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 statement about buspirone for anxiety is correct?

  1. AIt is highly addictive
  2. BIt takes weeks to work and is not useful as an as-needed drug
  3. CIt works within minutes during a panic attack, like a benzodiazepine
  4. DIt must be taken with alcohol
2.Mental health nursingHard

The daughter of a man with moderate dementia says she is exhausted, is not sleeping and feels guilty for getting angry with him. What is the most helpful nursing response?

  1. AAdvise her to take on more responsibility for his care so that she feels less guilty
  2. BTell her that good daughters do not get angry with their parents
  3. CAcknowledge her strain and discuss support such as respite care and carers' groups
  4. DSuggest that she stops visiting him for a few months so that she can rest and forget about her guilt
3.Clinical psychologyMedium

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

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

Which finding best supports the role of serotonin and other monoamines, rather than circumstance alone, in depression?

  1. ADepression never runs in families
  2. BEveryone who experiences a loss becomes depressed
  3. CDepression rates are equal in all countries, regardless of large differences in social and economic circumstances
  4. DDrugs that act on monoamine systems reduce depressive symptoms more than placebo in randomised trials
5.PharmacologyMedium

Why are patients taking simvastatin often advised to avoid large amounts of grapefruit juice?

  1. AGrapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
  2. BGrapefruit blocks cholesterol absorption and causes low cholesterol
  3. CGrapefruit speeds up simvastatin breakdown in the liver, so the drug stops working
  4. DGrapefruit makes the tablet dissolve in the mouth
6.PharmacologyHard

A teenager took a large overdose of diphenhydramine. He is agitated, hot, flushed and confused, with dry skin, dilated pupils and a full bladder. What is this pattern?

  1. ASerotonin syndrome
  2. BAnticholinergic toxidrome
  3. CCholinergic toxidrome
  4. DOpioid toxidrome

3Solutions

1.Mental health nursing

Answer: B · It takes weeks to work and is not useful as an as-needed drug

Why this is the answer

Buspirone has little sedation and low dependence risk, but its effect builds up over weeks. It is taken regularly, not as needed.

Answer

B · It takes weeks to work and is not useful as an as-needed drug
2.Mental health nursing

Answer: C · Acknowledge her strain and discuss support such as respite care and carers' groups

Why this is the answer

Caregiver strain is common and can affect both the carer and the patient. Recognising it, and offering respite, practical support and carers' groups, helps the carer continue safely.

Answer

C · Acknowledge her strain and discuss support such as respite care and carers' groups
3.Clinical psychology

Answer: A · 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

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

Answer: D · Drugs that act on monoamine systems reduce depressive symptoms more than placebo in randomised trials

Why this is the answer

Antidepressants targeting monoamines outperform placebo on average, though by modest margins. This supports a biological contribution but does not show that low serotonin alone causes depression.

Answer

D · Drugs that act on monoamine systems reduce depressive symptoms more than placebo in randomised trials
5.Pharmacology

Answer: A · Grapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk

Why this is the answer

Grapefruit compounds inhibit intestinal CYP3A4, so more simvastatin is absorbed. Higher levels increase the risk of muscle damage; drugs such as some calcium channel blockers and ciclosporin are also affected.

Answer

A · Grapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
6.Pharmacology

Answer: B · Anticholinergic toxidrome

Why this is the answer

Anticholinergic toxicity causes hyperthermia, dry flushed skin, mydriasis, urinary retention, tachycardia and delirium. Dry skin helps distinguish it from serotonin syndrome and sympathomimetic poisoning, which cause sweating.

Answer

B · Anticholinergic toxidrome

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