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Antai-Otong Psychiatric Nursing Biological 2nd Edition
CHAPTER 1HISTORY OF PSYCHIATRIC NURSING
MULTIPLE CHOICE
a. | potential to cause harm |
b. | managed care principles |
c. | availability of improved neuroleptic medications |
d. | concern for humane treatment of the mentally ill |
ANS: B
Because of the dramatic influence of managed care on health care delivery systems, acutely ill clients are most likely to be diverted from hospitalization or receive shorter lengths of stay.
PTS: 1
a. | long-term commitment to a state hospital |
b. | brief care in the least restrictive environment |
c. | intensive psychotherapy with a private practitioner |
d. | 14 days of treatment in a private psychiatric hospital |
ANS: B
Because of the dramatic influence of managed care on health care delivery systems, acutely ill clients are most likely to be diverted from hospitalization or receive shorter lengths of stay.
PTS: 1
a. | removing the chains from the mentally ill and providing humane treatment |
b. | discovering the benefit of chlorpromazine (Thorazine) for treating the mentally ill |
c. | promoting the use of better trained personnel in hospitals for the mentally ill |
d. | moving the treatment of the mentally ill from the large state institutions to the community |
ANS: A
Philippe Pinel was placed in charge of Bicetre, a large hospital for the mentally ill. He demonstrated that the mentally ill improved when released from their chains and provided humane treatment. His work brought sweeping changes in French institutions for the mentally ill.
PTS: 1
a. | hypnosis | c. | dream analysis |
b. | paradoxical intention | d. | desensitization |
ANS: A
Franz Mesmer used techniques that were a form of hypnotism and which stemmed from the ancient use of trances. His work later became the basis of hypnosis.
PTS: 1
a. | worked with the poor and mentally ill in the tenements of New York City |
b. | encouraged states to establish full service community mental health centers |
c. | spoke to state legislatures and was instrumental in getting state hospitals built |
d. | established the first school of nursing which included psychiatric nursing care |
ANS: C
Dorothea Lynde Dix brought attention to the deplorable conditions in the mental institutions to various state legislatures. Renewed legislative concern led to the proliferation of state hospitals.
PTS: 1
a. | work with mentally ill inmates in jails and prisons |
b. | shared stories of mentally ill private clients of Clifford Beers |
c. | tormenting personal experiences as a patient in mental institutions |
d. | work with clients who were under hypnosis and their recall of the past |
ANS: C
Clifford Beers had been treated for mental illness and contributed to preventive care through his classic work entitled A Mind That Found Itself. This work provided a descriptive account of Beers tormenting experiences in mental institutions.
PTS: 1
a. | publishing the first textbook on psychiatric nursing |
b. | being the first graduate psychiatric nurse in the United States |
c. | serving as the first director of nursing of a state mental hospital |
d. | developing the first educational course for psychiatric technicians |
ANS: B
In 1873, Linda Richards was the first graduate psychiatric nurse in the United States.
PTS: 1
a. | acrogeria | c. | apathy |
b. | anodynia | d. | acuity |
ANS: C
The four, as identified by Eugen Bleuler, are associative looseness, autism, ambivalence, and affect impairment. Clients with affect impairment exhibit flattened or inappropriate affect to situations. Apathy is a form of affect impairment.
PTS: 1
a. | 1868 | c. | 1944 |
b. | 1896 | d. | 1952 |
ANS: D
The American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders in 1952. The current version DSM-IV-TR is a direct consequence of several revisions.
PTS: 1
a. | Sigmund Freud | c. | Karen Horney |
b. | Karl Gustav Jung | d. | Harry Stack Sullivan |
ANS: D
Harry Stack Sullivan postulated the hypothesis of interpersonal theory. He believed that anxiety interfered with the ability to cope and communicate effectively resulting in mental illness. He believed that anxiety could be lessened by a meaningful interpersonal relationship that stressed the process of effective communication.
PTS: 1
a. | checking for any threats to safety |
b. | identifying the roles of significant others |
c. | assessing the clients strengths and limitations |
d. | building a relationship of mutual understanding |
ANS: D
Hildegard Peplau wrote Interpersonal Relations in Nursing: A Conceptual Framework of Reference for Psychodynamic Nursing. She asserted that all nurse-client interactions are opportunities to build a mutual understanding and that identifying goals has an impact on client outcomes and responses.
PTS: 1
a. | Elavil (amitriptyline) | c. | Eskalith (lithium carbonate) |
b. | Haldol (Haloperidol) | d. | Thorazine (chlorpromazine) |
ANS: D
Psychotropics emerged in the 1950s with the introduction of Thorazine (chlorpromazine) to reduce psychiatric symptoms. While Haldol (Haloperidol) is a psychotropic, it was not introduced until the 1970s. Elavil (amitriptyline) is tricyclic used for depression, and Eskalith (lithium carbonate) is used for bipolar disorder.
PTS: 1
a. | psychiatrists and psychiatric nurses educating politicians and the public |
b. | optimism over new psychodynamic approaches and the major tranquilizers |
c. | patients in large psychiatric hospitals demanding a less restrictive treatment |
d. | family and friends of persons with mental illness who wanted them at home |
ANS: B
The optimism generated by new psychodynamic approaches and major tranquilizers led to the Community Mental Health Movement of the 1960s. This resulted in the deinstitutionalization of many chronically ill who were referred to community resources for less restrictive treatment.
PTS: 1
a. | illness | c. | rehabilitation |
b. | primary prevention | d. | managed care |
ANS: A
Prior to community based care, the care in mental hospitals focused on illness and custodial care. Little attention was placed on primary prevention or tertiary prevention (rehabilitation). Managed care is a much newer concept.
PTS: 1
a. | transference | c. | the here and now |
b. | long-term analysis | d. | early childhood experiences |
ANS: C
The psychotherapies of the 1960s were developed by Maslow, Berne, Pearls, and others who broke away from traditional long-term psychotherapy and focused on self-actualization therapy that put clients in touch with themselves and focused more on the here and now and not on early life experiences. Transference, long-term analysis, and early childhood experiences are fundamental concepts which relate to psychoanalytic therapies supported by such individuals as Freud and Jung.
PTS: 1
a. | decrease in the interest of the community in the mentally ill |
b. | lack of adequate numbers of masters prepared psychiatric nurses |
c. | federal government no longer funding Community Mental Health Centers |
d. | lack of demand for services due to newer psychotropic medications |
ANS: C
By 1984 the federal government had stopped funding the Community Mental Health Centers and there was an overall lack of adequate funding. This led to fragmentation of community mental health services and a lack of coordination in aftercare or rehabilitation.
PTS: 1
a. | developing and maintaining a trusting relationship with the client |
b. | coordinating the care of the client with the rest of the health care team |
c. | getting the client to comply fully with changes in the treatment regimen |
d. | finding out about relationships with significant others in the household |
ANS: A
Despite the advantages of telemedicine and other informational systems, the disadvantage is difficulty in forming trusting interactions with the family and client when not face-to-face.
PTS: 1
a. | accept the clients right to take any medicine she chooses to take at home |
b. | assist the client in researching the benefits and risks of this herbal medicine |
c. | make a note of the herbal medicine as well as the dosage amount and frequency |
d. | insist the client stop all herbal medicine immediately and stay away from them |
ANS: B
The growing number of consumers using complementary therapies suggests that psychiatric nurses must familiarize themselves with the advantages and potential risks of these approaches. The client, as an informed consumer and partner with the nurse in her care, needs to be informed as well.
PTS: 1
a. | become culturally competent |
b. | keep up with diagnostic changes |
c. | be aware of new drug study results |
d. | communicate with clients by e-mail |
ANS: A
While it is important for psychiatric nurses to recognize the importance of the Internet and informational systems, a more important need is for nurses to have cultural competency skills in order to respond to individual clients and to meet global and community health needs of diverse client populations.
PTS: 1
a. | love and belonging needs | c. | safety and physical needs |
b. | developing psychosocial skills | d. | rehabilitation back into society |
ANS: C
The first formal training for nurses of the mentally ill in the United States was organized in 1882 and focused primarily on custodial care which included the provision of safety and physical needs. This training placed little emphasis on developing psychosocial skills or addressing love and belonging needs. Rehabilitation back into society was not a focus of mental health care until the late 1950s and early 1960s.
PTS: 1
a. | American Nurses Association |
b. | National Mental Health Act of 1946 |
c. | National Alliance for the Mentally Ill |
d. | World War I work with mentally ill soldiers |
ANS: B
Increased funding as a result of the National Mental Health Act of 1946 allowed university nursing schools to increase the number of trained psychiatric-mental health nurses available in order to promote the quality of psychiatric nursing education in undergraduate schools. Nursing schools changed from teaching a custodial role to teaching a role with therapeutic and preventative perspectives.
PTS: 1
a. | offering nursing scholarships for study of psychiatric nursing at the masters level |
b. | offering certification for qualified psychiatric mental health nursing clinical specialists |
c. | requiring accredited nursing schools to have a psychiatric-mental health nursing course |
d. | requiring schools of nursing seeking accreditation to limit clinical experiences at night |
ANS: C
The National League for Nursing (NLN) required that the schools they accredited have an identifiable psychiatric-mental health nursing course. This requirement supported and advanced the significance of psychiatric-mental health nursing practice to the nursing profession. Currently a branch of the NLN, the National League for Nursing Accrediting Commission (NLNAC) is responsible for accrediting nursing programs.
PTS: 1
a. | facilitating communication, social interaction, and self-care |
b. | forming an alliance with the client and increasing compliance |
c. | orienting the client, reducing any psychosis, and keeping the client safe |
d. | teaching the client about mental illness and medication benefits and risks |
ANS: A
Gwen Tudor stressed the importance of the interpersonal therapeutic relationship between client and nurse. She described the three major functions of the psychiatric nurse to be facilitator of communication, social interaction, and self-care. In addition, she stressed the significance of social context and its impact on the nurses attitude and responses.
PTS: 1
a. | American Nurses Association |
b. | The National Institutes of Health |
c. | Department of Health and Human Services |
d. | National League for Accreditation of Nursing, Inc. |
ANS: A
The ANA began publishing psychiatric-mental health nursing standards in 1967 with a recent version entitled Psychiatric Mental Health: Scope and Standards of Practice published in 2000. It was developed from the input of nurses in the psychiatric-mental health nursing specialty and addresses each step of the nursing process.
PTS: 1
a. | Psychiatric nursing staff were now reimbursed for college tuition. |
b. | Medications could no longer be given without a client consent form. |
c. | Nurses were replaced by other health care professionals and attendants. |
d. | Nurses were now required to have psychiatric-mental health nursing courses. |
ANS: C
The Mental Health Act of 1980 and the National Plan for the Chronically Ill in 1981 focused on increasing remission and decreasing exacerbation of symptoms through continuity of care in the communities and health care organizations. The result was that nurses were replaced with other health care professionals and attendants to run units and direct client care.
PTS: 1
a. | education of the public in regard to the treatment of mental illness |
b. | private practice groups of several psychiatric nursing clinical specialists |
c. | integration of holistic and evidence-based health care concepts into practice |
d. | contributions to groups lobbying for the advancement of psychiatric nursing |
ANS: C
Understanding that evidence-based health care is the driving force behind treatment approaches, client responses, treatment efficacy, and the integration of holistic health care concepts into practice are crucial to the survival of the psychiatric-mental health specialty.
PTS: 1
a. | primary, secondary, and tertiary care |
b. | the well, the sick, and the worried well |
c. | inpatient, outpatient, and partial hospitalization |
d. | custodial care, psychosocial programming, and community reentry |
ANS: A
Gerald Caplan developed and wrote about primary, secondary, and tertiary care in the late 1950s and early 1960s just as hospitals were discharging large numbers of patients into the community and nurses as well as other mental health professionals began to work on primary prevention in the community.
PTS: 1
a. | the cost of community based care compared with inpatient care |
b. | the effects of interactions with significant others on recidivism rates |
c. | the benefits of complementary therapies in treatment of mental illness |
d. | increasing nursing knowledge about the neurobiology of mental illness |
ANS: D
In 1990, Angela McBride wrote that the research agenda for psychiatric nurses is an important component of integrating biological concepts into practice and areas that need change include closing the gap of nursing knowledge regarding the relevance of the neurobiology of mental illness.
PTS: 1
a. | biological drives | c. | id, ego, and superego |
b. | genetic inheritance | d. | interpersonal relationships |
ANS: D
Karen Horney was a Neo-Freudian who objected to Freuds idea that neurosis and personality development is based on biological drives. Neo-Freudians stressed the impact of disturbed interpersonal relationships in maladaptive responses and minimized the biological factors of mental illness.
PTS: 1
a. | the brain | c. | discovery |
b. | neuroscience | d. | technology |
ANS: A
On July 25, 1989, the United States Congress proclaimed the 1990s as the decade of the brain.
PTS: 1
a. | 1 in 3 | c. | 1 in 7 |
b. | 1 in 5 | d. | 1 in 10 |
ANS: A
The research of David Eisenberg and colleagues (1993) suggests that one in three clients seeking conventional health care was also using complementary therapies.
PTS: 1
a. | Martha Rogers | c. | Hildegard Peplau |
b. | Imogene King | d. | Dorothea Orem |
ANS: C
The importance of the nurses therapeutic use of self was advanced in 1952 by Hildegard Peplaus text, Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing.
PTS: 1
a. | essentially nonexistent |
b. | emphasized the nursing process and research |
c. | involved use of various psychotherapeutic interventions |
d. | focused on providing a safe, kind, and clean environment |
ANS: A
In the late 18th century, the role of the nurse was essentially nonexistent.
PTS: 1
a. | are not an important issue in the United States |
b. | do not require nurses to have any special training |
c. | can result in a short- and long-term traumatic sequel |
d. | usually do not require the services of a psychiatric nurse |
ANS: C
Recent studies indicate that terrorism and man-made and natural disasters can result in a short- or long-term sequel.
PTS: 1
a. | National League for Nursing |
b. | American Nurses Association |
c. | National Institute of Mental Health |
d. | National Center for Nursing Research |
ANS: B
In 1973, the American Nurses Association established the first certification program for psychiatric nurses.
PTS: 1
a. | Sigmund Freud | c. | Adolph Meyer |
b. | Clifford Beers | d. | Harry Stack Sullivan |
ANS: C
Adolph Meyer stressed preventive care and the need for formal training in child psychiatry.
PTS: 1
MULTIPLE RESPONSE
a. | National League for Nursing |
b. | Coalition of Psychiatric Nurses |
c. | Nurses in Action for Better Mental Health |
d. | American Association of Colleges of Nursing |
e. | American Psychiatric Nurses Association |
f. | International Society of Psychiatric-Mental Health Nurses |
ANS: B, E, F
The Alliance of Psychiatric Mental Health Nurses is composed of the American Psychiatric Nurses Association (APNA), Coalition of Psychiatric Nurses (CPA), and the International Society of Psychiatric-Mental Health Nurses (ISPN).
PTS: 1
a. | herbs |
b. | biofeedback |
c. | acupuncture |
d. | aroma therapy |
e. | massage therapy |
f. | nutritional approaches |
ANS: A, B, C, D, E, F
Complementary therapies include the use of herbs, biofeedback, acupuncture, aroma therapy, massage therapy, and nutritional approaches.
PTS: 1
a. | occurred during the 19th Century |
b. | occurred during the 20th Century |
c. | involved only secondary prevention |
d. | was a result of better treatment in the state hospitals |
e. | offered services to clients, families, and communities |
f. | was a result of the Community Mental Health Centers Act |
ANS: B, E, F
Deinstitutionalization resulted from the Community Mental Health Centers Act of 1963. Services were provided to clients, families, communities, and various cultures.
PTS: 1
a. | Mental illness was seen as incurable. |
b. | Custodial care was provided in asylums. |
c. | Bloodletting was a common practice. |
d. | Insanity was associated with sin and demonic possession. |
e. | Herbs, precious stones, and ointments were used for treatment. |
f. | The mentally ill were treated with patience and understanding. |
ANS: A, D, E
During ancient times, mental illness was associated with sin and demonic possess, and it was thought to be incurable. Healers used herbs, precious stones, and ointments when treating these individuals.
PTS: 1
CHAPTER 3INTERFACING BIOLOGICAL-BEHAVIORAL CONCEPTS INTO PSYCHIATRIC NURSING PRACTICE
MULTIPLE CHOICE
a. | relief that family interactions are no longer thought to be the major cause of mental illness |
b. | happy that their family member will soon be able to be cured of mental illness |
c. | upset that findings indicate that some illnesses are due to structural changes |
d. | frightened that the person with mental illness will be taking newer, less tested drugs |
ANS: A
In the past, parents and siblings were thought to be responsible for many mental illnesses, and they have felt demoralized and blamed for their loved ones illness. With current research demonstrating that the cause of mental illness is more complex and may include neurobiological and genetic factors, the burden of blame and guilt is reduced.
PTS: 1
a. | The hypothalamic-pituitary-adrenal axis has a great deal to do with mental disorders. |
b. | The brain gives rise to emotions and contributes to disturbances in affect or mood. |
c. | There is a tenuous balance of four humors in the body that contribute to mood. |
d. | All persons with mental disorders need to be treated kindly in a relaxing setting. |
ANS: B
Hippocrates surmised that the brain gives rise to pleasure, joy, pain, and grief, and it contributes to disturbances in affect and mood. Hippocrates early description of the tenuous balance of four humors (blood, phlegm, and yellow and black bile) and their relationship to mood disorders proved inaccurate.
PTS: 1
a. | fluoxetine (Prozac) | c. | clozapine (Clozaril) |
b. | quetiapine (Seroquel) | d. | haloperidol (Haldol) |
ANS: A
Prozac is one of the serotonergic reuptake blocking agents. Other SSRIs include paroxetine (Paxil), sertraline (Zoloft), and fluvoxamine (Luvox). Clozaril is an atypical antipsychotic and Haldol is one of the older major psychotropics (antipsychotics).
PTS: 1
a. | sertraline (Zoloft) |
b. | loxapine (Loxitane) |
c. | olanzapine (Zyprexa) |
d. | fluphenazine decanoate (Prolix Decanoate) |
ANS: A
Both patients could receive Zoloft because it is a selective serotonergic reuptake blocking agent (SSRI). These medications have been found to be effective in treating major depression as well as eating, impulsivity, and anxiety disorders. Olanzapine (Zyprexa) is an atypical antipsychotic. Loxapine (Loxitane) and fluphenazine decanoate (Prolix Decanoate) are both typical antipsychotics.
PTS: 1
a. | The brain gets bigger due to excess fluid as you age. |
b. | There is very little loss of neurons after the fifth decade. |
c. | There is no definitive evidence of mental decline with aging. |
d. | If you are going to become forgetful, it usually happens by age 60. |
ANS: C
The brain does get smaller and there is significant loss of neurons after the fifth decade. There is no definitive evidence of mental decline with aging.
PTS: 1
a. | neurotransmitter dysfunction |
b. | a variety of contributing factors |
c. | a failure of the immunological system |
d. | underlying structural defects in the brain |
ANS: B
A variety of factors are implicated in the cause of mental illness. (No one cause has been found.) These factors include abnormalities in structure of the brain, neurotransmitter production or absorption, neuroendocrine responses, immune responses, and genetic predisposition. All have been found to contribute to mental disorders.
PTS: 1
a. | astrocytomas | c. | liver disease |
b. | paresthesias | d. | heart disease |
ANS: D
The link between mood disturbances, such as depression, and adverse outcomes in heart disease, specifically myocardial infarction, is well documented and accounts for half of the cases of depression in those recovering from myocardial infarction. Literature supports the fact that there is an arrhythmic mechanism that is the link between psychological factors and sudden cardiac death.
PTS: 1
a. | a change in sexual functioning |
b. | uncontrollable coughing at times |
c. | effect of exercise on the clients mood |
d. | any change in mood, especially depression |
ANS: D
Many medications used to treat medical conditions contribute to a depressed mood, and this is possible with some medications used to treat hypertension. While it would be helpful to know the effect of exercise on mood, changes in sexual functioning, and problems with coughing associated with the medication, it is most important to assess for and treat any depression.
PTS: 1
a. | bulimia | c. | ringing in the ears |
b. | nervous leg syndrome | d. | cognitive impairment |
ANS: D
For years, health providers have recognized that cognitive impairment may be linked with depressive disorders. Negative self-reverent cognitions, which are related to perceptions of loss, are believed to be a mediator of depressive symptoms.
PTS: 1
a. | GABA | c. | acetylcholine |
b. | dopamine | d. | norepinephrine |
ANS: C
Some researchers have found that the brain adapts to aging by preserving an abundance of nerve cells rich in acetylcholine in neurotransmitter pathways between the hippocampus and the cerebral cortex. These changes are linked to higher cortical functioning.
PTS: 1
a. | Jacksonian seizures | c. | occasional inappropriate affect |
b. | childlike silliness | d. | progressive speech difficulties |
ANS: D
Frontotemporal dementia is characterized with symptoms similar to AD with progressive speech difficulties associated particularly with FTD when it affects primarily the left frontotemporal lobe.
PTS: 1
a. | stimulate the production of cortisone |
b. | stimulate the respiratory center of the brain |
c. | regulate the production of thyroid hormones |
d. | prolong the life of existing cholinergic neurons |
ANS: D
Drugs that prolong the life of existing cholinergic neurons include donepezil (Aricept) which is given to clients with Alzheimers disease.
PTS: 1
a. | aurothioglucose (Sogonal) |
b. | ceftuzixime sodium (Cefizox) |
c. | clonidine hydrochloride (Duraclon) |
d. | galantamine hydrobromide (Reminyl) |
ANS: D
Like donepezil (Aricept), the drug galantamine hydrobromide (Reminyl) prolongs the life of existing cholinergic neurons and may delay the clinical decline in clients with Alzheimers disease.
PTS: 1
a. | serotonin | c. | norepinephrine |
b. | acetylcholine | d. | gamma-aminobutyric acid |
ANS: D
Scientists have identified norepinephrine, dopamine, acetylcholine, and serotonin as excitatory transmitters. They have identified gamma-aminobutyric acid as an example of an inhibitory transmitter.
PTS: 1
a. | weeks of workouts with weight lifting |
b. | the release of large amounts of glucagon |
c. | the hypothalamic-pituitary-adrenal response |
d. | ability to control the mind with specific thoughts |
ANS: C
The hypothalamic-pituitary-adrenal axis will respond when a person is subjected to stress including threats of harm or danger to self or others.
PTS: 1
a. | myasthenia gravis | c. | functional psychosis |
b. | conversion disorder | d. | systemic lupus erythematosus |
ANS: C
Abnormalities in the HPA axis are known to contribute to and are diagnostic of functional psychosis, phobias, bipolar disorder, depressive disorder, and anxiety disorder.
PTS: 1
a. | proving a connection between AIDS and the development of depression |
b. | interconnections between the nervous system and the immune system |
c. | providing clients at high risk for mental illness with preventative measures |
d. | immunizing clients with psychiatric illness against neurological problems |
ANS: B
Psychoneuroimmunology is a developing knowledge concerned with the interconnections between the nervous system and the immune system.
PTS: 1
a. | There is a deficiency in dopamine and/or specific dopamine receptors. |
b. | It is caused by a systemic virus that is most likely carried by a mosquito. |
c. | This involves the destruction of the myelin sheath and problems in conduction. |
d. | The immune system has attacked itself in a failure to recognize its own cells as self. |
ANS: D
When the immune system fails to differentiate self from nonself, it can attack itself as in autoimmune diseases like systemic lupus erythematosus (SLE).
PTS: 1
a. | New research points to a relationship to thyroid dysfunction. |
b. | Panic disorders have been recently linked to immune dysfunction. |
c. | Early childhood experiences coupled with genetic defects are implicated. |
d. | This disorder is most likely a learned behavior according to recent research. |
ANS: B
Recently, psychiatric illnesses, notably affective disorders and panic disorders, have been linked to immune dysfunction.
PTS: 1
a. | early 1900s | c. | the Korean conflict |
b. | World War II | d. | mid-1970s |
ANS: A
Genetic theories regarding the cause of schizophrenia date back to Kraepelin in the early 1900s. Kraepelin observed that bizarre behavior was commonly found in families of clients with schizophrenia.
PTS: 1
a. | Schizophrenia is most likely a group of related genetic disorders. |
b. | Lack of family support is the major cause of relapse and recidivism. |
c. | Environmental factors are just as relevant as genetic processes. |
d. | It is unlikely that the cause of schizophrenia is genetic in nature. |
ANS: C
Twin, adoption, and family studies to determine the impact of environmental factors on genetic expression have shown that environmental factors are just as important as molecular-based genetic processes. Environmental factors include parental treatment or caregiving patterns, family structures, age spacing, and gender. These factors may buffer or protect genetically vulnerable clients.
PTS: 1
a. | living with a friend or relative who is an alcoholic |
b. | being in a location where there is access to alcohol |
c. | having an alcoholic parent or grandparent and being in college |
d. | suffering from bipolar disorder and having visual hallucinations |
ANS: C
The role of genetic factors and alcoholism has been well supported by twin, family, and adoption studies. Some people with a genetic predisposition to alcoholism do not drink alcohol or abuse substances because they have seen the harm it does to an individual and the family. Affect and mood disorders are not as great a risk as having genetic markers and environmental factors such as peer pressure and access.
PTS: 1
a. | GABA | c. | acetylcholine |
b. | dopamine | d. | norepinephrine |
ANS: B
The mesolimbic-mesocortical areas of the brain contain the various types of dopamine receptors including those that generate reward and reinforcement behaviors. Clients with a biochemical predisposition to alcoholism will gain reinforcement directly from the alcohol and its interaction with specific dopamine receptors.
PTS: 1
a. | They can be used to prolong the expected life span. |
b. | They can be used to control negative emotions. |
c. | Stem cells can be used as universal donor cells. |
d. | Use of stem cells will cure quicker and cheaper than drugs. |
ANS: C
As universal donor cells, stem cells could offer cures to currently incurable diseases such as childhood diabetes, Alzheimers, and spinal cord injury.
PTS: 1
a. | sharply decreased | c. | increased a small amount |
b. | stayed about the same | d. | increased sharply |
ANS: D
The use of herbal medicines has risen sharply over the past decade from 3% to 12%. Herbal therapy use exists across age, gender, culture, and ethnic groups. The most cited health problems addressed by this form of therapy include chronic pain, anxiety, arthritis, chronic fatigue syndrome, and headaches. One reason for the increased use of herbal medicine is that it is readily available on the Internet, pharmacies, and health food stores.
PTS: 1
a. | acetycholinesterase levels |
b. | adrenal hormonal production |
c. | protein kinase C (PKC) activities |
d. | dopamine receptor site receptivity |
ANS: C
Lithium and valproate acid regulate protein kinase C (PKC) activities and have efficacy in the treatment of acute mania. PKC is a group of calcium and phospholipid-dependent enzymes and is found to be elevated during acute mania. Treatment with lithium and valproate acid depresses PKC activity during mania.
PTS: 1
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