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 depression and measuring its severity
  3. CScreening for alcohol problems
  4. DAssessing the severity of alcohol withdrawal
2.Mental health nursingHard

An 81-year-old woman's memory has slowly worsened over 2 years. She repeats questions and gets lost in familiar places, but she is alert and her attention is normal. Which condition is most likely?

  1. AA neurocognitive disorder such as Alzheimer's disease
  2. BDelirium
  3. CNormal ageing with mild forgetfulness
  4. DBrief psychotic disorder in later life
3.Clinical psychologyMedium

In Beck's cognitive model of depression, the "cognitive triad" consists of negative views about:

  1. AOneself, the world and the future
  2. BParents, friends and teachers
  3. CBody, mind and spirit
  4. DOne's past, present and future only
4.Clinical psychologyHard

The "Dodo bird verdict" in psychotherapy research refers to the finding that:

  1. AUntreated clients on waiting lists improve faster than treated clients
  2. BDifferent bona fide therapies often produce broadly similar outcomes
  3. COnly psychoanalysis is effective for depression
  4. DMedication always outperforms psychotherapy
5.PharmacologyMedium

Which patient should usually not receive a live vaccine?

  1. AA healthy 1-year-old child
  2. BA healthy adult nurse who works on a children's ward
  3. CA patient with mild seasonal allergies
  4. DA patient receiving chemotherapy for leukaemia
6.PharmacologyHard

A patient who used heroin a few hours ago is given a first dose of buprenorphine and quickly develops severe withdrawal. Why?

  1. ABuprenorphine is a high-affinity partial agonist that displaces heroin
  2. BBuprenorphine causes an allergic reaction in heroin users
  3. CBuprenorphine has no effect at opioid receptors
  4. DBuprenorphine is a pure antagonist like naloxone with no agonist effect

3Solutions

1.Mental health nursing

Answer: B · 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

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

Answer: A · A neurocognitive disorder such as Alzheimer's disease

Why this is the answer

Gradual, progressive memory loss with impaired daily functioning and normal alertness suggests dementia, most commonly Alzheimer's disease. Delirium is acute and fluctuating with impaired attention.

Answer

A · A neurocognitive disorder such as Alzheimer's disease
3.Clinical psychology

Answer: A · Oneself, the world and the future

Why this is the answer

Beck proposed that depressed people hold negative views of the self, the world (or experiences) and the future, maintained by cognitive distortions.

Answer

A · Oneself, the world and the future
4.Clinical psychology

Answer: B · Different bona fide therapies often produce broadly similar outcomes

Why this is the answer

Meta-analyses often find small differences between established therapies, which has been taken to support common factors such as the alliance. Some disorders, such as OCD and phobias, show clear advantages for specific treatments like exposure.

Answer

B · Different bona fide therapies often produce broadly similar outcomes
5.Pharmacology

Answer: D · A patient receiving chemotherapy for leukaemia

Why this is the answer

Live attenuated vaccines can cause serious infection in immunosuppressed people and are generally avoided in pregnancy. Inactivated vaccines are safe but may give a weaker response.

Answer

D · A patient receiving chemotherapy for leukaemia
6.Pharmacology

Answer: A · Buprenorphine is a high-affinity partial agonist that displaces heroin

Why this is the answer

Buprenorphine binds mu receptors more strongly than heroin but activates them less, so it can precipitate withdrawal. Induction is started when the patient already has mild to moderate withdrawal signs.

Answer

A · Buprenorphine is a high-affinity partial agonist that displaces heroin

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