parkinson disease involves changes in transmission of dopamine and acetylcholine; therefore, these drugs also complicate the care of a patient with the disorder. Osteoarthritis and Graves' disease should have no synergistic effect with this medication.
A nurse caring for a patient prescribed a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to what outcome?
- A. Mood improvement
- B. Logical thought processes
- C. Reduced levels of motor activity
- D. Decreased extrapyramidal symptoms
Correct Answer: A
Rationale: SSRIs affect mood, relieving depression in many patients. SSRIs do not act to reduce thought disorders. SSRIs reduce depression but have little effect on motor hyperactivity. SSRIs do not produce extrapyramidal symptoms.
A patient demonstrates disorganized thinking associated related to a diagnosis of schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Brainstem
- B. Cerebellum
- C. Temporal lobe
- D. Prefrontal cortex
Correct Answer: D
Rationale: The prefrontal cortex is responsible for intellectual functioning. The temporal lobe is responsible for the sensation of hearing. The cerebellum regulates skeletal muscle coordination and equilibrium. The brainstem regulates internal organs.
The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing what effect?
- 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
Correct Answer: A
Rationale: If the reuptake of a substance is inhibited, then it accumulates in the synaptic gap and its concentration increases, permitting the ease of the transmission of impulses across the synaptic gap. Normal transmission of impulses across synaptic gaps is consistent with a normal rather than a depressed mood. The other options are not associated with blocking neurotransmitter reuptake.
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