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 physical finding is common in bulimia nervosa?

  1. AVery low body weight with lanugo hair
  2. BRaised blood pressure, a fast pulse and a high temperature
  3. CSwelling of the salivary glands at the angle of the jaw
  4. DA high serum potassium level
2.Mental health nursingHard

A child has been admitted several times with unexplained fevers that only happen when her mother is present. Staff see the mother tampering with the child's IV line. What is the priority action?

  1. ADiscuss the matter with the mother alone and ask her to stop
  2. BDischarge the child home with the mother as soon as possible
  3. CDocument the event carefully in the notes and wait to see whether it happens again before telling anyone else
  4. DEnsure the child's safety and follow child protection procedures
3.Clinical psychologyMedium

Selective serotonin reuptake inhibitors (SSRIs) increase serotonin in the synapse by:

  1. ADestroying serotonin receptors
  2. BBlocking dopamine release
  3. CBlocking the reuptake of serotonin into the presynaptic neuron
  4. DSpeeding up the breakdown of serotonin by monoamine oxidase enzymes
4.Clinical psychologyHard

An older patient becomes confused over two days after starting a new medication, with attention that varies through the day. Her daughter says her memory was normal last week. What is the most appropriate interpretation?

  1. ADelirium, which needs a search for a physical or drug cause
  2. BLate-onset schizophrenia
  3. CNormal ageing
  4. DEarly Alzheimer's disease, which needs a referral to a memory clinic
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. CDry mouth, faster heart rate and dilated pupils
  4. DBronchial secretions, wheeze and tearing of the eyes
6.PharmacologyHard

A patient on lisinopril for hypertension starts taking ibuprofen every day for knee pain. What is the main concern?

  1. AWeaker blood pressure control, kidney injury and high potassium
  2. BFaster liver metabolism of lisinopril, so it stops working
  3. CA large fall in blood pressure, with fainting and falls on standing up
  4. DA higher risk of a dry cough than with lisinopril alone

3Solutions

1.Mental health nursing

Answer: C · Swelling of the salivary glands at the angle of the jaw

Why this is the answer

Repeated vomiting can enlarge the parotid glands and erode tooth enamel. Patients with bulimia often have a normal weight, and purging tends to lower potassium.

Answer

C · Swelling of the salivary glands at the angle of the jaw
2.Mental health nursing

Answer: D · Ensure the child's safety and follow child protection procedures

Why this is the answer

This suggests factitious disorder imposed on another, which is a form of child abuse. The nurse protects the child and reports through safeguarding procedures. Confronting the parent alone can increase the risk to the child.

Answer

D · Ensure the child's safety and follow child protection procedures
3.Clinical psychology

Answer: C · Blocking the reuptake of serotonin into the presynaptic neuron

Why this is the answer

SSRIs block the serotonin transporter, so serotonin stays longer in the synaptic cleft. Clinical effects usually take several weeks.

Answer

C · Blocking the reuptake of serotonin into the presynaptic neuron
4.Clinical psychology

Answer: A · Delirium, which needs a search for a physical or drug cause

Why this is the answer

Acute onset with fluctuating attention suggests delirium, a medical emergency with causes such as drugs, infection or dehydration. Dementia develops gradually over months to years.

Answer

A · Delirium, which needs a search for a physical or drug cause
5.Pharmacology

Answer: C · 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

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

Answer: A · Weaker blood pressure control, kidney injury and high potassium

Why this is the answer

NSAIDs block prostaglandins that dilate the afferent arteriole and promote sodium loss. With an ACE inhibitor this can reduce blood pressure control and cause kidney injury and hyperkalaemia, especially if a diuretic is also used.

Answer

A · Weaker blood pressure control, kidney injury and high potassium

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