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

Which serum lithium range is commonly quoted as the maintenance therapeutic range?

  1. AAbout 3.5 to 5.0 mmol/L
  2. BAbout 0.6 to 1.2 mmol/L (target ranges vary between guidelines)
  3. CAbout 0.01 to 0.05 mmol/L
  4. DAbout 2.0 to 3.0 mmol/L (higher levels are needed for acute mania)
2.Mental health nursingHard

A man whose wife died a month ago is rude and angry with the nurses about small things. What is the best understanding of his behaviour?

  1. AHe has antisocial personality disorder that was not noticed before
  2. BHis anger may be part of grief, displaced onto staff, so she should not take it personally
  3. CHe does not care about his wife's death and is using it as an excuse to be rude
  4. DHe should be told that his behaviour is unacceptable and that visits will be stopped
3.Clinical psychologyMedium

Rosenhan's study "On being sane in insane places" raised concerns about:

  1. AThe ethics of animal research
  2. BThe validity of psychiatric diagnosis
  3. CThe effectiveness of CBT
  4. DThe safety of antidepressants
4.Clinical psychologyHard

A man who hears the word "thud" is admitted to hospital, then behaves normally. Staff record his note-taking as "engages in writing behaviour". In Rosenhan's study, what does this illustrate?

  1. APseudopatients developed real symptoms in hospital
  2. BStaff deliberately falsified records
  3. COnce a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
  4. DNote-taking is a recognised symptom of schizophrenia, so the staff were right to record it as such
5.PharmacologyMedium

Which factor increases the risk of lithium toxicity?

  1. AA high-salt diet
  2. BTaking the dose with food
  3. CDrinking extra water
  4. DDehydration
6.PharmacologyHard

What is the main mechanism of action of proton pump inhibitors such as omeprazole?

  1. ANeutralising acid in the stomach
  2. BCompetitive blocking of histamine H2 receptors on parietal cells
  3. CCoating the ulcer to protect it
  4. DIrreversible inhibition of the H⁺/K⁺-ATPase in parietal cells

3Solutions

1.Mental health nursing

Answer: B · About 0.6 to 1.2 mmol/L (target ranges vary between guidelines)

Why this is the answer

Many textbooks quote 0.6–1.2 mmol/L (mEq/L) for maintenance, and some guidelines recommend lower targets such as 0.6–0.8. Levels above about 1.5 are associated with toxicity. Follow the local laboratory and prescriber.

Answer

B · About 0.6 to 1.2 mmol/L (target ranges vary between guidelines)
2.Mental health nursing

Answer: B · His anger may be part of grief, displaced onto staff, so she should not take it personally

Why this is the answer

Anger is a common part of grief and may be directed at staff who are safer targets. The nurse responds calmly, sets limits if needed and invites him to talk about his loss.

Answer

B · His anger may be part of grief, displaced onto staff, so she should not take it personally
3.Clinical psychology

Answer: B · The validity of psychiatric diagnosis

Why this is the answer

Pseudopatients who reported hearing a single word were admitted and kept for weeks, suggesting diagnosis was influenced by context. The study's methods have been questioned since.

Answer

B · The validity of psychiatric diagnosis
4.Clinical psychology

Answer: C · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder

Why this is the answer

Rosenhan argued that the label "schizophrenic" made staff see ordinary behaviour as pathological. Critics such as Spitzer argued the study did not prove diagnosis was invalid.

Answer

C · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
5.Pharmacology

Answer: D · Dehydration

Why this is the answer

When the body is short of water or sodium, the kidney reabsorbs more lithium, so its level rises. Thiazides, ACE inhibitors and NSAIDs can have the same effect.

Answer

D · Dehydration
6.Pharmacology

Answer: D · Irreversible inhibition of the H⁺/K⁺-ATPase in parietal cells

Why this is the answer

PPIs irreversibly block the proton pump, the last step of acid secretion. H2 blockers (such as famotidine) act earlier and are less powerful; antacids only neutralise.

Answer

D · Irreversible inhibition of the H⁺/K⁺-ATPase in parietal cells

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