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

In families of people with schizophrenia, which pattern of "high expressed emotion" is linked to a higher rate of relapse?

  1. AFrequent criticism, hostility and emotional over-involvement
  2. BEncouraging the patient to take part in activities
  3. CRegular contact with the care team and other families
  4. DCalm, supportive and warm communication
2.Mental health nursingHard

A patient has had delusions and hallucinations for a year. For most of this time he has also had episodes of major depression, but for at least two weeks at a time his psychotic symptoms continued without any mood symptoms. Which diagnosis best fits this pattern?

  1. ADelusional disorder
  2. BBrief psychotic disorder
  3. CSchizoaffective disorder
  4. DMajor depression with psychotic features
3.Clinical psychologyMedium

The therapeutic alliance refers to:

  1. AA legal contract between a clinic and an insurer
  2. BThe collaborative bond and agreement on goals and tasks between therapist and client
  3. CThe client's diagnosis, as agreed independently by two psychiatrists at the initial assessment
  4. DA group of therapists who share referrals
4.Clinical psychologyHard

A therapist asks a client to rate the evidence for and against the thought "I always fail". Which technique is this?

  1. ASystematic desensitisation
  2. BToken economy
  3. CFree association
  4. DCognitive restructuring
5.PharmacologyMedium

How does sucralfate help a peptic ulcer heal?

  1. AIt blocks histamine H2 receptors in the stomach
  2. BIt neutralises acid by releasing bicarbonate
  3. CIt kills Helicobacter pylori directly
  4. DIt forms a protective coating over the ulcer base
6.PharmacologyHard

Probenecid has been used to raise plasma penicillin levels. How does it do this?

  1. AIt inhibits the liver metabolism of penicillin
  2. BIt displaces penicillin from plasma proteins
  3. CIt blocks the tubular secretion of penicillin in the kidney
  4. DIt increases the absorption of penicillin from the small intestine

3Solutions

1.Mental health nursing

Answer: A · Frequent criticism, hostility and emotional over-involvement

Why this is the answer

High expressed emotion, including criticism, hostility and over-involvement, is associated with relapse. Family psychoeducation and support can reduce it.

Answer

A · Frequent criticism, hostility and emotional over-involvement
2.Mental health nursing

Answer: C · Schizoaffective disorder

Why this is the answer

In schizoaffective disorder, a major mood episode occurs alongside schizophrenia symptoms, mood episodes are present for most of the illness, and psychotic symptoms are also present for at least 2 weeks without a mood episode. In psychotic depression, the psychosis occurs only during the mood episode.

Answer

C · Schizoaffective disorder
3.Clinical psychology

Answer: B · The collaborative bond and agreement on goals and tasks between therapist and client

Why this is the answer

The therapeutic alliance consistently predicts therapy outcome across different approaches, which supports the importance of common factors in psychotherapy.

Answer

B · The collaborative bond and agreement on goals and tasks between therapist and client
4.Clinical psychology

Answer: D · Cognitive restructuring

Why this is the answer

Cognitive restructuring identifies automatic thoughts, examines evidence and replaces distortions such as overgeneralisation with balanced thoughts.

Answer

D · Cognitive restructuring
5.Pharmacology

Answer: D · It forms a protective coating over the ulcer base

Why this is the answer

Sucralfate forms a gel-like barrier that sticks to the ulcer and protects it from acid and pepsin. It is taken on an empty stomach and can reduce the absorption of other drugs taken at the same time.

Answer

D · It forms a protective coating over the ulcer base
6.Pharmacology

Answer: C · It blocks the tubular secretion of penicillin in the kidney

Why this is the answer

Penicillins are excreted largely by organic anion transporters in the proximal tubule. Probenecid competes for these transporters, so penicillin is excreted more slowly and its level stays higher.

Answer

C · It blocks the tubular secretion of penicillin in the kidney

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