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 physical finding is common in bulimia nervosa?

  1. AA high serum potassium level
  2. BSwelling of the salivary glands at the angle of the jaw
  3. CVery low body weight with lanugo hair
  4. DRaised blood pressure, a fast pulse and a high temperature
2.Mental health nursingHard

An 80-year-old surgical patient becomes confused overnight, with fluctuating attention and pulling at his IV line. He was well oriented on admission. What is the most appropriate interpretation?

  1. ANormal ageing that needs no action
  2. BRapid progression of dementia that cannot be treated, so no further tests are needed
  3. CBad behaviour that needs restraint immediately
  4. DProbable delirium: look for an underlying physical cause and inform the team
3.Clinical psychologyMedium

A person avoids buses, shops, open car parks and queues because escape might be difficult if they panic. Which diagnosis fits best?

  1. AAgoraphobia
  2. BClaustrophobia as a specific phobia
  3. CGeneralised anxiety disorder
  4. DSocial anxiety disorder
4.Clinical psychologyHard

A therapist says: "Rather than fighting the thought 'I'm a failure', notice it as just a thought, and act on what matters to you." Which therapy does this best represent?

  1. AClassical psychoanalysis
  2. BSystematic desensitisation
  3. CAcceptance and commitment therapy (ACT)
  4. DRational emotive behaviour therapy
5.PharmacologyMedium

A patient with insulin-treated diabetes is found unconscious with very low blood glucose. There is no IV access. Which drug can a trained helper give?

  1. AIntramuscular adrenaline
  2. BGlucagon by injection or nasal spray
  3. CRapid-acting insulin under the skin
  4. DOral glucose gel poured into the mouth
6.PharmacologyHard

A patient who used cocaine has chest pain, agitation, a high temperature, sweating, tachycardia and dilated pupils. Which drug class is commonly first-line for the agitation and sympathetic overactivity?

  1. AOpioid antagonists
  2. BAntihistamines
  3. CBenzodiazepines
  4. DAnticholinergic drugs

3Solutions

1.Mental health nursing

Answer: B · Swelling of the salivary glands at the angle of the jaw

Why this is the answer

Repeated vomiting can enlarge the parotid glands and erode tooth enamel. Patients with bulimia often have a normal weight, and purging tends to lower potassium.

Answer

B · Swelling of the salivary glands at the angle of the jaw
2.Mental health nursing

Answer: D · Probable delirium: look for an underlying physical cause and inform the team

Why this is the answer

Acute, fluctuating confusion suggests delirium, often caused by infection, pain, drugs, dehydration, urinary retention or hypoxia. It is a medical emergency; the cause is treated and the patient is kept safe with non-drug measures first.

Answer

D · Probable delirium: look for an underlying physical cause and inform the team
3.Clinical psychology

Answer: A · Agoraphobia

Why this is the answer

Agoraphobia involves fear of at least two situations (public transport, open spaces, enclosed spaces, crowds or queues, being outside alone) because escape or help might be unavailable.

Answer

A · Agoraphobia
4.Clinical psychology

Answer: C · Acceptance and commitment therapy (ACT)

Why this is the answer

ACT (Hayes) uses acceptance, cognitive defusion and values-based action. Unlike traditional cognitive therapy, it does not try to dispute the content of thoughts.

Answer

C · Acceptance and commitment therapy (ACT)
5.Pharmacology

Answer: B · Glucagon by injection or nasal spray

Why this is the answer

Glucagon breaks down liver glycogen and raises blood glucose. Nothing is given by mouth to an unconscious patient because of the risk of choking and aspiration.

Answer

B · Glucagon by injection or nasal spray
6.Pharmacology

Answer: C · Benzodiazepines

Why this is the answer

Cocaine causes a sympathomimetic toxidrome. Benzodiazepines reduce agitation, tachycardia, hypertension and hyperthermia, while cooling and cardiac monitoring are also given.

Answer

C · Benzodiazepines

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