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A patient presents with anxiety, increased heart rate, and fear. The nurse would suspect the presence of a high concentration of which neurotransmitter?
- A. GABA
- B. Histamine
- C. Acetylcholine
- D. Norepinephrine
Correct Answer: D
Rationale: Norepinephrine is the neurotransmitter associated with sympathetic nervous system stimulation, preparing the individual for the 'fight-or-flight' response. GABA is a mediator of anxiety level. A high concentration of histamine is associated with an inflammatory response. A high concentration of acetylcholine is associated with parasympathetic nervous system stimulation.
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A nurse should assess a patient taking a medication with anticholinergic properties for inhibition of what function?
- A. Parasympathetic nervous system
- B. Sympathetic nervous system
- C. Reticular activating system
- D. Medulla oblongata
Correct Answer: A
Rationale: Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic nervous system. When acetylcholine action is inhibited by anticholinergic drugs, parasympathetic symptoms such as blurred vision, dry mouth, constipation, and urinary retention appear. The functions of the sympathetic nervous system, the reticular activating system, and the medulla oblongata are not affected by anticholinergic medications.
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.
The nurse wants to assess for disturbances in circadian rhythms in a patient admitted for major depressive disorder. Which question best implements this assessment?
- A. Do you ever see or hear things that others do not?
- B. Do you have problems with short-term memory?
- C. How would you describe your sleep pattern?
- D. How would you describe your thinking?
Correct Answer: C
Rationale: Mood changes throughout the day are related to circadian rhythms. Questions about sleep pattern would also be relevant to circadian rhythms. The question about seeing or hearing things is relevant to the assessment for illusions and hallucinations. The question about thinking is relevant to the assessment of thought processes. The other question is relevant to assessment of memory.
A patient taking an antipsychotic medication develops restlessness and an uncontrollable need to be in motion. A nurse can correctly analyze that these symptoms are related to which drug action?
- A. Anticholinergic effects
- B. Dopamine-blocking effects
- C. Endocrine-stimulating effects
- D. Ability to stimulate spinal nerves
Correct Answer: B
Rationale: Medications that block dopamine often produce disturbances of movement (extrapyramidal side effects) such as akathisia because dopamine affects neurons involved in both the thought processes and movement regulation. Anticholinergic effects include dry mouth, blurred vision, urinary retention, and constipation. Akathisia is not caused by endocrine stimulation or spinal nerve stimulation.
An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)
- A. Prefrontal cortex
- B. Occipital lobe
- C. Temporal lobe
- D. Parietal lobe
- E. Basal ganglia
Correct Answer: A,C,D
Rationale: The prefrontal cortex, parietal, and temporal lobes of the cerebrum play a key role in the storage and processing of memories. The occipital lobe is predominantly involved with vision. The basal ganglia influence the integration of physical movement, as well as some thoughts and emotions.