Self Assessment: Neurobiology and Medication Adherence Concepts

Self Assessment: Neurobiology and Medication Adherence Concepts

Self Assessment: Neurobiology and Medication Adherence Concepts

QUESTION 1

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

	A.	Motivation
	B.	Skills
	C.	Logistics
	D.	Education

0 points   

QUESTION 2

1. 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?

	A.	Preparation
	B.	Action
	C.	Contemplation
	D.	Maintenance

0 points   

QUESTION 3

1. 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?

	A.	microglial
	B.	macroglial

0 points   

QUESTION 4

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

	A.	True
	B.	False

0 points   

QUESTION 5

1. Which neurotransmitter is considered the major excitatory neurotransmitter?

	A.	Glycine
	B.	GABA
	C.	Glutamate
	D.	Serotonin

0 points   

QUESTION 6

1. 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?

	A.	Slow effector pathways
	B.	Modulated effector pathways
	C.	Rapid effector pathways
	D.	NMDA glutamate receptor pathways

0 points   

QUESTION 7

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

	A.	Sufficient understanding or acceptance of the illness
	B.	Abuse of the medication
	C.	Expense
	D.	Is the desired effect recognized at a lower daily dose?

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QUESTION 8

1. 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.

• Histological classification includes bipolar, unipolar, and multipolar.

1. Classifications using a combination of structural, functional, and neurotransmitter type provide the most robust and useful description.
2. Classification by neurotransmitter type alone provides the most useful description.

	A.	I only
	B.	III only
	C.	I, II, and V only
	D.	I, II, III, IV, and V
	E.	I, III, and IV

0 points   

QUESTION 9

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

	A.	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.
	B.	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).
	C.	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.

0 points   

QUESTION 10

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

	A.	glutamate, GABA, dopamine, serotonin, norepinephrine, histamine, steroids, nitric oxide
	B.	glutamate, GABA, dopamine, norepinephrine, serotonin, acetylcholine, histamine, endogenous opioids, steroids, cannabinoids, nitric oxide
	C.	glutamate, GABA, dopamine, serotonin, acetylcholine, endogenous opioids, nitric oxide, cannabinoids, steroids
	D.	glutamate, GABA, dopamine, serotonin, norepinephrine, endogenous opioids, steroids, histamine, nitric oxide

0 points   

QUESTION 11

1. 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.	Intracellular activation of second messengers
	B.	Protein phosphorylation
	C.	Modification of gene expression

0 points   

QUESTION 12

1. Neurotransmitters are defined by four essential characteristics. These are:

	A.	Neurotransmitters are synthesized within presynaptic neurons.
	B.	Depolarization of a neuron results in the release of a neurotransmitter, which exerts a multitude of actions on the postsynaptic neuron.
	C.	Their action on postsynaptic neurons can be replicated by administering a drug that mimics the activity of the endogenous neurotransmitter.
	D.	Their action in the synaptic cleft is terminated by a specific action.
	E.	A, C, and D only

0 points   

QUESTION 13

1. 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?

	A.	Substance misuse
	B.	Knowledge deficits
	C.	Attitude ad belief system
	D.	Mood

0 points   

QUESTION 14

1. 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?

	A.	Stabilizes dopamine concentrations in the CNS
	B.	Induces anxiety
	C.	Causes hallucinations
	D.	Reduces platelet function

0 points   

QUESTION 15

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

	A.	Slow effector pathways
	B.	Rapid effector pathways
	C.	NMDA glutamate receptor pathways
	D.	Modulated effector pathways

0 points   

QUESTION 16

1. 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?

	A.	Cerebral cortex
	B.	Brainstem
	C.	Subcortical structures
	D.	Cerebellum

0 points   

QUESTION 17

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

	A.	Mesocortical
	B.	Tuberoinfundibular
	C.	Nigrostriatal
	D.	Mesolimbic

0 points   

QUESTION 18

1. 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)?

	A.	Slow effector pathways/G-protein coupled receptor
	B.	Slow effector pathway/ion channel
	C.	Rapid effector pathways/G-protein coupled receptor
	D.	Rapid effector pathway/ion channel

0 points   

QUESTION 19

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

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

0 points   

QUESTION 20

1. 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)?

	A.	Cell body, dendrites, Axon, Axon terminals
	B.	Dendrites, Axon, Cell body, Axon, Axon terminals
	C.	Dendrites, Cell body, Axon, Axon terminals
	D.	Axon terminals, Axon, Cell body, Dendrites

Question 1

1. Which neurotransmitter is considered the major excitatory neurotransmitter?

	A.	Glycine
	B.	GABA
	C.	Glutamate
	D.	Serotonin

0 points

Question 2

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

	A.	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.
	B.	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).
	C.	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.

0 points

Question 3

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

	A.	glutamate, GABA, dopamine, serotonin, norepinephrine, histamine, steroids, nitric oxide
	B.	glutamate, GABA, dopamine, norepinephrine, serotonin, acetylcholine, histamine, endogenous opioids, steroids, cannabinoids, nitric oxide
	C.	glutamate, GABA, dopamine, serotonin, acetylcholine, endogenous opioids, nitric oxide, cannabinoids, steroids
	D.	glutamate, GABA, dopamine, serotonin, norepinephrine, endogenous opioids, steroids, histamine, nitric oxide

0 points

Question 4

1. 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?

	A.	Slow effector pathways
	B.	Modulated effector pathways
	C.	Rapid effector pathways
	D.	NMDA glutamate receptor pathways

0 points

Question 5

1. 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?

	A.	Stabilizes dopamine concentrations in the CNS
	B.	Induces anxiety
	C.	Causes hallucinations
	D.	Reduces platelet function

0 points

Question 6

1. 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.

	A.	I only
	B.	III only
	C.	I, II, and V only
	D.	I, II, III, IV, and V
	E.	I, III, and IV

0 points

Question 7

1. 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?

	A.	Substance misuse
	B.	Knowledge deficits
	C.	Attitude ad belief system
	D.	Mood

0 points

Question 8

1. 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?

	A.	Cerebral cortex
	B.	Brainstem
	C.	Subcortical structures
	D.	Cerebellum

0 points

Question 9

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

	A.	Mesocortical
	B.	Tuberoinfundibular
	C.	Nigrostriatal
	D.	Mesolimbic

0 points

Question 10

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

	A.	True
	B.	False

0 points

Question 11

1. Neurotransmitters are defined by four essential characteristics. These are:

	A.	Neurotransmitters are synthesized within presynaptic neurons.
	B.	Depolarization of a neuron results in the release of a neurotransmitter, which exerts a multitude of actions on the postsynaptic neuron.
	C.	Their action on postsynaptic neurons can be replicated by administering a drug that mimics the activity of the endogenous neurotransmitter.
	D.	Their action in the synaptic cleft is terminated by a specific action.
	E.	A, C, and D only

0 points

Question 12

1. 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?

	A.	microglial
	B.	macroglial

0 points

Question 13

1. 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?

	A.	Preparation
	B.	Action
	C.	Contemplation
	D.	Maintenance

0 points

Question 14

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

	A.	Sufficient understanding or acceptance of the illness
	B.	Abuse of the medication
	C.	Expense
	D.	Is the desired effect recognized at a lower daily dose?

0 points

Question 15

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

	A.	Motivation
	B.	Skills
	C.	Logistics
	D.	Education

0 points

Question 16

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

	A.	Slow effector pathways
	B.	Rapid effector pathways
	C.	NMDA glutamate receptor pathways
	D.	Modulated effector pathways

0 points

Question 17

1. 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.	Intracellular activation of second messengers
	B.	Protein phosphorylation
	C.	Modification of gene expression

0 points

Question 18

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

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

0 points

Question 19

1. 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)?

	A.	Cell body, dendrites, Axon, Axon terminals
	B.	Dendrites, Axon, Cell body, Axon, Axon terminals
	C.	Dendrites, Cell body, Axon, Axon terminals
	D.	Axon terminals, Axon, Cell body, Dendrites

0 points

Question 20

1. 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)?

	A.	Slow effector pathways/G-protein coupled receptor
	B.	Slow effector pathway/ion channel
	C.	Rapid effector pathways/G-protein coupled receptor
	D.	Rapid effector pathway/ion channel