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

A veteran with PTSD sits with his back to the wall, scans the room constantly and jumps at every door slam. Which symptom group do these behaviours belong to?

  1. AAvoidance
  2. BChanges in arousal and reactivity
  3. CIntrusion symptoms
  4. DDissociative amnesia for the trauma
2.Mental health nursingHard

A patient in a manic episode is interrupting other patients and becoming louder in the day room. What is the most appropriate nursing action?

  1. ATurn up the music to distract the group
  2. BEncourage a competitive group game to use up energy
  3. CCalmly guide the patient to a quieter area with less stimulation and set clear, simple limits
  4. DArgue with the patient about the behaviour in front of everyone until the patient agrees to stop
3.Clinical psychologyMedium

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

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

The "Dodo bird verdict" in psychotherapy research refers to the finding that:

  1. AUntreated clients on waiting lists improve faster than treated clients
  2. BMedication always outperforms psychotherapy
  3. CDifferent bona fide therapies often produce broadly similar outcomes
  4. DOnly psychoanalysis is effective for depression
5.PharmacologyMedium

Which adverse effect of ciprofloxacin should a patient report at once?

  1. ADarker stools than usual
  2. BMild tiredness in the first few days
  3. CPain or swelling in a tendon, such as the Achilles tendon
  4. DA slightly bitter or metallic taste for a while after each dose
6.PharmacologyHard

A nurse gave a patient ten times the prescribed dose of hydromorphone. The patient is currently alert. What is the most appropriate sequence of actions?

  1. AMonitor closely, have naloxone ready, inform the prescriber and report
  2. BChange the chart so that it shows the correct dose, and continue to monitor
  3. CSay nothing because the patient is alert
  4. DGive another dose later to balance it out

3Solutions

1.Mental health nursing

Answer: B · Changes in arousal and reactivity

Why this is the answer

Hypervigilance and an exaggerated startle response belong to the arousal and reactivity group, along with irritability, poor concentration and sleep problems.

Answer

B · Changes in arousal and reactivity
2.Mental health nursing

Answer: C · Calmly guide the patient to a quieter area with less stimulation and set clear, simple limits

Why this is the answer

Patients with mania benefit from a calm, low-stimulus environment, firm and consistent limits and simple, non-competitive activities.

Answer

C · Calmly guide the patient to a quieter area with less stimulation and set clear, simple limits
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 · Different bona fide therapies often produce broadly similar outcomes

Why this is the answer

Meta-analyses often find small differences between established therapies, which has been taken to support common factors such as the alliance. Some disorders, such as OCD and phobias, show clear advantages for specific treatments like exposure.

Answer

C · Different bona fide therapies often produce broadly similar outcomes
5.Pharmacology

Answer: C · Pain or swelling in a tendon, such as the Achilles tendon

Why this is the answer

Fluoroquinolones can cause tendinitis and tendon rupture. Patients should stop exercise and report tendon pain promptly.

Answer

C · Pain or swelling in a tendon, such as the Achilles tendon
6.Pharmacology

Answer: A · Monitor closely, have naloxone ready, inform the prescriber and report

Why this is the answer

The patient may become sedated and develop respiratory depression later, so close monitoring and a ready antidote are needed. The prescriber is informed, the patient is told honestly, and the error is reported to improve the system.

Answer

A · Monitor closely, have naloxone ready, inform the prescriber and report

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