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 who started lithium 2 weeks ago has a fine tremor of the hands and is passing more urine than usual. Her level is within the therapeutic range. How should the nurse interpret this?

  1. AThese are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
  2. BThese symptoms mean that the lithium is not working, so the dose should be stopped and a new drug chosen
  3. CThese are definite signs of severe lithium toxicity, so emergency dialysis is needed straight away
  4. DThese are signs of an allergic reaction, so she should never take lithium again
2.Mental health nursingHard

A patient with capacity has signed consent for a course of ECT. After two sessions, she says she wants to stop. What is correct?

  1. AHer signed consent becomes binding after the first session, so the agreed course must now be completed
  2. BShe can withdraw her consent at any time, and her decision must be respected and reported to the team
  3. CShe must complete the course once she has signed
  4. DShe can only stop if her family agrees
3.Clinical psychologyMedium

Which feature distinguishes generalised anxiety disorder from panic disorder?

  1. ARepetitive rituals
  2. BSudden attacks of intense fear peaking within minutes
  3. CFear of a single specific object, such as spiders or heights
  4. DPersistent, excessive worry about many everyday matters
4.Clinical psychologyHard

A man says that a famous singer is secretly in love with him and sends him coded messages through her songs. Apart from this, his thinking and behaviour are normal, with no hallucinations. Which diagnosis fits best?

  1. ADelusional disorder, erotomanic type
  2. BSchizophrenia, paranoid type
  3. CBipolar disorder with mania
  4. DNarcissistic personality disorder
5.PharmacologyMedium

Which adverse effect is typical of metoclopramide, especially in young people?

  1. ASevere constipation
  2. BLow blood glucose
  3. CDry cough
  4. DExtrapyramidal movement disorders such as acute dystonia
6.PharmacologyHard

The clearance of a drug falls to half because of kidney failure, while its volume of distribution stays the same. What happens to its half-life?

  1. AIt stays the same
  2. BIt doubles
  3. CIt increases fourfold
  4. DIt halves

3Solutions

1.Mental health nursing

Answer: A · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored

Why this is the answer

Fine tremor, thirst, polyuria and mild nausea are common early effects of lithium. A coarse tremor, vomiting, diarrhoea, confusion or unsteadiness suggest toxicity.

Answer

A · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
2.Mental health nursing

Answer: B · She can withdraw her consent at any time, and her decision must be respected and reported to the team

Why this is the answer

A person with capacity can withdraw consent at any time. The nurse informs the team, who discuss the decision with her. Treatment without consent is only possible under specific legal conditions.

Answer

B · She can withdraw her consent at any time, and her decision must be respected and reported to the team
3.Clinical psychology

Answer: D · Persistent, excessive worry about many everyday matters

Why this is the answer

GAD involves ongoing, hard-to-control worry about various topics for at least six months. Panic disorder involves recurrent unexpected panic attacks.

Answer

D · Persistent, excessive worry about many everyday matters
4.Clinical psychology

Answer: A · Delusional disorder, erotomanic type

Why this is the answer

Delusional disorder involves one or more delusions for at least a month without meeting criteria for schizophrenia, and functioning is not markedly impaired apart from the delusion. Erotomanic delusions concern another person being in love with the patient.

Answer

A · Delusional disorder, erotomanic type
5.Pharmacology

Answer: D · Extrapyramidal movement disorders such as acute dystonia

Why this is the answer

Metoclopramide is a dopamine D2 antagonist. Blocking dopamine in the basal ganglia can cause dystonia and other extrapyramidal effects, more often in young adults.

Answer

D · Extrapyramidal movement disorders such as acute dystonia
6.Pharmacology

Answer: B · It doubles

Why this is the answer

Half-life is proportional to Vd and inversely proportional to clearance. Halving clearance doubles the half-life, so the drug accumulates and takes longer to reach steady state.

Answer

B · It doubles

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