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 patient says, "I feel like I'm dying inside." Which nurse response best uses the technique of exploring?

  1. A"Everyone feels that way sometimes."
  2. B"Let's talk about something more cheerful."
  3. C"You shouldn't say things like that."
  4. D"Tell me more about what that feeling is like for you."
2.Mental health nursingHard

A patient is pacing, has clenched fists and is shouting at staff. What is the most appropriate first approach?

  1. AUse calm verbal de-escalation, keep a safe distance and make sure both of you have an exit
  2. BTurn your back and ignore the behaviour
  3. CRestrain the patient immediately
  4. DStand close to the patient and raise your voice so that you clearly take control of the situation
3.Clinical psychologyMedium

Which criterion of abnormality judges behaviour as abnormal when it is rare in the population?

  1. ADeviation from social norms
  2. BStatistical infrequency
  3. CFailure to function adequately
  4. DDeviation from ideal mental health
4.Clinical psychologyHard

A therapist helps a client with panic disorder deliberately bring on dizziness by spinning in a chair, without using safety behaviours. What is this technique called and why is it used?

  1. AFlooding, so the client forgets their trauma
  2. BAversion therapy, so the client learns to associate panic with physical discomfort
  3. CInteroceptive exposure, so the client learns bodily sensations are not dangerous
  4. DFree association, so unconscious fears come to light
5.PharmacologyMedium

Which adverse effect of doxorubicin requires monitoring of heart function?

  1. ARapid rise in cholesterol
  2. BPericarditis caused by infection
  3. CSevere hypertension during the infusion itself
  4. DCumulative heart muscle damage leading to heart failure
6.PharmacologyHard

A patient has received a sodium nitroprusside infusion for several days. He becomes confused and develops a metabolic acidosis. What should be suspected?

  1. ACyanide toxicity from nitroprusside breakdown
  2. BHypoglycaemia from nitroprusside
  3. CHyperkalaemia from the infusion
  4. DAn allergic reaction to the plastic of the infusion bag

3Solutions

1.Mental health nursing

Answer: D · "Tell me more about what that feeling is like for you."

Why this is the answer

Exploring asks the patient to describe an experience in more detail. Generalising, disapproving and changing the subject block the patient from talking.

Answer

D · "Tell me more about what that feeling is like for you."
2.Mental health nursing

Answer: A · Use calm verbal de-escalation, keep a safe distance and make sure both of you have an exit

Why this is the answer

De-escalation uses a calm voice, simple language, active listening and offering choices, while keeping a safe distance and an exit route. Restraint is a last resort if there is imminent danger.

Answer

A · Use calm verbal de-escalation, keep a safe distance and make sure both of you have an exit
3.Clinical psychology

Answer: B · Statistical infrequency

Why this is the answer

Statistical infrequency defines abnormality as behaviour far from the average. Its weakness is that some rare traits, such as very high IQ, are desirable.

Answer

B · Statistical infrequency
4.Clinical psychology

Answer: C · Interoceptive exposure, so the client learns bodily sensations are not dangerous

Why this is the answer

Interoceptive exposure provokes feared bodily sensations so the client can test catastrophic predictions and habituate. It is a core part of CBT for panic disorder.

Answer

C · Interoceptive exposure, so the client learns bodily sensations are not dangerous
5.Pharmacology

Answer: D · Cumulative heart muscle damage leading to heart failure

Why this is the answer

Anthracyclines such as doxorubicin can damage heart muscle, and the risk increases with cumulative dose. Heart function is assessed before and during treatment; the drug can also turn urine red.

Answer

D · Cumulative heart muscle damage leading to heart failure
6.Pharmacology

Answer: A · Cyanide toxicity from nitroprusside breakdown

Why this is the answer

Nitroprusside releases cyanide, which is normally converted to thiocyanate. With high doses, long infusions or poor organ function, cyanide and thiocyanate can accumulate; the infusion is also protected from light.

Answer

A · Cyanide toxicity from nitroprusside breakdown

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