As part of the stress response, the HPA axis is stimulated. Which structures make up this system?

Hippocampus, parietal lobe, and amygdala.

Hypothalamus, pituitary gland, and adrenal glands.

Hindbrain, pyramidal nervous system, and anterior cerebrum.

Hepatic artery, parasympathetic nervous system, and acoustic nerve.

Answer and Explanation

The Correct Answer is B

Choice A reason: The hippocampus and amygdala modulate stress responses but are not part of the HPA axis. The parietal lobe processes sensory information, not stress hormones. The HPA axis involves cortisol release, driven by hypothalamic-pituitary-adrenal interactions, not these structures, making this choice incorrect.

Choice B reason: The HPA axis comprises the hypothalamus, which releases CRH, the pituitary gland, which secretes ACTH, and the adrenal glands, which produce cortisol. This system regulates stress responses via neuroendocrine signaling, modulating amygdala and prefrontal cortex activity to manage stress and maintain homeostasis.

Choice C reason: The hindbrain regulates basic functions like breathing, not stress responses. The pyramidal nervous system and anterior cerebrum are not anatomical structures involved in the HPA axis. Cortisol release, critical for stress, is driven by hypothalamic-pituitary-adrenal interactions, not these regions.

Choice D reason: The hepatic artery, parasympathetic nervous system, and acoustic nerve are unrelated to the HPA axis. The parasympathetic system modulates rest, not stress, while the HPA axis involves hypothalamic CRH, pituitary ACTH, and adrenal cortisol, driving the body’s stress response.

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Correct Answer is D

Explanation

Choice A reason: Auditory hallucinations are positive symptoms of schizophrenia, driven by mesolimbic dopamine excess, causing sensory perceptions without stimuli. They reflect hyperactive neural signaling, not the diminished motivation or functioning characteristic of negative symptoms, making this incorrect.

Choice B reason: Threatening behavior is a positive symptom, reflecting dopamine-driven impulsivity and agitation in schizophrenia’s mesolimbic pathway. Negative symptoms involve deficits like apathy, not active behaviors, making this choice unrelated to negative symptom criteria.

Choice C reason: Delusions of grandeur are positive symptoms, stemming from excessive dopamine in the mesolimbic system, causing exaggerated beliefs. Negative symptoms involve reduced emotional or behavioral expression, not active psychotic beliefs, making this choice incorrect.

Choice D reason: Poor personal hygiene is a negative symptom of schizophrenia, reflecting reduced motivation and self-care due to prefrontal cortex dopamine hypofunction. This deficit in volition and functioning aligns with negative symptoms, distinguishing it from positive symptoms like hallucinations.

A. A score over 8 requires immediate hospitalization. B. Give the patient a follow-up appointment. Hospitalization may be needed soon. C. That action would seem to be appropriate based on the score. D. I think you should strongly consider a benzodiazepine for this patient.

Correct Answer is A

Explanation

Choice A reason: A SAD PERSONS score over 8 indicates high suicide risk, driven by serotonin dysregulation and amygdala hyperactivity, necessitating hospitalization to prevent self-harm. Immediate intervention stabilizes neurochemical imbalances and ensures safety, addressing the acute risk effectively.

Choice B reason: A follow-up appointment is inadequate for a score of 10, indicating high suicide risk. Serotonin and dopamine dysregulation heighten impulsivity, and delaying hospitalization risks self-harm, as outpatient care cannot address acute amygdala-driven suicidal ideation effectively.

Choice C reason: Sending the patient home with a score of 10 is unsafe, as high suicide risk involves serotonin deficits and amygdala hyperactivity. This disregards the need for immediate intervention to stabilize neurochemical imbalances and ensure safety, making it inappropriate.

Choice D reason: Benzodiazepines address anxiety but not suicide risk directly. A score of 10 indicates severe serotonin dysregulation and amygdala-driven impulsivity, requiring hospitalization, not anxiolytics, which may mask symptoms without addressing the underlying neurochemical suicide risk.

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As part of the stress response, the HPA axis is stimulated. Which structures make up this system?

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Naxlex Comprehensive Predictor Exams

A patient diagnosed with schizophrenia has auditory hallucinations, delusions of grandeur, poor personal hygiene, and threatening behavior. Which assessment finding would the nurse regard as a negative symptom of schizophrenia?

Correct Answer is D

Explanation

A nurse states, "I evaluated a new patient using the modified SAD PERSONS scale and got a score of 10. Should I send the patient home?" Select the best reply.

Correct Answer is A

Explanation

A hospitalized client diagnosed with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which medication would the nurse expect to administer?

A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. Which drug should the nurse anticipate will be prescribed?

Monoamine oxidase inhibitors are used to treat which of the following?

A nurse is assessing a client who is grieving. The nurse suspects that the client is experiencing complicated bereavement based on which statement by the client?

The nurse conducts a health history assessment for a client who is depressed. Which question should the nurse include to determine the client’s protective factors for suicide?

Which patient meets the criteria for hospice services?

A client on an inpatient psychiatric unit yells "My roommate is Satan's crafty minion" and attempts to strangle him. The patient is refusing redirection. What medication should the nurse expect the on-call provider to order?

A patient states, "I feel detached from myself and weird all the time. It is as though I am looking at life through a cloudy window. Everything seems unreal. It really messes up things at work and school." This scenario is most suggestive of which health problem?