Neurobiology and Medication Adherence Concepts NURS 6630

Question 1

Neurotransmitters are defined by four essential characteristics. These are:

Answer B should read a “discrete” (not multitude) action on the post synaptic neuron.

Answer

Neurotransmitters are synthesized within presynaptic neurons.

Answer

Depolarization of a neuron results in the release of a neurotransmitter, which exerts a multitude of actions on the postsynaptic neuron.

Answer

Their action on postsynaptic neurons can be replicated by administering a drug that mimics the activity of the endogenous neurotransmitter.

Answer

Their action in the synaptic cleft is terminated by a specific action.

Answer

A, C, and D only

Question 2

Upon blocking a Serotonin reuptake pump, what happens in the synaptic cleft and on the post synaptic cell membrane?

A, C, and D are misrepresentations of what occurs when you increase Serotonin in the synaptic cleft. There is no effect on the pre-synaptic neuron, and the increases in Serotonin result in a reduction of receptor concentration on the post-synaptic neuron.

Answer

The result will be an increase in available Serotonin in the synaptic cleft causing the post synaptic cell to increase the number of Serotonin receptors.

Answer

The result will be an increase in the available Serotonin in the synaptic cleft causing the post synaptic neuron to reduce the number of Serotonin receptors.

Answer

The result will be an increase in Serotonin in the synaptic cleft resulting in an increase in reuptake pumps on the presynaptic neuron.

Answer

The result will be an increase in Serotonin in the synaptic cleft resulting in a decrease in reuptake pumps on the pre-synaptic neuron.

Question 3

Neurotransmission is unidirectional insofar as chemical and electrical conduction is concerned within the individual neuron. Of the following descriptions, which best characterizes the order of neurotransmitter/receptor interaction that results in an electrical signal impulse and the release of another neurotransmitter for interaction in the synaptic cleft (signal conduction through a neuron)?

All of the other options are mis-sequenced in signal conduction.

Answer

Cell body, dendrites, Axon, Axon terminals

Answer

Dendrites, Axon, Cell body, Axon, Axon terminals

Answer

Dendrites, Cell body, Axon, Axon terminals

Answer

Axon terminals, Axon, Cell body, Dendrites

Question 4

¹Neurons are classified in several different ways. From the following statements, select which ones are true.

The two structural classifications are projection neurons and local inter-neurons.
Function classifications are made up of two subcategories: excitatory and inhibitory.
Histological classification includes bipolar, unipolar, and multipolar.
Classifications using a combination of structural, functional, and neurotransmitter type provide the most robust and useful description.
Classification by neurotransmitter type alone provides the most useful description.

I only

III only

Statement II would need to include modulatory function to be correct, and Statement V does not include structural and functional classification systems.

Answer

I, II, and V only

Answer

I, II, III, IV, and V

Answer

I, III, and IV

Question 5

Receptors trigger one of two effector pathways resulting in changes in neuronal activity. These changes will, ultimately, effect gene expression. Which effector pathway is characterized by ion flux through transmitter-activated channels resulting in an altered membrane potential and neuronal activity?

Answer B is fictitious, D is a type of rapid effector pathway, and A represents G-protein coupled receptors.

Answer

Slow effector pathways

Answer

Modulated effector pathways

Answer

Rapid effector pathways

Answer

NMDA glutamate receptor pathways

Question 6

Introducing adherence in facilitating treatment goals is something that would be necessary in a patient who has previously displayed nonadherence patterns.

True

False

It is introduced as early as possible in treatment to mitigate the risks associated with nonadherence.

Question 7

Serotonin (5HT) is a neurotransmitter associated with mood, sleep, and psychosis. There are several serotonin receptors all over the human body. A unique aspect of the second generation antipsychotics is their ability to block 5HT2a receptors. What is the effect of this inhibition?

B represents antagonism of 5HT1a, C represents a 5HT2a agonist, and D represents what happens when you inhibit SERT.

Answer

Stabilizes dopamine concentrations in the CNS

Answer

Induces anxiety

Answer

Causes hallucinations

Answer

Reduces platelet function

Question 8

Treatment adherence is affected by several different factors. Clinical factors include mood, anxiety, psychosis, and substance misuse. There are also patient factors such as knowledge, attitude, and beliefs; economic and racial/ethnic disparities, and clinical encounters. A patient who presents hopeless, with decreased energy, and poor concentration is affected by which factor?

Mood

These are signs of an altered mood.

Answer

Substance misuse

Answer

Knowledge deficits

Answer

Attitude ad belief system

Question 9

If a patient admits to taking his medication every other day (instead of daily, as prescribed), a potential concern would be:

Expense

A represents a patient taking his medication sporadically, B represents a patient taking too much medication, and D represents a patient taking a lower-than-prescribed dose but daily

Answer

Sufficient understanding or acceptance of the illness

Answer

Abuse of the medication

Answer

Is the desired effect recognized at a lower daily dose?

Question 10

The human brain is subcategorized into four major structures. These structures include the cerebral cortex, brainstem, subcortical structures, and the cerebellum. Of these major categories, which one houses the area of the brain that has been found in some neuropathological studies of patients with schizophrenia to be of smaller size?

Brainstem

The area of the brain in question is part of the thalamus, which is located in the subcortical structures. The other options are incorrect, geographically speaking.

Answer

Cerebral cortex

Answer

Subcortical structures

Answer

Cerebellum

Question 11

Of the components of patient-focused interventions to enhance adherence, which component includes the following strategies: adaptive thinking, use of cues, and support?

Skills

Logistics

Education

Skills include adaptive thinking, problem solving, use of cues, and support.

Answer

Motivation

Question 12

Which of the following consists of all the known major neurotransmitters that are relevant in psychiatry?

all the other options are missing neurotransmitters considered important in psychiatry

Answer

glutamate, GABA, dopamine, serotonin, norepinephrine, histamine, steroids, nitric oxide

Answer

glutamate, GABA, dopamine, norepinephrine, serotonin, acetylcholine, histamine, endogenous opioids, steroids, cannabinoids, nitric oxide

Answer

glutamate, GABA, dopamine, serotonin, acetylcholine, endogenous opioids, nitric oxide, cannabinoids, steroids

Answer

glutamate, GABA, dopamine, serotonin, norepinephrine, endogenous opioids, steroids, histamine, nitric oxide

Question 13

Glia cells play a supportive role to the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia and macroglia. Of these two cell types, which one plays an active and critical role in glutamatergic neurotransmission by providing a co-agonist required for glutamate receptor function?

Microglial cells are small, phagocytic cells related to peripheral macrophages.

Answer

microglial

Answer

macroglial

Question 14

The synaptic cleft is best characterized by which of the following statements?

Answer A represents a neuron communicating with itself and Answer B states that the synapse is the space between the cell body (not dendrites) and axon terminals.

Answer

The synaptic cleft is the space between a single neuron’s dendrites and axon terminals in which intracellular communication occurs through the release of neurotransmitters allowing for signal conduction throughout the central nervous system.

Answer

The synaptic cleft is the space between the cell body and axon terminals that allows for release of neurotransmitters from the presynaptic neuron for intercellular communication with an adjacent neuron (post synaptic neuron).

Answer

The synaptic cleft is an area where dendrites and axon terminals are within close proximity, allowing for the release of a neurotransmitter from a presynaptic neuron that can interact with receptors on dendritic cells of a post synaptic neuron, which is the main basis for intercellular communication of neurons.

Question 15

A patient arrives in the ED via EMS having a grand mal seizure. The ED physician instructs the RN to give 10 milligrams of Diazepam IV X1 dose STAT. The patient’s seizure breaks within 2 minutes of the Diazepam being administered. The mechanism by which this medication causes rapid resolution of seizure activity is via which receptor type (effector pathway/receptor subtype)?

Options B and C are mismatched, and Option A shows effects days to weeks after activation.

Answer

Slow effector pathways/G-protein coupled receptor

Answer

Slow effector pathway/ion channel

Answer

Rapid effector pathways/G-protein coupled receptor

Answer

Rapid effector pathway/ion channel

Question 16

G-protein coupled receptors are targets for several psychiatric medications. Given what we know about these receptors, what is the ultimate result we will see when one of them is activated in a way that would potentiate an action?

A and B are both steps in the activities seen leading up to modification of gene expression.

Answer

Intracellular activation of second messengers

Answer

Protein phosphorylation

Answer

Modification of gene expression

Question 17

G-protein coupled receptors are examples of what type of effector pathway?

Answer D is fictitious, B represents ion channel receptors, and C is a type of rapid effector pathway.

Answer

Slow effector pathways

Answer

Rapid effector pathways

Answer

NMDA glutamate receptor pathways

Answer

Modulated effector pathways

Question 18

When dopamine (subtype 2) receptors are blocked in this pathway (system), it is evident by EPS.

D is associated with positive symptoms in schizophrenia, B is associated with lactation, A is associated with affect.

Answer

Mesocortical

Answer

Tuberoinfundibular

Answer

Nigrostriatal

Answer

Mesolimbic

Question 19

Which neurotransmitter is considered the major excitatory neurotransmitter?

Glycine

GABA

Glutamate

Serotonin

A and B are inhibitory, and D is involved in mood and sleep.

Question 20

Motivation is a component of patient-focused interventions to enhance adherence. Based on the transtheoretical model, readiness to change can fluctuate across five stages. Which stage is represented by the patient who is aware that a problem exists and, while seriously thinking about overcoming it, has not yet committed to a plan of action?

Action

Answer

Preparation

Answer

Contemplation

Answer

Maintenance

Neurobiology and Medication Adherence Concepts NURS 6630

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