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

A patient with limited English needs a mental health assessment. Who should interpret?

  1. AA trained professional interpreter
  2. BThe patient's 12-year-old son
  3. CThe nurse, using an online translation app on her phone for the whole assessment
  4. DAnother patient on the ward who speaks the language
2.Mental health nursingHard

A patient with borderline personality disorder and frequent self-harm says, "I'm going to kill myself tonight," after an argument on the phone. A colleague says, "She always says that." What should the nurse do?

  1. AWait until the next morning to see if she still feels the same once the argument has settled down
  2. BTell the patient she is only seeking attention
  3. CCarry out a full suicide risk assessment, as with any patient who expresses suicidal intent
  4. DAgree with the colleague and take no action at all
3.Clinical psychologyMedium

Which side effect is a long-term risk of first-generation (typical) antipsychotics?

  1. ASerotonin syndrome
  2. BHypertensive crisis after cheese
  3. CTardive dyskinesia
  4. DPhysical dependence like benzodiazepines
4.Clinical psychologyHard

The "scientist-practitioner" (Boulder) model in clinical psychology means that clinicians should:

  1. AUse research evidence to guide practice and evaluate their own interventions
  2. BAvoid research completely
  3. CPrescribe medication as their main treatment, following psychiatric guidelines closely
  4. DOnly conduct laboratory experiments
5.PharmacologyMedium

A patient receives lactulose for hepatic encephalopathy. Which finding shows that it is working?

  1. ANo bowel movement for three days, with less confusion than before
  2. BBetter alertness and orientation, with two to three soft stools a day
  3. CHigher blood ammonia with improved appetite
  4. DTen watery stools a day and a low serum potassium
6.PharmacologyHard

Why are tetracyclines usually avoided in pregnancy and in young children (under 8 years in US guidance, under 12 years in the UK)?

  1. AThey cause severe hearing loss in children
  2. BThey bind to growing teeth and bone and stain the teeth permanently
  3. CThey block the action of growth hormone and stunt the child's growth
  4. DThey cause grey baby syndrome in infants

3Solutions

1.Mental health nursing

Answer: A · A trained professional interpreter

Why this is the answer

Professional interpreters translate accurately and keep confidentiality. Family members, especially children, may filter information and should not interpret sensitive assessments such as those about suicide or abuse.

Answer

A · A trained professional interpreter
2.Mental health nursing

Answer: C · Carry out a full suicide risk assessment, as with any patient who expresses suicidal intent

Why this is the answer

People with borderline personality disorder have a significantly raised risk of suicide. Every statement of suicidal intent must be assessed; labelling it as attention-seeking can lead to missed risk.

Answer

C · Carry out a full suicide risk assessment, as with any patient who expresses suicidal intent
3.Clinical psychology

Answer: C · Tardive dyskinesia

Why this is the answer

Long-term dopamine blockade can cause tardive dyskinesia, with involuntary repetitive movements of the face, tongue and limbs, which may be irreversible.

Answer

C · Tardive dyskinesia
4.Clinical psychology

Answer: A · Use research evidence to guide practice and evaluate their own interventions

Why this is the answer

The Boulder model trains clinical psychologists to integrate scientific research and clinical practice, the basis of evidence-based practice.

Answer

A · Use research evidence to guide practice and evaluate their own interventions
5.Pharmacology

Answer: B · Better alertness and orientation, with two to three soft stools a day

Why this is the answer

Lactulose is adjusted to give about two to three soft stools a day and to lower ammonia, improving mental status. Excessive diarrhoea can cause dehydration and electrolyte loss.

Answer

B · Better alertness and orientation, with two to three soft stools a day
6.Pharmacology

Answer: B · They bind to growing teeth and bone and stain the teeth permanently

Why this is the answer

Tetracyclines chelate calcium and are deposited in growing teeth and bones. This can cause permanent yellow-brown staining of the teeth and may affect bone growth. Short courses of doxycycline are sometimes still used in younger children for specific serious infections.

Answer

B · They bind to growing teeth and bone and stain the teeth permanently

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