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 man with few physical symptoms is convinced he has cancer, checks his body many times a day and is not reassured by normal test results. According to DSM-5, which disorder does this suggest?

  1. AConversion disorder
  2. BSomatic symptom disorder
  3. CIllness anxiety disorder
  4. DFactitious disorder
2.Mental health nursingHard

A nurse realises she has given a patient another patient's olanzapine dose. What should she do first?

  1. AAssess the patient, including his vital signs and level of sedation
  2. BFill in an incident report before checking the patient
  3. CSay nothing, because one dose will not cause harm
  4. DGive the patient his own prescribed medicine as well, to stay on schedule
3.Clinical psychologyMedium

A client says "I failed one test, so I will fail everything." Which cognitive distortion is this?

  1. APersonalisation
  2. BOvergeneralisation
  3. CEmotional reasoning
  4. DMind reading
4.Clinical psychologyHard

Expressed emotion research led to family interventions in schizophrenia. Which outcome do these interventions most reliably improve?

  1. AThe genetic risk of siblings
  2. BRelapse and readmission rates
  3. CThe patient's IQ score
  4. DThe need for any antipsychotic medication
5.PharmacologyMedium

Benzathine benzylpenicillin (penicillin G benzathine) is ordered. Which route is correct?

  1. AIntravenous infusion over 30 minutes
  2. BIntravenous push
  3. CDeep intramuscular only
  4. DSubcutaneous in the abdomen
6.PharmacologyHard

Newborns given chloramphenicol can develop "grey baby syndrome". What is the main reason?

  1. AThe newborn kidney excretes the drug too quickly, so higher doses are given
  2. BChloramphenicol is converted to vitamin K in neonates
  3. CImmature glucuronidation in the liver lets the drug accumulate
  4. DNewborns produce antibodies against the drug

3Solutions

1.Mental health nursing

Answer: C · Illness anxiety disorder

Why this is the answer

In illness anxiety disorder, the person is preoccupied with having or getting a serious illness, with no or only mild symptoms. In somatic symptom disorder, the distressing physical symptoms themselves are prominent. ICD-11 calls this condition hypochondriasis.

Answer

C · Illness anxiety disorder
2.Mental health nursing

Answer: A · Assess the patient, including his vital signs and level of sedation

Why this is the answer

After a medicine error, the first step is to assess and monitor the patient for any effects. The nurse then informs the prescriber and the nurse in charge, follows instructions, documents and reports the incident.

Answer

A · Assess the patient, including his vital signs and level of sedation
3.Clinical psychology

Answer: B · Overgeneralisation

Why this is the answer

Overgeneralisation draws a sweeping conclusion from a single event. Beck's cognitive therapy teaches clients to notice and test such distortions.

Answer

B · Overgeneralisation
4.Clinical psychology

Answer: B · Relapse and readmission rates

Why this is the answer

Family interventions that teach communication and problem solving and reduce criticism lower relapse and readmission, usually alongside medication.

Answer

B · Relapse and readmission rates
5.Pharmacology

Answer: C · Deep intramuscular only

Why this is the answer

Benzathine penicillin is a depot suspension given deep IM. Accidental intravenous injection can cause cardiorespiratory arrest and death.

Answer

C · Deep intramuscular only
6.Pharmacology

Answer: C · Immature glucuronidation in the liver lets the drug accumulate

Why this is the answer

Neonates have low glucuronyl transferase activity, so chloramphenicol is not conjugated and builds up. High levels cause circulatory collapse with grey skin. It shows how organ immaturity changes pharmacokinetics.

Answer

C · Immature glucuronidation in the liver lets the drug accumulate

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