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
Which postpartum presentation is a psychiatric emergency?
- ATearfulness and mood swings on the third day after birth
- BTiredness and worry about feeding the baby in the first week
- CConfusion, hallucinations and rapidly changing mood a few days after birth
- DFeeling tearful at times but enjoying the baby and sleeping well when she can
2.Mental health nursingHard
A patient with an anxiety disorder speaks so quickly about her worries that the nurse cannot follow. Which response is most helpful?
- A"Let's slow down and talk about one thing at a time. What worries you most right now?"
- B"There's really nothing to worry about, so just try to relax."
- C"You're talking too fast, so we'll have to stop for today."
- D"Let me tell you what I think your problem is, and then we can talk."
3.Clinical psychologyMedium
In suicide risk assessment, which factor is one of the strongest predictors of a future suicide attempt?
- AA previous suicide attempt
- BTalking openly to a therapist
- CBeing a university student
- DHaving a large circle of friends
4.Clinical psychologyHard
Comorbidity means that:
- AA symptom is shared by everyone in a group
- BA disorder is caused by a physical illness that occurs at the same time
- CA disorder runs in families
- DA person meets criteria for two or more disorders at the same time
5.PharmacologyMedium
A prescriber gives a verbal medication order in an emergency. What should the nurse do?
- AGive the drug without recording the order
- BRemember it and write it in the chart at the end of the shift
- CWrite it down and read it back to the prescriber to confirm
- DAsk another nurse to remember the order
6.PharmacologyHard
A patient taking dabigatran has a life-threatening bleed. Which specific reversal agent is used?
- AIdarucizumab
- BProtamine sulfate
- CVitamin K
- DAndexanet alfa
3Solutions
1.Mental health nursing
Answer: C · Confusion, hallucinations and rapidly changing mood a few days after birth
Why this is the answer
Postpartum psychosis usually begins within days to weeks of birth and can include confusion, delusions and hallucinations. It carries risks to mother and baby and needs immediate assessment, often in hospital.
C · Confusion, hallucinations and rapidly changing mood a few days after birth
2.Mental health nursing
Answer: A · "Let's slow down and talk about one thing at a time. What worries you most right now?"
Why this is the answer
Focusing directs the conversation to one main concern, which reduces overwhelm and makes the problem easier to work on. A calm, slow pace from the nurse also helps lower anxiety.
A · "Let's slow down and talk about one thing at a time. What worries you most right now?"
3.Clinical psychology
Answer: A · A previous suicide attempt
Why this is the answer
A history of suicide attempts is among the strongest risk factors. Asking directly about suicidal thoughts does not increase risk and is part of good assessment.
A · A previous suicide attempt
4.Clinical psychology
Answer: D · A person meets criteria for two or more disorders at the same time
Why this is the answer
Comorbidity is the co-occurrence of disorders in the same person, which complicates diagnosis and treatment and raises questions about categorical classification.
D · A person meets criteria for two or more disorders at the same time
5.Pharmacology
Answer: C · Write it down and read it back to the prescriber to confirm
Why this is the answer
Reading back the drug, dose, route and frequency confirms the order and catches errors. Verbal orders are documented immediately and signed by the prescriber according to policy.
C · Write it down and read it back to the prescriber to confirm
6.Pharmacology
Answer: A · Idarucizumab
Why this is the answer
Idarucizumab is an antibody fragment that binds dabigatran. Andexanet alfa reverses factor Xa inhibitors, protamine reverses heparin, and vitamin K reverses warfarin.