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

What is the PHQ-9 used for?

  1. AMonitoring involuntary movements caused by antipsychotics
  2. BScreening for alcohol problems
  3. CAssessing the severity of alcohol withdrawal
  4. DScreening for depression and measuring its severity
2.Mental health nursingHard

During a ward community meeting, several patients complain that the ward is too noisy at night. What reflects a therapeutic milieu?

  1. AAsk the patients to write their complaints down and then do nothing
  2. BTell the patients that the rules cannot be changed
  3. CDiscuss the problem openly and involve patients in finding a solution
  4. DEnd the meeting so the complaint is not discussed further
3.Clinical psychologyMedium

A person has distressing symptoms that started two weeks after a serious car crash and have lasted ten days. Which diagnosis is most appropriate?

  1. APost-traumatic stress disorder
  2. BAdjustment disorder
  3. CAcute stress disorder
  4. DGeneralised anxiety disorder
4.Clinical psychologyHard

Ayllon and Azrin introduced a token economy on a psychiatric ward. What was the main finding and limitation?

  1. AThe method cured schizophrenia within weeks
  2. BPatients' hallucinations disappeared permanently, and the gains lasted after discharge
  3. CTokens had no effect on behaviour
  4. DTarget behaviours increased, but gains often did not generalise outside the ward
5.PharmacologyMedium

A patient with difficulty swallowing is prescribed several tablets. Which one should not be crushed?

  1. AA plain paracetamol tablet
  2. BA plain aspirin dispersible tablet
  3. CA tablet that the pharmacist says may be crushed
  4. DA modified-release (extended-release) tablet
6.PharmacologyHard

Why can beta blockers mask the warning signs of hypoglycaemia in people with diabetes?

  1. AThey raise blood glucose so that hypoglycaemia cannot occur at all
  2. BThey cause hyperthermia that hides sweating
  3. CThey block insulin release completely
  4. DThey blunt adrenergic symptoms such as tremor and palpitations

3Solutions

1.Mental health nursing

Answer: D · Screening for depression and measuring its severity

Why this is the answer

The Patient Health Questionnaire-9 asks how often each of the nine depression symptoms has occurred in the last 2 weeks. Item 9 asks about thoughts of self-harm, which always needs follow-up.

Answer

D · Screening for depression and measuring its severity
2.Mental health nursing

Answer: C · Discuss the problem openly and involve patients in finding a solution

Why this is the answer

In a therapeutic milieu, the ward environment itself is used for treatment. Shared decision-making in community meetings builds responsibility, social skills and trust.

Answer

C · Discuss the problem openly and involve patients in finding a solution
3.Clinical psychology

Answer: C · Acute stress disorder

Why this is the answer

Acute stress disorder covers trauma symptoms lasting from three days to one month after the event. If symptoms persist beyond a month, PTSD may be diagnosed.

Answer

C · Acute stress disorder
4.Clinical psychology

Answer: D · Target behaviours increased, but gains often did not generalise outside the ward

Why this is the answer

Token economies increased self-care and work behaviours in long-stay patients, but changes tended to fade without reinforcement, and the approach raised ethical concerns about control.

Answer

D · Target behaviours increased, but gains often did not generalise outside the ward
5.Pharmacology

Answer: D · A modified-release (extended-release) tablet

Why this is the answer

Crushing modified-release products destroys the release mechanism and can cause toxic peaks. Enteric-coated tablets should also not be crushed; the pharmacist can advise on liquid or other forms.

Answer

D · A modified-release (extended-release) tablet
6.Pharmacology

Answer: D · They blunt adrenergic symptoms such as tremor and palpitations

Why this is the answer

Tremor, palpitations and anxiety in hypoglycaemia are adrenaline-driven; beta blockade dampens them, so patients may notice low glucose later. Sweating is cholinergic and often persists.

Answer

D · They blunt adrenergic symptoms such as tremor and palpitations

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