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 young person who took LSD at a festival is frightened by what he is seeing. What is the most helpful nursing approach?

  1. AShine a bright light in his eyes every few minutes to check his pupils and keep him alert until it wears off
  2. BLeave him alone in a dark room so that he can sleep it off
  3. CStay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass
  4. DArgue with him that what he sees is not real until he accepts it
2.Mental health nursingHard

A patient who is stable on lithium tells the nurse she has started taking ibuprofen every day for back pain. What should the nurse do?

  1. AAdvise her to double her lithium dose
  2. BTell her it is fine, because ibuprofen is sold without a prescription and is safe
  3. CTell her to also take a diuretic for the swelling
  4. DInform the prescriber, because ibuprofen can raise lithium to toxic levels
3.Clinical psychologyMedium

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

  1. AMind reading
  2. BOvergeneralisation
  3. CPersonalisation
  4. DEmotional reasoning
4.Clinical psychologyHard

An interview that follows a fixed set of questions in a fixed order to reach a diagnosis is called:

  1. AA free association session
  2. BA projective test
  3. CAn unstructured interview
  4. DA structured clinical interview
5.PharmacologyMedium

Which group of effects would the nurse expect after a dose of an anticholinergic drug such as atropine?

  1. ADiarrhoea, frequent urination and sweating
  2. BHeavy salivation, slow heart rate and small pupils
  3. CBronchial secretions, wheeze and tearing of the eyes
  4. DDry mouth, faster heart rate and dilated pupils
6.PharmacologyHard

A patient on digoxin is started on amiodarone. What change should the nurse expect?

  1. ADigoxin levels rise, so the digoxin dose is often reduced
  2. BNo interaction is expected
  3. CAmiodarone levels fall to zero
  4. DDigoxin levels fall sharply, so the digoxin dose is doubled

3Solutions

1.Mental health nursing

Answer: C · Stay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass

Why this is the answer

For a frightening hallucinogen experience, a calm setting, a supportive person and simple reassurance usually help. The nurse also monitors vital signs and watches for injury or other substances.

Answer

C · Stay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass
2.Mental health nursing

Answer: D · Inform the prescriber, because ibuprofen can raise lithium to toxic levels

Why this is the answer

NSAIDs reduce lithium excretion, so levels can rise into the toxic range. The prescriber should review the pain treatment and lithium monitoring.

Answer

D · Inform the prescriber, because ibuprofen can raise lithium to toxic levels
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: D · A structured clinical interview

Why this is the answer

Structured interviews such as the SCID ask standard questions tied to diagnostic criteria, increasing reliability compared with unstructured interviews.

Answer

D · A structured clinical interview
5.Pharmacology

Answer: D · Dry mouth, faster heart rate and dilated pupils

Why this is the answer

Anticholinergic drugs block muscarinic receptors, so parasympathetic effects are reduced. This gives dry mouth, tachycardia, dilated pupils, constipation and urinary retention.

Answer

D · Dry mouth, faster heart rate and dilated pupils
6.Pharmacology

Answer: A · Digoxin levels rise, so the digoxin dose is often reduced

Why this is the answer

Amiodarone inhibits P-glycoprotein and reduces digoxin clearance, so digoxin levels rise. The digoxin dose is often reduced, and the patient is monitored for bradycardia and toxicity; amiodarone also raises warfarin levels.

Answer

A · Digoxin levels rise, so the digoxin dose is often reduced

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