Neurobiology and Medication Adherence Concepts NURS 6630

Neurobiology and Medication Adherence Concepts NURS 6630

Neurobiology and Medication Adherence Concepts


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By Day 7

Complete the 20-question self assessment to gauge your understanding of this module’s content.

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Correct answers will be available on Dec 18 at 10:59pm.
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Question 1

0 / 0 pts
Neurotransmitters are defined by four essential characteristics. These are:

Neurotransmitters are synthesized within presynaptic neurons.

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

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

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

A, C, and D only

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

Question 2

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

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.

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.

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

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

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.

Question 3

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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)?

Cell body, dendrites, Axon, Axon terminals

Dendrites, Axon, Cell body, Axon, Axon terminals

Dendrites, Cell body, Axon, Axon terminals

Axon terminals, Axon, Cell body, Dendrites

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

Question 4

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

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

I only

III only

I, II, and V only

I, II, III, IV, and V

I, III, and IV

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

Question 5

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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?

Slow effector pathways

Modulated effector pathways

Rapid effector pathways

NMDA glutamate receptor pathways

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

Question 6

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



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

Question 7

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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?

Stabilizes dopamine concentrations in the CNS

Induces anxiety

Causes hallucinations

Reduces platelet function

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

Question 8

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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?

Substance misuse

Knowledge deficits

Attitude ad belief system


These are signs of an altered mood.

Question 9

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

Sufficient understanding or acceptance of the illness

Abuse of the medication


Is the desired effect recognized at a lower daily dose?

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

Question 10

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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?

Cerebral cortex


Subcortical structures


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.

Question 11

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





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

Question 12

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

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

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

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

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

all the other options are missing neurotransmitters considered important in psychiatry

Question 13

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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.

Question 14

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

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.

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).

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.

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.

Question 15

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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)?

Slow effector pathways/G-protein coupled receptor

Slow effector pathway/ion channel

Rapid effector pathways/G-protein coupled receptor

Rapid effector pathway/ion channel

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

Question 16

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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?

Intracellular activation of second messengers

Protein phosphorylation

Modification of gene expression

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

Question 17

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

Slow effector pathways

Rapid effector pathways

NMDA glutamate receptor pathways

Modulated effector pathways

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

Question 18

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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.

Question 19

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Which neurotransmitter is considered the major excitatory neurotransmitter?





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

Question 20

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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?






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