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

Which effects of methadone should the nurse monitor for?

  1. AAgranulocytosis and a sore throat
  2. BRespiratory depression, sedation and a prolonged QT interval
  3. CHair loss, weight loss and a painful red rash on the face
  4. DHypertensive crisis after eating aged cheese
2.Mental health nursingHard

A 30-year-old who used cocaine an hour ago has crushing chest pain and sweating. What is the priority?

  1. ALet him rest, because the pain will pass when the drug wears off
  2. BReassure him that young people do not have heart problems
  3. CTreat it as a possible heart attack, with an urgent ECG and medical review
  4. DGive him a benzodiazepine for the anxiety and send him home to rest once he feels calmer
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. CElectroconvulsive therapy
  4. DPsychoanalysis
4.Clinical psychologyHard

A soldier develops PTSD while most comrades exposed to the same battle do not. Which model best explains this difference?

  1. AThe token economy model
  2. BThe diathesis–stress model
  3. CThe statistical infrequency model
  4. DThe medical model of infection
5.PharmacologyMedium

While giving medicines, a patient says, "That pill looks different from the one I usually take." What should the nurse do?

  1. AStop and recheck the order and the medicine before giving it
  2. BReassure the patient and give the pill anyway
  3. CExplain that only the staff decide which medicines are given
  4. DGive the pill and check the chart afterwards
6.PharmacologyHard

Why are antipsychotics used with great caution in older people with dementia?

  1. AThey always cure the dementia and stop all behaviour problems
  2. BThey cause severe hypoglycaemia in older people
  3. CThey are linked to a higher risk of stroke and death
  4. DThey are not absorbed in people over 65

3Solutions

1.Mental health nursing

Answer: B · Respiratory depression, sedation and a prolonged QT interval

Why this is the answer

Methadone can cause respiratory depression, especially when starting or with other sedatives, and it can prolong the QT interval. It has a long half-life, so toxicity can build up over several days.

Answer

B · Respiratory depression, sedation and a prolonged QT interval
2.Mental health nursing

Answer: C · Treat it as a possible heart attack, with an urgent ECG and medical review

Why this is the answer

Cocaine can cause coronary vasospasm, myocardial infarction and arrhythmias, even in young people without heart disease. Chest pain after cocaine use needs urgent cardiac assessment.

Answer

C · Treat it as a possible heart attack, with an urgent ECG and medical review
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: B · The diathesis–stress model

Why this is the answer

The diathesis–stress model holds that a stressor causes disorder mainly in people with pre-existing vulnerabilities, such as genetic risk, prior trauma or poor social support.

Answer

B · The diathesis–stress model
5.Pharmacology

Answer: A · Stop and recheck the order and the medicine before giving it

Why this is the answer

A patient's concern can reveal a wrong drug or wrong patient error. The nurse rechecks the order and product, and may call the pharmacy; a different brand or strength may explain the change.

Answer

A · Stop and recheck the order and the medicine before giving it
6.Pharmacology

Answer: C · They are linked to a higher risk of stroke and death

Why this is the answer

In older people with dementia, antipsychotics increase the risk of stroke and death. Non-drug approaches are tried first, and antipsychotics are used at low doses for short periods if needed.

Answer

C · They are linked to a higher risk of stroke and death

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