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

How does obsessive-compulsive personality disorder differ from obsessive-compulsive disorder?

  1. AIt starts suddenly in later life after a stressful event and goes away on its own within a few months
  2. BIt is a lasting pattern of perfectionism and control without true obsessions and compulsions
  3. CIt always involves repeated hand washing and checking rituals
  4. DPeople with it always feel that their behaviour is senseless and unwanted
2.Mental health nursingHard

A patient taking sertraline is given tramadol for pain. A few hours later he is agitated, sweating, tremulous and has clonus in his ankles. What is the most likely problem?

  1. AOpioid withdrawal
  2. BAlcohol withdrawal
  3. CNeuroleptic malignant syndrome
  4. DSerotonin syndrome
3.Clinical psychologyMedium

A person avoids buses, shops, open car parks and queues because escape might be difficult if they panic. Which diagnosis fits best?

  1. AGeneralised anxiety disorder
  2. BClaustrophobia as a specific phobia
  3. CSocial anxiety disorder
  4. DAgoraphobia
4.Clinical psychologyHard

Which statement about the placebo effect in antidepressant trials is most accurate?

  1. APlacebos work only in physical illnesses
  2. BPlacebo response rates are substantial, so trials need control groups to show drug effects
  3. CPlacebo response is so strong that antidepressants have never shown any benefit over it in trials
  4. DPlacebo effects never occur in depression
5.PharmacologyMedium

Why should loperamide usually be avoided in bloody diarrhoea with fever?

  1. ALoperamide is an antibiotic that causes resistance
  2. BLoperamide causes severe hypertension when there is an infection
  3. CLoperamide makes the bleeding worse by blocking platelets
  4. DSlowing the gut may keep bacteria and toxins in the bowel longer
6.PharmacologyHard

Why is vancomycin given by mouth, not intravenously, for Clostridioides difficile infection?

  1. AOral vancomycin is absorbed into the blood better than IV vancomycin
  2. BOral vancomycin is not absorbed, so it reaches high levels in the colon
  3. CThe oral form is cheaper but has the same effect as IV
  4. DIntravenous vancomycin causes C. difficile infection

3Solutions

1.Mental health nursing

Answer: B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions

Why this is the answer

In OCPD, rigid perfectionism, orderliness and control are part of the personality and usually feel right to the person. In OCD, the person has intrusive obsessions and compulsions that they usually find distressing.

Answer

B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions
2.Mental health nursing

Answer: D · Serotonin syndrome

Why this is the answer

Tramadol has serotonergic effects, and combining it with an SSRI can cause serotonin syndrome. The serotonergic drugs are stopped and the patient is treated supportively; severe cases need intensive care.

Answer

D · Serotonin syndrome
3.Clinical psychology

Answer: D · Agoraphobia

Why this is the answer

Agoraphobia involves fear of at least two situations (public transport, open spaces, enclosed spaces, crowds or queues, being outside alone) because escape or help might be unavailable.

Answer

D · Agoraphobia
4.Clinical psychology

Answer: B · Placebo response rates are substantial, so trials need control groups to show drug effects

Why this is the answer

Placebo response in depression trials is often 30–40%, so randomised placebo-controlled designs are needed to show the specific effect of a drug.

Answer

B · Placebo response rates are substantial, so trials need control groups to show drug effects
5.Pharmacology

Answer: D · Slowing the gut may keep bacteria and toxins in the bowel longer

Why this is the answer

In dysentery or suspected C. difficile infection, antimotility drugs may prolong illness and increase complications such as toxic megacolon. The cause is assessed and fluids are replaced first.

Answer

D · Slowing the gut may keep bacteria and toxins in the bowel longer
6.Pharmacology

Answer: B · Oral vancomycin is not absorbed, so it reaches high levels in the colon

Why this is the answer

Oral vancomycin stays in the gut and acts directly on C. difficile in the colon. IV vancomycin is not excreted into the gut in useful amounts, so it does not treat this infection.

Answer

B · Oral vancomycin is not absorbed, so it reaches high levels in the colon

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