Chapter 4. Concepts of Psychobiology(FREE)

Chapter 4. Concepts of Psychobiology

Multiple Choice

1. A depressed client states, “I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again.” Which nursing response is appropriate?A. “Medications are one way to address chemical imbalances. Environmental and interpersonal factors can also have an impact on biological factors.”B. “Because biological factors are the sole cause of depression, medications will improve your mood.”C. “Environmental factors have been shown to exert the most influence in the development of depression.”D. “Researchers have been unable to demonstrate a link between nature (biology and genetics) and nurture (environment).”

ANS: A

The nurse should advise the client that medications are one treatment approach to address biological factors, but there are other factors that affect mood. The nurse should educate the client on environmental and interpersonal factors that can lead to depression and the potential for psychological treatments to have a positive impact on biological factors.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Health Promotion and Maintenance

2. A client diagnosed with major depressive disorder asks, “What part of my brain controls my emotions?” Which nursing response is appropriate?A. “The occipital lobe governs perceptions, judging them as positive or negative.”B. “The parietal lobe has been linked to depression.”C. “The medulla regulates key biological and psychological activities.”D. “The limbic system is largely responsible for one’s emotional state.”

ANS: D

The nurse should explain to the client that the limbic system is largely responsible for one’s emotional state. This system is often called the “emotional brain” and is associated with feelings, sexuality, and social behavior. The occipital lobes are the area of visual reception and interpretation. Somatosensory input (touch, taste, temperature, etc.) occurs in the parietal lobes. The medulla contains vital centers that regulate heart rate and reflexes.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Health Promotion and Maintenance

3. Which part of the nervous system should a nurse identify as playing a major role during stressful situations?

A. Peripheral nervous system

B. Somatic nervous system

C. Sympathetic nervous system

D. Parasympathetic nervous system

ANS: C

The nurse should identify that the sympathetic nervous system plays a major role during stressful situations. The sympathetic nervous system prepares the body for the fight-or-flight response. The parasympathetic nervous system is dominant when an individual is in a nonstressful state.

KEY: Cognitive Level: Comprehension | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance

4. Which client statement reflects an understanding of the effect of circadian rhythms on a person’s ability to function?A. “When I dream about my mother’s horrible train accident, I become hysterical.” B. “I get really irritable during my menstrual cycle.”C. “I’m a morning person. I get my best work done in the a.m.”

D. “Every February, I tend to experience periods of sadness.”

ANS: C

By stating, “I am a morning person,” the client demonstrates an understanding that circadian rhythms may influence a variety of regulatory functions, including the sleep–wake cycle, regulation of body temperature, and patterns of activity. Most humans follow a 24-hour cycle that is largely affected by light and darkness.

KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity

5. Which types of adoption studies should a nurse recognize as providing useful information for the psychiatric community? A. Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy

B. Studies in which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill

C. Studies in which monozygotic twins from mentally ill parents were raised separately by different adoptive parents

D. Studies in which monozygotic twins were raised together by mentally ill biological parents

E. All of the above

ANS: E

The nurse should determine that all of the studies could possibly benefit the psychiatric community. The studies may reveal research findings relating genetic links to mental illness. Adoption studies allow comparisons to be made of the influences of the environment versus genetics.

KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Evaluation | Client Need: Health Promotion and Maintenance

6. Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse should recognize that this situation validates which study perspective? A. The study of neuroendocrinology

B. The study of psychoimmunology

C. The study of diagnostic technology

D. The study of neurophysiology

ANS: B

Psychoimmunology is the branch of medicine that studies the effects of social and psychological factors on the functioning of the immune system. Studies of the biological response to stress hypothesize that individuals become more susceptible to physical illness following exposure to stressful stimuli.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

7. A withdrawn client diagnosed with schizophrenia expresses little emotion and refuses to attend group therapy. What altered component of the nervous system should a nurse recognize as being implicated in this behavior?

A. Dendrites

B. Axons

C. Neurotransmitters

D. Synapses

ANS: C

The nurse should recognize that neurotransmitters play an essential function in the role of human emotion and behavior. Neurotransmitters are targeted and affected by many psychotropic medications.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity

8. An instructor is teaching nursing students about neurotransmitters. Which term best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron?A. Regeneration

B. Reuptake

C. Recycling

D. Retransmission

ANS: B

The nursing instructor should best explain that the process by which neurotransmitters are released into the synaptic cleft and returned to the presynaptic neuron is by reuptake. Reuptake is the process by which neurotransmitters are stored for reuse.

KEY: Cognitive Level: Comprehension | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance

9. A nurse concludes that a restless, agitated client is manifesting a “fight-or-flight” response. The nurse should associate this response with which neurotransmitter?A. Acetylcholine

B. Dopamine

C. Serotonin

D. Norepinephrine

ANS: D

The nurse should associate the neurotransmitter norepinephrine with the “fight-or-flight” response. Norepinephrine produces activity in the sympathetic postsynaptic nerve terminal and is associated with the regulation of mood, cognition, perception, locomotion, sleep, and arousal.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Analysis | Client Need: Physiological Integrity

10. A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client’s neurotransmitters should a nurse expect to be elevated?A. Serotonin

B. Dopamine

C. Gamma-aminobutyric acid (GABA)

D. Histamine

ANS: B

The nurse should expect that elevated dopamine levels might be an attributing factor to the client’s current level of functioning. Dopamine functions include regulation of movements and coordination, emotions, and voluntary decision-making ability.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need: Physiological Integrity

11. A client’s wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client’s therapist stresses the importance of proper sleep, nutrition, and exercise. What is the best rationale for the therapist’s advice? A. The therapist is using an interpersonal approach.B. The client has an alteration in neurotransmitters.

C. It is routine practice to remind clients about nutrition, exercise, and rest.D. The client is susceptible to illness due to effects of stress on the immune system.

ANS: D

The therapist’s advice should be based on the knowledge that the client has been exposed to stressful stimuli and is at an increased risk of developing illness due to the effects of stress on the immune system. The study of this branch of medicine is called psychoimmunology.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Physiological Integrity

12. Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level?A. Major depression

B. Schizophrenia

C. Anorexia nervosa

D. Alzheimer’s disease

ANS: B

Although the exact mechanism is unknown, there may be some correlation between decreased levels of the hormone prolactin and the diagnosis of schizophrenia. Some studies have shown an inverse relationship between prolactin concentrations and symptoms of schizophrenia.

KEY: Cognitive Level: Comprehension| Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

13. Which cerebral structure should a nursing instructor describe to students as the “emotional brain”?A. The cerebellum

B. The limbic system

C. The cortex

D. The left temporal lobe

ANS: B

The limbic system is often referred to as the “emotional brain.” The limbic system is largely responsible for one’s emotional state and is associated with feelings, sexuality, and social behavior.

KEY: Cognitive Level: Comprehension| Integrated Processes: Nursing Process: Analysis | Client Need: Psychosocial Integrity

14. A nurse understands that the abnormal secretion of growth hormone may play a role in which illness?A. Acute mania

B. Schizophrenia

C. Anorexia nervosa

D. Alzheimer’s disease

ANS: C

A nurse should understand that research has found a correlation between abnormal levels of growth hormone and anorexia nervosa. The growth hormone is responsible for growth in children, as well as continued protein synthesis throughout life.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

15. A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the presentation of these symptoms? A. Abnormal levels of serotonin

B. Decreased levels of dopamine

C. Increased levels of norepinephrine

D. Decreased levels of acetylcholine

ANS: D

The nurse should correlate memory deficits and decreased motor function with decreased levels of acetylcholine. Acetylcholine is a major effector chemical of the autonomic nervous system. Functions of acetylcholine include sleep regulation, pain perception, the modulation and coordination of movement, and memory.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

16. A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness?A. Mania

B. Schizophrenia

C. Anxiety

D. Depression

ANS: D

The nurse should recognize that a decrease in norepinephrine levels would play a significant role in generating the symptoms of depression. The functions of norepinephrine include the regulation of mood, cognition, perception, locomotion, cardiovascular functioning, and sleep and arousal.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Analysis | Client Need: Physiological Integrity

17. Which client diagnosis should a nurse associate with a decrease in gamma-aminobutyric acid (GABA)?

A. Alzheimer’s disease

B. Schizophrenia

C. Panic disorder

D. Depression

ANS: C

The nurse should associate a decrease in GABA with panic disorder. Enhancement of the GABA system is the mechanism of action by which benzodiazepines produce a calming effect, thus reducing anxiety. Alterations in the GABA system are also associated with movement disorders and epilepsy.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Analysis | Client Need: Physiological Integrity

18. A nurse should expect that an increase in dopamine activity might play a significant role in the development of which mental illness?A. Schizophrenia

B. Depression

C. Body dysmorphic disorder

D. Parkinson’s disease

ANS: A

The nurse should expect that an increase in dopamine activity might play a significant role in the development of schizophrenia. Dopamine functions include regulation of emotions, coordination, and voluntary decision-making ability. Increased dopamine activity is also associated with mania.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Analysis | Client Need: Physiological Integrity

19. A nursing instructor is teaching about the monoamine category of neurotransmitters. Which student statement indicates that learning about the function of norepinephrine has occurred?A. Norepinephrine functions to regulate movement, coordination, and emotions.

B. Norepinephrine functions to regulate mood, cognition, and perception.

C. Norepinephrine functions to regulate arousal, libido, and appetite.D. Norepinephrine functions to regulate pain, inflammatory response, and wakefulness.

ANS: B

The functions of norepinephrine include the regulation of mood, cognition, perception, locomotion, and cardiovascular function. Norepinephrine has also been implicated in certain mood disorders such as depression and mania, anxiety states, and schizophrenia.

KEY: Cognitive Level: Comprehension | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance

20. A student nurse is studying the effect of the drug isocarboxazid (Marplan) on neurobiology. The student should recognize that the neurotransmitter serotonin is catabolized by which enzyme?

A. Glycosyltransferase

B. Peptidase

C. Polymerase

D. Monoamine oxidase

ANS: D

Serotonin that is not returned to be stored in the axon terminal vesicles is catabolized by the enzyme monoamine oxidase. A monoamine oxidase inhibitor, such as Marplan, inhibits this catabolism, providing more available serotonin at the neuron synapse.

KEY: Cognitive Level: Application | Integrated Processes: Teaching/Learning | Client Need: Physiological Integrity

21. During a sleep study, a delta rhythm has been recorded for a client experiencing sleep apnea. The nurse recognizes that which characteristic is associated with this rhythm, and what stage of sleep activity would be documented?

A. Delta rhythm is a period of dozing, occurring in stage 1 of sleep activity.

B. Delta rhythm is a period of deep and restful sleep, occurring in stage 3 of sleep activity.

C. Delta rhythm is a period of relaxed waking, occurring in stage 0 of sleep activity.

D. Delta rhythm is a period of dreaming, occurring in stage 2 of sleep activity.

ANS: B

Stage 3–delta rhythm is a period of deep and restful sleep. Muscles are relaxed, heart rate and blood pressure fall, and breathing slows. No eye movement occurs.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

Multiple Response

22. Which of the following information should a nurse include when explaining causes of anorexia nervosa to a client? Select all that apply.A. There is a possible correlation between abnormal secretion of growth hormone and anorexia nervosa. B. There is a possible correlation between antidiuretic hormone levels and anorexia nervosa.

C. There is a possible correlation between low levels of gonadotropin and anorexia nervosa.

D. There is a possible correlation between increased levels of prolactin and anorexia nervosa.

E. There is a possible correlation between altered levels of oxytocin and anorexia nervosa.

ANS: A, C

The nurse should explain to the client that there is a possible correlation between anorexia nervosa and decreased levels of growth hormones and gonadotropin. Anorexia nervosa has also been correlated with increased cortisol levels.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Physiological Integrity

23. Which of the following symptoms should a nurse associate with increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client? Select all that apply.

A. Depression

B. Fatigue

C. Increased libido

D. Mania

E. Hyperexcitability

ANS: A, B

The nurse should associate depression and fatigue with increased levels of TSH. TSH is only increased when thyroid levels are low, as in the diagnosis of hypothyroidism. In addition to depression and fatigue, other symptoms such as decreased libido, memory impairment, and suicidal ideation are also associated with chronic hypothyroidism.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need: Physiological Integrity

24. Which of the following symptoms should a nurse expect to assess in a client experiencing elevated levels of thyroid hormone? Select all that apply.

A. Emotional lability

B. Depression

C. Insomnia

D. Restlessness

E. Apathy

ANS: A, C, D

The nurse should assess the client with an elevated level of thyroid hormone for evidence of emotional lability, insomnia, and restlessness. Elevated levels of thyroid hormone indicate a diagnosis of hyperthyroidism or Grave’s disease, which is also associated with the symptoms of irritability, anxiety, and weight loss.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity