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UT Arlington NURS 5315 - Chapter 19 Exam

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Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety DisordersMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. Which would be considered a positive symptom of schizophrenia?a. Blunted affectb. Auditory hallucinationsc. Poverty of speechd. Lack of social interactionANS: BPositive symptoms frequently occur during a psychotic episode, when an individual loses touch with reality and experiences something that should be absent (e.g., hallucinations). The remaining options are classified as negative symptoms.PTS: 1 DIF: Cognitive Level: Remembering 2. A healthcare professional is seeing a patient with suspected schizophrenia. For which prenatal occurrence should the professional assess?a. Viral infectionb. Maternal depressionc. Maternal smokingd. Exposure to toxic wasteANS: AA leading hypothesis for the cause of schizophrenia suggests that the illness results from neurodevelopmental defects that occur in fetal life. Several early environmental factors have been suggested to increase the risk of developing schizophrenia, including viral infection during pregnancy, prenatal nutritional deficiencies, and perinatal complications, such as birth defects and neonatal hypoxia. No current research supports the theory that any of the other options are prenatal triggers of schizophrenia.PTS: 1 DIF: Cognitive Level: Applying 3. Which neurotransmitter is reduced in people with schizophrenia?a. Dopamineb. Gamma-aminobutyric acidc. Acetylcholined. SerotoninANS: BIn the dorsal prefrontal cortex of schizophrenic brains, glutamic acid decarboxylase, the major enzyme in gamma-aminobutyric acid GABA biosynthesis, is diminished, which likely impairs synaptic performance and cognitive and behavioral functions associated with this brain region. Dopamine levels may be elevated in schizophrenia; however a current view questions whether dopamine is altered in this way. Acetylecholine is a neurotransmitter working at neuromuscular connections. Serotonin levels are diminished in depression.PTS: 1 DIF: Cognitive Level: Remembering 4. A patient has positive signs of schizophrenia and is scheduled for a brain scan. What part of the brain does the healthcare professional expect the scan will focus on?a. Parietal lobeb. Limbic systemc. Temporal lobed. HypothalamusANS: COnly temporal lobe alterations may be responsible for the production of positive schizophrenic symptoms, such as hallucinations, delusions, thought disorders, and bizarre behavior.PTS: 1 DIF: Cognitive Level: Remembering 5. A patient has started on clozapine. The healthcare professional educates the patient that this drug blocks which neurotransmitter receptor?a. Norepinephrineb. Gamma-aminobutyric acidc. Serotonind. DopamineANS: DThe dopamine hypothesis initially suggested that abnormal elevation in dopaminergic transmission contributes to the onset of schizophrenia. This hypothesis was based on pharmacologic studies showing that antipsychotic drugs are potent blockers of brain dopamine receptors. Clozapine is a second-generation atypical antipsychotic drug that works by blocking dopamine receptors.PTS: 1 DIF: Cognitive Level: UnderstandingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with what?a. Schizophreniab. Major depressionc. Maniad. Panic disorderANS: BExcessive activation of the HPA system resulting in elevated glucocorticoid secretion is found in a large percentage (30% to 70%) of people with major depression, suggesting that mechanisms responsible for HPA hormone alterations contribute to the pathophysiologic condition of depression. HPA system abnormalities do not necessarily exist in individuals with schizophrenia, mania, or panic disorder.PTS: 1 DIF: Cognitive Level: Remembering 7. The common property among the three types of medications used to treat depression is that they do what?a. Increase neurotransmitter levels within the synapseb. Increase neurotransmitter levels in the presynapsec. Decrease neurotransmitter levels in the postsynapsed. Decrease neurotransmitter levels within the synapseANS: AAll available antidepressants share the common property, albeit through different mechanisms, that increasing monoamine neurotransmitter levels within the synapse is the basis for their antidepressant effects.PTS: 1 DIF: Cognitive Level: Remembering 8. What is the link between major depression and cortisol secretion?a. Individuals with depression show suppression of plasma cortisol when given dexamethasone.b. Individuals with depression have a decreased plasma cortisol level, despite the administration of exogenous corticosteroids.c. Individuals with depression show that persistently elevated plasma cortisol levels can result in inflammation that is believed to trigger depression.d. Individuals with depression have normal plasma cortisol levels throughout the day when they take antidepressant medication as prescribed.ANS: CPersistent elevations in cortisol may also induce immunosuppression that compromises the body’s immune systems to contain inflammation and infectious diseases. Increasing evidence suggests that inflammation is another risk factor that triggers the onset of depression. The options related to dexamethasone and exogenous corticosteroids are not true as they apply to depression and cortisol secretion.PTS: 1 DIF: Cognitive Level: Remembering 9. A decrease in receptor binding for which neurotransmitter is found in individuals with depression?a. Norepinephrineb. Serotoninc. Dopamined. AcetylcholineANS: BPostmortem and/or brain imaging studies of individuals with depression reveal a widespread decrease in serotonin 5-HT1A-receptor subtype binding in frontal, temporal, and limbic cortex, as well as serotonin-transporter binding in cerebral cortex and hippocampus. A decrease in receptor binding is not observed in the other neurotransmitters.PTS: 1 DIF: Cognitive Level: Remembering 10. A severely depressed patient has been taking venlafaxine but is now pregnant and asks the healthcare professional what treatment options are available for her. What therapy does the professional discuss as a first choice?a. Electroconvulsive therapy (ECT)b. Switch to haloperidolc. Intensive psychotherapy until the baby is weanedd. Limit zinc and magnesium in the dietANS:

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