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

An agitated patient has not responded to verbal de-escalation. A PRN medicine is prescribed. What is the most appropriate step?

  1. APlace him in seclusion and then decide about medicine later
  2. BOffer the oral medicine first, before considering an injection
  3. CGive an intramuscular injection at once without offering any choice
  4. DHide the medicine in his drink without telling him
2.Mental health nursingHard

During a session, a patient asks the nurse, "Are you married? Do you have children?" Which response is most appropriate?

  1. AEnd the session because personal questions are not allowed
  2. BAnswer briefly or decline politely, then return the focus to the patient
  3. CIgnore the question completely and stay silent until the patient changes the subject
  4. DShare details about the nurse's family to build a friendship
3.Clinical psychologyMedium

Which treatment is recommended as first-line for chronic insomnia in adults?

  1. ALong-term daily benzodiazepines or other hypnotic drugs
  2. BCognitive behavioural therapy for insomnia (CBT-I)
  3. CPsychoanalysis
  4. DElectroconvulsive therapy
4.Clinical psychologyHard

A 22-year-old has had hallucinations and delusions for two months, after which they fully resolve. No mood episode occurred. Which diagnosis fits best?

  1. ABrief psychotic disorder
  2. BSchizophrenia
  3. CSchizoaffective disorder
  4. DSchizophreniform disorder
5.PharmacologyMedium

Why is testing for HLA-B*15:02 recommended before carbamazepine in people of some Asian ancestries?

  1. AThis gene variant makes carbamazepine ineffective
  2. BIt greatly raises the risk of Stevens–Johnson syndrome
  3. CThis gene variant causes carbamazepine to raise blood glucose
  4. DThis gene variant speeds up the kidney excretion of carbamazepine
6.PharmacologyHard

A patient's record shows anaphylaxis to penicillin. Amoxicillin has been prescribed. What should the nurse do?

  1. AWithhold it and contact the prescriber, as amoxicillin is a penicillin
  2. BGive the amoxicillin with an antihistamine to prevent a reaction
  3. CGive the amoxicillin, as it belongs to a different antibiotic group
  4. DGive half the dose and observe for a reaction

3Solutions

1.Mental health nursing

Answer: B · Offer the oral medicine first, before considering an injection

Why this is the answer

Offering oral medication respects choice and is less restrictive than an injection. Covert administration is only lawful in specific, documented circumstances, not as a routine approach.

Answer

B · Offer the oral medicine first, before considering an injection
2.Mental health nursing

Answer: B · Answer briefly or decline politely, then return the focus to the patient

Why this is the answer

Patients often ask personal questions out of curiosity or to make the relationship more equal. A brief answer or a polite refusal, followed by redirecting to the patient's concerns, maintains boundaries without rejecting the patient.

Answer

B · Answer briefly or decline politely, then return the focus to the patient
3.Clinical psychology

Answer: B · Cognitive behavioural therapy for insomnia (CBT-I)

Why this is the answer

CBT-I combines sleep restriction, stimulus control, sleep hygiene and cognitive techniques. It has lasting effects and is recommended before hypnotic drugs.

Answer

B · Cognitive behavioural therapy for insomnia (CBT-I)
4.Clinical psychology

Answer: D · Schizophreniform disorder

Why this is the answer

Schizophreniform disorder has the symptoms of schizophrenia but lasts between one and six months. Duration is the main feature separating it from brief psychotic disorder and schizophrenia.

Answer

D · Schizophreniform disorder
5.Pharmacology

Answer: B · It greatly raises the risk of Stevens–Johnson syndrome

Why this is the answer

The HLA-B*15:02 allele, common in parts of South-East Asia, is strongly linked to carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis. Carriers are given a different drug.

Answer

B · It greatly raises the risk of Stevens–Johnson syndrome
6.Pharmacology

Answer: A · Withhold it and contact the prescriber, as amoxicillin is a penicillin

Why this is the answer

Amoxicillin is a penicillin, so it must not be given to someone with penicillin anaphylaxis. The nurse holds the dose, informs the prescriber and makes sure the allergy is clearly recorded.

Answer

A · Withhold it and contact the prescriber, as amoxicillin is a penicillin

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