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Chapter 2

Origin: Chapter 02- Neuroscience-Biology and Behavior, 1
Chapter: 02
Client Needs: D-4
Cognitive Level: Knowledge
Difficulty: Easy
Integrated Process: Teaching/Learning
Objective: 01
Page and Header: 21, Neuroanatomy and Neurophysiology
1. The basic units of structure and function in the nervous system are called which of the following?
A) Glial cells
B) Neurons
C) Axons
D) Dendrites
Ans: B
Feedback:
Neurons, or nerve cells, are the basic units of structure and function in the nervous system. Glial cells provide mechanical and metabolic support for neurons. Each neuron consists of a cell body and snakelike extensions called dendrites and axons. Because the dendrites and axons are subcomponents or the neuron itself, they are not considered to be the basic structural and functional units of the nervous system.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 2
Chapter: 02
Client Needs: D-4
Cognitive Level: Knowledge
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 01
Page and Header: 21, Neurons
2. The structure and function of a neuron form the basis for the overall function of the nervous system. What are the components of a neuron?
A) A glial cell, nucleus, organelles, dendrites, and axons
B) A glial cell, nucleus, dendrites, and synapses
C) A cell body, nucleus, organelles, dendrites, and axons
D) A cell body, nucleus, axon, and synapses
Ans: C
Feedback:
Each neuron consists of a cell body with a nucleus, other organelles, and snakelike extensions called dendrites and axons that funnel information in and out. Between each neuron are spaces called synapses, which serve as points of cellular contact. Glial cells and synapses are not components of a neuron.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 3
Chapter: 02
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 02, 03
Page and Header: 24, First and Second Messengers
3. A patient has researched the role of neurotransmitters in her mental illness. What is the role of neurotransmitters?
A) Excite the receptor cell located inside the synaptic cleft.
B) Inhibit the receptor cell found inside of glial cells.
C) Communicate information within the receptor cell.
D) Communicate information from one cell or cell group to another.
Ans: D
Feedback:
Neurotransmitters are referred to as first messengers, which refers to molecules that communicate information or change from one cell or cell group to another, cause an immediate effect, and are typically found in circuitry that produces behavior. Glial cells are not involved in neurotransmission and receptor cells do not lie within the synapse.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 4
Chapter: 02
Client Needs: D-4
Cognitive Level: Knowledge
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 02
Page and Header: 24, First and Second Messengers
4. Because neurotransmitters are responsible for immediately transmitting impulses between nerve cells, they are known as which of the following?
A) First messengers
B) Second messengers
C) Receptors
D) Synapses
Ans: A
Feedback:
Neurotransmitters are referred to as first messengers, which denotes that they are molecules that communicate information or change from one cell or cell group to another, cause an immediate effect, and are typically found in circuitry that produces behavior. A second messenger is a substance manufactured from the coupling of a first messenger to a receptor. Neurotransmitters can initiate the action of second messengers but neurotransmitter themselves are not second messengers.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 5
Chapter: 02
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 03
Page and Header: 26, Understanding Biologic Foundations 2.2
5. A nurse is caring for a patient who is addicted to alcohol and drugs and is discussing the pathway of the brain responsible for this behavior. The nurse should know that the pathway of the brain thought to be involved in pleasurable sensations and the euphoria resulting from use of drugs is called the:
A) Tuberinfundibular dopamine pathway
B) Nigrostriatal dopamine pathway
C) Mesocortical dopamine pathway
D) Mesolimbic dopamine pathway
Ans: D
Feedback:
The mesolimbic pathway is thought to be involved in pleasurable sensations and euphoria resulting from substance abuse. Deficiencies in the nigrostriatal pathway result in movement disorders (eg, Parkinson’s disease) and contribute to certain side effects of antipsychotic medications. The mesocortical pathway is thought to mediate both the negative and cognitive symptoms of psychosis. The tuberoinfundibular pathway regulates prolactin secretion.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 6
Chapter: 02
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 04
Page and Header: 30, Limbic System
6. A client lives with acquired deficits in emotional control, memory, and learning. What part of this client’s brain is most likely affected?
A) Basal ganglia
B) Brainstem
C) Limbic system
D) Cerebellum
Ans: C
Feedback:
The limbic system controls emotions, memory, and learning. The basal ganglia initiates and controls voluntary motor activities and muscle tone. The brainstem controls respiration, gastrointestinal motility, circulation, and sleep and wakefulness, and it directs visual and auditory reflexes. The cerebellum controls and guides movements and maintains muscle tone.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 7
Chapter: 02
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 04
Page and Header: 30, Cerebellum
7. You are caring for a mental health client who has developed difficulty with balance and muscle tone after a car accident that involved a head injury. Based on this information, what area of the brain was most likely injured in the accident?
A) Diencephalon
B) Brainstem
C) Cerebellum
D) Pons
Ans: C
Feedback:
The cerebellum coordinates the voluntary muscles and maintains balance and muscle tone. The diencephalon maintains homeostasis and controls the autonomic nervous system and the pituitary gland. The brainstem connects the cerebrum and diencephalon with the spinal cord. The pons helps regulate respiration.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 8
Chapter: 02
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 04
Page and Header: 29, Diencephalon
8. A client who experiences dysfunction in the hypothalamus is most likely to have
A) Maintaining homeostasis
B) Processing sensory input
C) Secreting melatonin
D) Integrating motor activities
Ans: A
Feedback:
The diencephalon consists of the thalamus, hypothalamus, and pineal gland. The hypothalamus maintains homeostasis and controls the autonomic nervous system and the pituitary gland.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 9
Chapter: 02
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 05
Page and Header: 32, Neuroplasticity
9. Sensory deprivation in infancy and childhood has adversely affected a boy’s brain development. Which characteristic of the brain was most directly involved in this process?
A) Neuroplasticity
B) Reactive plasticity
C) Adaptive plasticity
D) Synaptic plasticity
Ans: A
Feedback:
Neuroplasticity is the brain’s ability to develop and alter in response to experiences with various stimuli. Reactive plasticity and adaptive plasticity are two basic phenomena involved in neuroplasticity, both of which depend on a structural change in neurons.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 10
Chapter: 02
Client Needs: B
Cognitive Level: Evaluation
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 06
Page and Header: 33, Interaction Between Genes and Environment
10. Rather than being 100%, concordance rates for schizophrenia in monozygotic twins are only 50%. Which of the following statements best explains this phenomenon?
A) Genetic predisposition to disease is frequently overstated.
B) One twin is inherently more vulnerable in every case.
C) Environmental experiences affect gene expression.
D) The genetic pathway responsible for vulnerability is unrelated to being a twin.
Ans: C
Feedback:
While human genes play an enormous role in certain pathologies, the pathophysiology of psychiatric disorders, like all disorders, depends on a complex interaction of genetic factors and environmental factors. These genetic and environmental factors also affect the brain’s development and subsequent function. Identical genetic material does not necessarily guarantee the development of a disease. Inherent vulnerability does not adequately explain this phenomenon.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 11
Chapter: 02
Client Needs: D-4
Cognitive Level: Knowledge
Difficulty: Easy
Integrated Process: Teaching/Learning
Objective: 06
Page and Header: 32, The Role of Genetics
11. The process by which DNA sequences are copied into ribonucleic acid (RNA) is which of the following?
A) Transcription
B) Phenotyping
C) Translation
D) Allele formation
Ans: A
Feedback:
Transcription is the process by which DNA sequences are copied into ribonucleic acid (RNA). Translation is the process by which information in RNA produces strings of amino acids, which in turn make up proteins (life’s building blocks). Combinations of genetic parameters altered by environmental influences over time are referred to as the phenotype. Each gene has a specific location on the chromosome called an allele.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 12
Chapter: 02
Client Needs: D-4
Cognitive Level: Knowledge
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 03
Page and Header: 22, Table 2.1, Some Neurotransmitters and Their Functions
12. Imbalances in neurotransmitters contribute to the development of mental disorders. Norepinephrine imbalance is implicated in the etiology of:
A) Schizophrenia
B) Mood disorders
C) Dementia
D) Generalized anxiety disorder
Ans: B
Feedback:
Norepinephrine is implicated in mood disorders. Dopamine is implicated in schizophrenia; gamma-aminobutyric acid (GABA) is implicated in dementia, schizophrenia, and anxiety disorders; and high levels of serotonin are implicated in anxiety disorders.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 13
Chapter: 02
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 03
Page and Header: 22, Table 2.1, Some Neurotransmitters and Their Functions
13. After testing, it is determined that a mental health client has low levels of serotonin. What symptom(s) would this individual most likely experience?
A) Fight-or-flight response
B) Sleep disturbances
C) Severe anxiety
D) Depression and impulsivity
Ans: D
Feedback:
Low levels of serotonin are associated with depression, aggression, suicidality, and impulsivity. High levels of serotonin are associated with anxiety disorders. Sleep disturbances are associated with acetylcholine. The fight-or-flight response is associated with epinephrine.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 14
Chapter: 02
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 05
Page and Header: 32, Neuroplasticity
14. A mental health client’s symptomatology has been partially attributed to the effects of neuroplasticity. What statements best describes this phenomenon?
A) Neuroplasticity is the ability of nervous tissue to change structure and functioning in response to new experiences.
B) Neuroplasticity determines a client’s response to psychotropic medications.
C) Neuroplasticity initiates the neuroendocrine-mediated physiologic events that prepare the body for “fight or flight.”
D) Neuroplasticity is the process by which the information in RNA produces strings of amino acids.
Ans: A
Feedback:
The brain’s ability to develop and alter in response to experience is known as neuroplasticity. This means that the brain adapts to new conditions during its maturation and during its constant interaction with its environment. In a sense, this also means that, to some degree, humans can create their own brains by exposing them to certain experiences. Neuroplasticity is not a component of gene expression and it does not initiate the fight-or-flight response.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 15
Chapter: 02
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 04
Page and Header: 30, Brain Development
15. A pediatric nurse develops an educational presentation for parents from a socially and economically disadvantaged area to help them create stimulating, rich environments for their children. Although all children may benefit from an enriched environment, the nurse should primarily target which of the following age groups?
A) Children older than 6 years, because they are developmentally ready for a new learning environment
B) Infants and children up to 18 months of age, because, by that time, the developing brain has reached 90% of its adult size and the foundations for future cognitive and social function are in place
C) Children older than 2 years, because younger children are still attached to their mothers
D) Infants and children younger than 3 years, because the brain is still rapidly developing
Ans: D
Feedback:
The systems that allow people to form and maintain emotional relationships develop during the first years of life. By the time that children are 3 years old, the brain is 90% of its adult size, and the emotional, behavioral, cognitive, and social foundation is in place for the rest of life. An argument can thus be made that interventions should focus on health promotion during this period of development.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 16
Chapter: 02
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing process
Objective: 07
Page and Header: 34, Memory, Repetition, and Learning
16. A client reveals that an uncle sexually abused her during her childhood. She states she recalls in detail the day and the events leading up to the first instance of the abuse. This memory is an example of which of the following types of memory?
A) Retrieved memory
B) Suppressed memory
C) Declarative memory
D) Procedural memory
Ans: C
Feedback:
Declarative or explicit memory storage constitutes a conscious memory for people, places, and things. Procedural or implicit memory is unconscious, and those memories are evident only in performance, not through conscious recall.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 17
Chapter: 02
Client Needs: C
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 05
Page and Header: 32, Neuroplasticity
17. A 34-year-old woman is 3 months postpartum following the birth of her first child and is being treated for postpartum depression. She states that she misses her career, was not ready to become a full-time mother, and resents the time she must devote to the baby. The infant looks well fed and well cared for. Basing the client’s plan of care on concepts of brain development and neuroplasticity, the nurse identifies which of the following goals as the priority?
A) The client will receive physical and emotional support from her husband.
B) The client will resume her job on a part-time basis.
C) The client will develop attachment with the infant.
D) The client will use daycare or other services to allow her more time to herself.
Ans: C
Feedback:
Neuroplasticity means that the brain adapts to new conditions during its constant interaction with its environment. Our brains continue to grow connections, and exposure to new learning results in brain changes, even into advanced old age. The mother can learn to embrace her new role as mother and develop an attachment with the infant.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 18
Chapter: 02
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 08
Page and Header: 37, Table 2.3, Neuroimaging Techniques
18. A client is being prepared for a neuroimaging study of glucose metabolism, blood flow, and neurotransmitter-receptor activity? What neuroimaging study will be performed on this client?
A) Magnetic resonance imaging (MRI)
B) Electroencephalogram (EEG)
C) Ultrasonography
D) Positron emission tomography (PET) scan
Ans: D
Feedback:
PET is used to examine brain functioning, including glucose metabolism, blood flow, and neurotransmitter-receptor activity. MRI, EEG, and ultrasound cannot assess each of these parameters of brain activity.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 19
Chapter: 02
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 03
Page and Header: 24, Psychiatric Implications
19. A nurse is participating in the care of a client whose treatment involves application of the principles of psychopharmacotherapy. As a result, the client’s treatment will prioritize which of the following?
A) Altering the molecular structure of the neuronal nuclei
B) Control of the environmental factors that are known to underlie mental illness
C) Altering the process of gene expression within neurons
D) Blocking or enhancing the effects of specific neurotransmitters
Ans: D
Feedback:
Psychopharmacotherapy involves blocking or enhancing certain neurotransmitters, especially those implicated in mental illness. Psychopharmacotherapy does address genetic factors or environment.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 20
Chapter: 02
Client Needs: D-4
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 06
Page and Header: 34, Stress–Diathesis Model
20. The stress–diathesis model has been discussed by the care team as a plausible explanation for the onset of a client’s major depression. This model would attribute the client’s illness as the result of the interplay between what factors? Select all that apply.
A) The pathological absence of neuroplasticity
B) The client’s predisposition toward developing depression
C) Cultural expectations for behavior
D) Life events that exceed the individual’s coping skills
E) The client’s adherence to prescribed treatmen
Ans: B, D
Feedback:
The stress–diathesis model was developed to demonstrate the dynamic between the individual’s predisposition (diathesis) toward developing a certain illness, and the levels of stress to which they are subjected and that exceed coping ability. This model does not prioritize the roles of neuroplasticity, culture, or adherence to treatment.

Origin: Chapter 02- Neuroscience-Biology and Behavior, 21
Chapter: 02
Client Needs: C
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 06
Page and Header: 33, Interaction Between Genes and Environment
21. An adult female client has been diagnosed with a personality disorder. What characteristic of this client’s experience would be considered to be a possible second hit in the etiology of her disorder?
A) The client’s current socioeconomic status
B) The client’s genetic phenotype
C) Abuse the client suffered as a teenager
D) Psychotropic medications that have been used without success
Ans: C
Feedback:
Examples of second hits might include intense experiential toxins, such as physical abuse or neglect, infections, or prenatal exposure to alcohol. Socioeconomic status, medications, and genetic factors are not normally categorized as second hits.