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

The wife of a man with alcohol dependence organises her life around his drinking, hides it from others and neglects her own needs. What does this pattern suggest?

  1. ALearned helplessness in the patient
  2. BCodependency
  3. CDelirium tremens
  4. DEnabling by the healthcare team
2.Mental health nursingHard

A patient taking sertraline is given tramadol for pain. A few hours later he is agitated, sweating, tremulous and has clonus in his ankles. What is the most likely problem?

  1. ASerotonin syndrome
  2. BOpioid withdrawal
  3. CAlcohol withdrawal
  4. DNeuroleptic malignant syndrome
3.Clinical psychologyMedium

The diathesis–stress model proposes that mental disorders arise from:

  1. AStress alone
  2. BAn underlying vulnerability combined with environmental stress
  3. CGenes alone
  4. DPoor parenting alone
4.Clinical psychologyHard

An older patient becomes confused over two days after starting a new medication, with attention that varies through the day. Her daughter says her memory was normal last week. What is the most appropriate interpretation?

  1. ALate-onset schizophrenia
  2. BNormal ageing
  3. CEarly Alzheimer's disease, which needs a referral to a memory clinic
  4. DDelirium, which needs a search for a physical or drug cause
5.PharmacologyMedium

Why is a spacer recommended with a metered-dose inhaler?

  1. AIt turns the inhaler into a nebuliser
  2. BIt removes the need to shake the inhaler
  3. CIt doubles the dose of drug released by each puff of the inhaler
  4. DMore drug reaches the lungs and less stays in the mouth
6.PharmacologyHard

A patient with an epidural infusion of local anaesthetic becomes hypotensive. What is the most likely mechanism?

  1. ABlockade of sympathetic nerves causes vasodilation
  2. BThe drug increases urine output and causes dehydration
  3. CThe epidural catheter has caused heavy bleeding
  4. DThe local anaesthetic causes a severe allergic reaction

3Solutions

1.Mental health nursing

Answer: B · Codependency

Why this is the answer

Codependency describes a family member whose life becomes centred on the other person's addiction, often with caretaking, covering up and neglect of self. Support groups such as Al-Anon can help.

Answer

B · Codependency
2.Mental health nursing

Answer: A · Serotonin syndrome

Why this is the answer

Tramadol has serotonergic effects, and combining it with an SSRI can cause serotonin syndrome. The serotonergic drugs are stopped and the patient is treated supportively; severe cases need intensive care.

Answer

A · Serotonin syndrome
3.Clinical psychology

Answer: B · An underlying vulnerability combined with environmental stress

Why this is the answer

The model holds that a predisposition (biological or psychological) leads to disorder only when triggered by sufficient stress.

Answer

B · An underlying vulnerability combined with environmental stress
4.Clinical psychology

Answer: D · Delirium, which needs a search for a physical or drug cause

Why this is the answer

Acute onset with fluctuating attention suggests delirium, a medical emergency with causes such as drugs, infection or dehydration. Dementia develops gradually over months to years.

Answer

D · Delirium, which needs a search for a physical or drug cause
5.Pharmacology

Answer: D · More drug reaches the lungs and less stays in the mouth

Why this is the answer

A spacer holds the aerosol so it can be inhaled slowly, without precise coordination. This improves lung delivery and reduces mouth side effects such as thrush from inhaled steroids.

Answer

D · More drug reaches the lungs and less stays in the mouth
6.Pharmacology

Answer: A · Blockade of sympathetic nerves causes vasodilation

Why this is the answer

Epidural local anaesthetics block sympathetic fibres as well as sensory nerves. This dilates blood vessels and lowers blood pressure, so fluids, position changes or vasopressors may be needed.

Answer

A · Blockade of sympathetic nerves causes vasodilation

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