Mental Health NCLEX Questions Neurobiology

A patient with depression mentions to the nurse, “My mother says depression is a chemical disorder. What does she mean?” The nurse’s response is based on the theory that depression primarily involves which of the following neurotransmitters?

a. Cortisol and GABA
b. COMT and glutamate
c. Monamine and glycine
d. Serotonin and norepinephrine

A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage to the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?

a. Observing the patient pick up a spoon
b. Asking the patient to recite the alphabet
c. Monitoring the patient’s blood pressure
d. Comparing the patient’s grip strength in both hands

3. The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor. The nurse’s answer will be based on information that the therapeutic action of psychotropic drugs is the result of their effect on:
   a. The temporal lobe; especially Wernicke’s area
   b. Dendrites and their ability to transmit electrical impulses
   c. The regulation of neurotransmitters especially dopamine
   d. The peripheral nervous system sensitivity to the psychotropic medications

A student nurse mutters that it seems entirely unnecessary to have to struggle with understanding the anatomy and physiology of the neurologic system. The mentor would base a response on the understanding that it is:

a. Necessary but generally for psychiatric nurses who focus primarily on behavioral interventions
b. A complex undertaking that advance practice psychiatric nurses frequently use in their practice
c. Important primarily for the nursing assessment of patients with brain trauma–caused cognitive symptoms
d. Necessary for planning psychiatric care for all patients especially those experiencing psychiatric disorders

A patient asks the nurse, “My wife has breast cancer. Could it be caused by her chronic depression?” Which response is supported by research data?

a. “Too much stress has been proven to cause all kinds of cancer.”
b. “There have been no research studies done on stress and disease yet.”
c. “Stress does cause the release of factors that suppress the immune system.”
d. “There appears to be little connection between stress and diseases of the body”

A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs. Of the aspects of functioning listed, which will the nurse identify as a focus of nursing intervention?

a. Expression of emotion
b. Detecting auditory stimuli
c. Receiving visual images
d. Processing associations

At admission, the nurse learns that some time ago the patient had an infarct in the right cerebral cortex. During assessment, the nurse would expect to find that the patient:

a. Demonstrates major deficiencies in speech
b. Is unable to effectively hold a spoon in the left hand
c. Has difficulty explaining how to go about using the telephone
d. Cannot use his right hand to shave himself or comb his own hair

A patient with chronic schizophrenia had a stroke involving the hippocampus. The patient will be discharged on low doses of haloperidol. The nurse will need to individualize the patient’s medication teaching by:

a. Including the patient’s caregiver in the education
b. Being careful to stress the importance of taking the medication as prescribed
c. Providing the education at a time when the patient is emotionally calm and relaxed
d. Encouraging the patient to crush or dissolve the medication to help with swallowing

The physician tells the nurse, “The medication I’m prescribing for the patient enhances the g-aminobutyric acid (GABA) system.” Which patient behavior will provide evidence that the medication therapy is successful?

a. The patient is actively involved in playing cards with other patients.
b. The patient reports that, “I don’t feel as anxious as I did a couple of days ago.”
c. The patient reports that both auditory and visual hallucinations have decreased.
d. The patient says that, “I am much happier than before I came to the hospital.”

The patient’s family asks whether a diagnosis of Parkinson’s disease creates an increased risk for any mental health issues. What question would the nurse ask to assess for such a comorbid condition?

a. “Has your father exhibited any signs of depression?”
b. “Does your father seem to experience mood swings?”
c. “Have you noticed your father talking about seeing things you can’t see?”
d. “Is your dad preoccupied with behaviors that he needs to repeat over and over?”

Which explanation for the prescription of donepezil (Aricept) would the nurse provide for a patient in the early stage of Alzheimer’s disease?

a. It will increase the metabolism of excess GABA.
b. Excess dopamine will be prevented from attaching to receptor sites.
c. Serotonin deficiency will be managed through a prolonged reuptake period.
d. The acetylcholine deficiency will be managed by inhibiting cholinesterase.

There remains a stigma attached to psychiatric illnesses. The psychiatric nurse makes the greatest impact on this sociological problem when:

a. Providing educational programming for patients and the public
b. Arranging for adequate and appropriate social support for the patient
c. Assisting the patient to achieve the maximum level of independent functioning
d. Regularly praising the patient for seeking and complying with appropriate treatment

The wife of a patient with paranoid schizophrenia tells the nurse, “I’ve learned that my husband has several close relatives with the same disorder. Does this problem run in families?” The response based on recent discoveries in the field of genetics would be:

a. “Your children should be monitored closely for the disorder.”
b. “Research tends to support a familiar tendency to schizophrenia.”
c. “There is no concrete evidence; it is just as likely a coincidence.”
d. “Only bipolar disorder has been identified to have a genetic component.”

A patient whose symptoms of mild depression have been managed with antidepressants is concerned about the affect of accepting a promotion that will require working the night shift. What will be the basis of the response the nurse gives to address the patient’s concern?

a. The connection between a new job and possible depression does exist.
b. The medication can be adjusted to manage any increase in depression.
c. The interruption in normal wake-sleep patterns can influence mood disorders.
d. The change in sleep routine can be managed with a healthy sleep hygiene routine.

15. The nurse is discouraged because the patient exhibiting negative symptoms of schizophrenia has shown no improvement with the planned interventions to reduce the symptoms. The mentor’s remark that helps place the problem in perspective is:
    a. “You aren’t responsible for the behavior of any other person.”
    b. “Patients can be perverse and cling to symptoms despite our efforts.”
    c. “Negative symptoms have been associated with genetic pathology.”
    d. “It will take several ‘trial and error’ attempts to get the right combination care.”

What assessment data would reinforce the diagnosis of temporal lobe injury in patient who experienced head trauma? Select all that apply.

a. Inability to balance a checkbook
b. Uncharacteristically aggressive
c. Affect fluctuates dramatically
d. Increased interest in sexual behaviors
e. Difficulty remembering the names of family members

A patient has begun experiencing dysfunction of the hypothalamus. What nursing interventions will the nurse include in the patient’s plan of care? Select all that apply.

a. Reinforcing clear physical boundaries
b. Assisting the patient with completing daily menus
c. Learning about healthy sleep hygiene habits
d. Monitoring and recording temperature every 4 hours
e. Monitoring and recording blood pressure every 4 hours

The nurse is preparing a patient for a positron emission tomography (PET) scan. Which instructions will the nurse include? Select all that apply.

a. There will likely be a 30 to 45 minute wait between the injection and the beginning of the scan.
b. A blindfold and earplugs may be used to help decrease reaction to the environment during the scan.
c. Make every attempt to lie still during the scan because movement will affect the imaging produced.
d. No food or fluids are to be ingested for at least 8 full hours before the scan and none during the scan.
e. Staying awake during the scan is important since the results are altered when the patient is in any phase of the sleep state.

A patient with schizophrenia is described as “having difficulty with executive functions.” What patient dysfunction can the nurse expect to assess behaviorally? Select all that apply.

a. Invades the personal space of others frequently
b. Consistently fails to bring money when going to buy snacks
c. Cannot remember the names of staff who often provide care
d. Requires repeated reinforcement on how to make a sandwich
e. Frequently speaks of hurting himself or of hurting other patients

The unit physicians have ordered magnetic resonance imaging (MRI) tests for the following patients. For which patients would the nurse decline to make test arrangements without further discussion with the physician? Select all that apply.

a. A patient who is claustrophobic
b. A patient who is breastfeeding
c. A patient who has an allergy to iodine
d. A patient who had a total knee replacement
e. A patient who is taking a neuroleptic medication