1Formulas and methods
Mental health nursing
Method
- Decide whether there is an immediate risk: suicide, violence, a drug emergency or a physical illness.
- Act on safety first: observe, remove means, de-escalate, stop a harmful drug, get help.
- Choose the therapeutic response: acknowledge feelings, present reality, avoid false reassurance and “why” questions.
- Respect rights: the least restrictive option, consent and confidentiality with its limits.
2Practice problems
1.Mental health nursingMedium
A patient with PTSD begins to dissociate during a conversation. Which grounding technique can the nurse use?
- ALeave her alone until the episode has passed on its own
- BAsk her to describe the traumatic event in as much detail as she can
- CAsk her to close her eyes and think back to the worst moment of the trauma
- DAsk her to name things she can see, hear and touch in the room right now
2.Mental health nursingHard
A woman arrives in the emergency department after a sexual assault and has a cut on her head that is bleeding. What is the priority?
- AAssess and treat her physical injuries, then offer forensic examination with her consent
- BCall the police and wait until they arrive before doing anything else, so that no evidence is lost by mistake
- CCollect forensic evidence before treating any injuries
- DAsk her for a detailed account of the assault before any care
3.Clinical psychologyMedium
Which personality disorder is marked by instability in relationships, self-image and emotions, together with marked impulsivity?
- ASchizoid personality disorder
- BBorderline personality disorder
- CAvoidant personality disorder
- DNarcissistic personality disorder
4.Clinical psychologyHard
Why is the medical model of mental illness criticised by proponents of the psychological approaches?
- AIt may overlook psychological and social causes and reduce people's sense of agency
- BIt denies that the brain and biological factors have any role in behaviour or emotion
- CIt rejects the use of medication entirely
- DIt is based only on dream analysis
5.PharmacologyMedium
A woman taking tamoxifen should report which symptom promptly?
- AUnusual vaginal bleeding or a painful swollen leg
- BMild hot flushes, especially at night, in the first months
- CSlightly dry skin
- DMild tiredness in the afternoon
6.PharmacologyHard
Why can beta blockers mask the warning signs of hypoglycaemia in people with diabetes?
- AThey block insulin release completely
- BThey blunt adrenergic symptoms such as tremor and palpitations
- CThey cause hyperthermia that hides sweating
- DThey raise blood glucose so that hypoglycaemia cannot occur at all
3Solutions
1.Mental health nursing
Answer: D · Ask her to name things she can see, hear and touch in the room right now
Why this is the answer
Grounding techniques use the senses to bring the person back to the here and now. Asking for details of the trauma during dissociation can deepen distress.
D · Ask her to name things she can see, hear and touch in the room right now
2.Mental health nursing
Answer: A · Assess and treat her physical injuries, then offer forensic examination with her consent
Why this is the answer
Medical care for injuries comes first. Forensic examination is offered, explained and carried out only with consent, and the nurse supports the survivor's control over each step.
A · Assess and treat her physical injuries, then offer forensic examination with her consent
3.Clinical psychology
Answer: B · Borderline personality disorder
Why this is the answer
Borderline personality disorder involves unstable relationships and identity, affective instability, fear of abandonment, impulsivity and recurrent self-harm. DBT is a well-supported treatment.
B · Borderline personality disorder
4.Clinical psychology
Answer: A · It may overlook psychological and social causes and reduce people's sense of agency
Why this is the answer
The medical model treats disorders as illnesses with biological causes, which reduces blame but can neglect life events, meaning and context, and may encourage passive reliance on drugs.
A · It may overlook psychological and social causes and reduce people's sense of agency
5.Pharmacology
Answer: A · Unusual vaginal bleeding or a painful swollen leg
Why this is the answer
Tamoxifen has oestrogen-like effects on the uterus and clotting, increasing the risk of endometrial cancer and venous thromboembolism. Hot flushes are common and expected.
A · Unusual vaginal bleeding or a painful swollen leg
6.Pharmacology
Answer: B · They blunt adrenergic symptoms such as tremor and palpitations
Why this is the answer
Tremor, palpitations and anxiety in hypoglycaemia are adrenaline-driven; beta blockade dampens them, so patients may notice low glucose later. Sweating is cholinergic and often persists.
B · They blunt adrenergic symptoms such as tremor and palpitations