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 activity is most suitable for a patient in an acute manic episode?

  1. AA competitive team game of volleyball
  2. BA walk with a staff member
  3. CA complicated board game such as chess with other patients
  4. DA long group discussion in the day room
2.Mental health nursingHard

A voluntary patient asks to leave the ward now. While talking, he says he plans to jump from a bridge on the way home. What should the nurse do?

  1. AStay with him and inform the team at once, so he can be urgently assessed under mental health law
  2. BTell him to go home now and come back tomorrow morning when he feels calmer and safer
  3. CLet him leave, because voluntary patients can always go when they want
  4. DAsk him to promise that he will not jump, and then let him go home on his own
3.Clinical psychologyMedium

Benzodiazepines reduce anxiety mainly by:

  1. AEnhancing the effect of GABA at GABA-A receptors
  2. BInhibiting monoamine oxidase
  3. CBlocking dopamine D2 receptors
  4. DBlocking serotonin reuptake into presynaptic neurons
4.Clinical psychologyHard

Learned helplessness (Seligman) was proposed as a model for:

  1. ASpecific phobias
  2. BAutism spectrum disorder
  3. CDepression
  4. DSchizophrenia
5.PharmacologyMedium

Why do patients taking clozapine need regular blood counts?

  1. AIt often causes iron-deficiency anaemia
  2. BIt can cause agranulocytosis
  3. CIt raises the platelet count dangerously
  4. DIt changes the blood group
6.PharmacologyHard

A patient on adalimumab for rheumatoid arthritis has a fever and cough on the day of her next injection. What should the nurse advise?

  1. ADouble the next dose to make up for the infection
  2. BGive the injection, as it will help the fever
  3. CStop the drug permanently without telling the prescriber
  4. DWithhold the injection and get the infection assessed first

3Solutions

1.Mental health nursing

Answer: B · A walk with a staff member

Why this is the answer

Solitary, non-competitive physical activity helps release energy safely. Competitive games, large groups and tasks requiring long concentration can increase agitation and conflict.

Answer

B · A walk with a staff member
2.Mental health nursing

Answer: A · Stay with him and inform the team at once, so he can be urgently assessed under mental health law

Why this is the answer

A voluntary patient who shows immediate serious risk may need urgent assessment under mental health legislation, which often includes short-term holding powers for nurses. The nurse acts quickly to keep him safe.

Answer

A · Stay with him and inform the team at once, so he can be urgently assessed under mental health law
3.Clinical psychology

Answer: A · Enhancing the effect of GABA at GABA-A receptors

Why this is the answer

Benzodiazepines increase GABA-A receptor activity, producing rapid calming effects. Because of tolerance and dependence, they are usually recommended only for short-term use.

Answer

A · Enhancing the effect of GABA at GABA-A receptors
4.Clinical psychology

Answer: C · Depression

Why this is the answer

After uncontrollable aversive events, animals and people may stop trying even when escape becomes possible, resembling the passivity and hopelessness of depression.

Answer

C · Depression
5.Pharmacology

Answer: B · It can cause agranulocytosis

Why this is the answer

Clozapine can cause severe neutropenia (agranulocytosis). Regular white cell and neutrophil counts allow treatment to be stopped before life-threatening infection occurs.

Answer

B · It can cause agranulocytosis
6.Pharmacology

Answer: D · Withhold the injection and get the infection assessed first

Why this is the answer

TNF inhibitors increase the risk of serious infections and can mask their signs. Doses are usually withheld during an active infection until it has been assessed and treated.

Answer

D · Withhold the injection and get the infection assessed first

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