Mental Health Nursing: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Mental health nursing

Method

  1. Decide whether there is an immediate risk: suicide, violence, a drug emergency or a physical illness.
  2. Act on safety first: observe, remove means, de-escalate, stop a harmful drug, get help.
  3. Choose the therapeutic response: acknowledge feelings, present reality, avoid false reassurance and “why” questions.
  4. Respect rights: the least restrictive option, consent and confidentiality with its limits.

2Practice problems

1.Mental health nursingMedium

Which monitoring is important for a patient starting valproate?

  1. ALiver function and signs of pancreatitis, and counselling about pregnancy risks
  2. BHearing tests
  3. CEye pressure only
  4. DLung function and regular chest X-rays, because of the risk of pulmonary fibrosis
2.Mental health nursingHard

Which finding best helps to distinguish serotonin syndrome from neuroleptic malignant syndrome?

  1. AFever is present only in serotonin syndrome
  2. BConfusion occurs only in neuroleptic malignant syndrome, never in serotonin syndrome
  3. CHyperreflexia and clonus with a rapid onset suggest serotonin syndrome
  4. DSweating occurs only in neuroleptic malignant syndrome
3.Clinical psychologyMedium

Which statement best distinguishes obsessive-compulsive personality disorder (OCPD) from OCD?

  1. AIn OCPD, intrusive unwanted thoughts trigger rituals that the person recognises as excessive
  2. BIn OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self
  3. COCPD is a psychotic disorder
  4. DOCPD always involves hand washing
4.Clinical psychologyHard

A therapist says: "Rather than fighting the thought 'I'm a failure', notice it as just a thought, and act on what matters to you." Which therapy does this best represent?

  1. ARational emotive behaviour therapy
  2. BSystematic desensitisation
  3. CAcceptance and commitment therapy (ACT)
  4. DClassical psychoanalysis
5.PharmacologyMedium

How does neostigmine improve muscle strength in myasthenia gravis?

  1. AIt blocks the autoantibodies against the receptor
  2. BIt inhibits acetylcholinesterase so more acetylcholine reaches the receptors
  3. CIt directly stimulates muscarinic receptors in muscle
  4. DIt increases the number of acetylcholine receptors at the neuromuscular junction
6.PharmacologyHard

A pregnant woman develops a deep vein thrombosis. Which anticoagulant is usually preferred?

  1. ALow-molecular-weight heparin, such as enoxaparin
  2. BAspirin alone
  3. CRivaroxaban, a direct oral factor Xa inhibitor
  4. DWarfarin

3Solutions

1.Mental health nursing

Answer: A · Liver function and signs of pancreatitis, and counselling about pregnancy risks

Why this is the answer

Valproate can cause hepatotoxicity and pancreatitis and causes birth defects and developmental problems if taken in pregnancy. It is generally avoided in women who could become pregnant unless strict conditions are met.

Answer

A · Liver function and signs of pancreatitis, and counselling about pregnancy risks
2.Mental health nursing

Answer: C · Hyperreflexia and clonus with a rapid onset suggest serotonin syndrome

Why this is the answer

Both can cause fever, confusion and autonomic instability. Serotonin syndrome starts within hours and causes neuromuscular excitation (hyperreflexia, clonus). NMS develops over days with "lead-pipe" rigidity and slowed reflexes.

Answer

C · Hyperreflexia and clonus with a rapid onset suggest serotonin syndrome
3.Clinical psychology

Answer: B · In OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self

Why this is the answer

OCPD is a pervasive pattern of perfectionism, orderliness and control that the person sees as appropriate (ego-syntonic). OCD obsessions are unwanted and distressing (ego-dystonic).

Answer

B · In OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self
4.Clinical psychology

Answer: C · Acceptance and commitment therapy (ACT)

Why this is the answer

ACT (Hayes) uses acceptance, cognitive defusion and values-based action. Unlike traditional cognitive therapy, it does not try to dispute the content of thoughts.

Answer

C · Acceptance and commitment therapy (ACT)
5.Pharmacology

Answer: B · It inhibits acetylcholinesterase so more acetylcholine reaches the receptors

Why this is the answer

Neostigmine inhibits acetylcholinesterase at the neuromuscular junction, so acetylcholine lasts longer and can activate the remaining nicotinic receptors more effectively.

Answer

B · It inhibits acetylcholinesterase so more acetylcholine reaches the receptors
6.Pharmacology

Answer: A · Low-molecular-weight heparin, such as enoxaparin

Why this is the answer

Heparins are large molecules that do not cross the placenta. Warfarin is teratogenic, and direct oral anticoagulants are not recommended in pregnancy.

Answer

A · Low-molecular-weight heparin, such as enoxaparin

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