QUESTION 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

3.75 points   

QUESTION 2 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

3.75 points   

QUESTION 3 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.

3.75 points   

QUESTION 4 Which      neurotransmitter is considered the major excitatory neurotransmitter?

A.

Glycine

B.

GABA

C.

Glutamate

D.

Serotonin

3.75 points   

QUESTION 5 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

3.75 points   

QUESTION 6 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

3.75 points   

QUESTION 7 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

3.75 points   

QUESTION 8 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

3.75 points   

QUESTION 9 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.

3.75 points   

QUESTION 10 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

3.75 points   

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?

A.

Motivation

B.

Skills

C.

Logistics

D.

Education

3.75 points   

QUESTION 12 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

3.75 points   

QUESTION 13 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

3.75 points   

QUESTION 14 When      dopamine (subtype 2) receptors are blocked in this pathway (system), it is      evident by EPS.

A.

Mesocortical

B.

Tuberoinfundibular

C.

Nigrostriatal

D.

Mesolimbic

3.75 points   

QUESTION 15 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

3.75 points   

QUESTION 16 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

3.75 points   

QUESTION 17 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

3.75 points   

QUESTION 18 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?

3.75 points   

QUESTION 19 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

3.75 points   

QUESTION 20 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

3.75 points   

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