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 PTSD begins to dissociate during a conversation. Which grounding technique can the nurse use?

  1. AAsk her to describe the traumatic event in as much detail as she can
  2. BAsk her to name things she can see, hear and touch in the room right now
  3. CLeave her alone until the episode has passed on its own
  4. DAsk her to close her eyes and think back to the worst moment of the trauma
2.Mental health nursingHard

A patient being treated for opioid dependence is about to receive his first dose of buprenorphine. He last used heroin 2 hours ago. What is the risk?

  1. ABuprenorphine will add to the heroin and cause a dangerous opioid overdose with respiratory depression
  2. BBuprenorphine can cause precipitated withdrawal if given while full agonists are still active
  3. CBuprenorphine will have no effect at all
  4. DThere is no risk; it should be given at once
3.Clinical psychologyMedium

In suicide risk assessment, which factor is one of the strongest predictors of a future suicide attempt?

  1. AA previous suicide attempt
  2. BBeing a university student
  3. CTalking openly to a therapist
  4. DHaving a large circle of friends
4.Clinical psychologyHard

A researcher finds that adoptees whose biological mothers had schizophrenia develop it more often than adoptees whose biological mothers did not, despite being raised by unaffected families. What does this design help to separate?

  1. AGenetic influences from the effects of the rearing environment
  2. BThe effects of antipsychotic medication from the effects of psychological therapy
  3. CPositive symptoms from negative symptoms
  4. DDiagnosis by DSM from diagnosis by ICD
5.PharmacologyMedium

How should a topical corticosteroid cream usually be applied?

  1. AUnder a tight plastic dressing every night without advice
  2. BOn broken, infected skin to speed healing
  3. CAs a thin layer to the affected area only, as directed
  4. DAs a thick layer over the whole body
6.PharmacologyHard

A patient on lisinopril for hypertension starts taking ibuprofen every day for knee pain. What is the main concern?

  1. AA large fall in blood pressure, with fainting and falls on standing up
  2. BWeaker blood pressure control, kidney injury and high potassium
  3. CA higher risk of a dry cough than with lisinopril alone
  4. DFaster liver metabolism of lisinopril, so it stops working

3Solutions

1.Mental health nursing

Answer: B · Ask her to name things she can see, hear and touch in the room right now

Why this is the answer

Grounding techniques use the senses to bring the person back to the here and now. Asking for details of the trauma during dissociation can deepen distress.

Answer

B · Ask her to name things she can see, hear and touch in the room right now
2.Mental health nursing

Answer: B · Buprenorphine can cause precipitated withdrawal if given while full agonists are still active

Why this is the answer

Buprenorphine displaces full agonists from opioid receptors but activates them less, causing sudden withdrawal. It is usually started when the patient already shows signs of withdrawal, assessed for example with a withdrawal scale.

Answer

B · Buprenorphine can cause precipitated withdrawal if given while full agonists are still active
3.Clinical psychology

Answer: A · A previous suicide attempt

Why this is the answer

A history of suicide attempts is among the strongest risk factors. Asking directly about suicidal thoughts does not increase risk and is part of good assessment.

Answer

A · A previous suicide attempt
4.Clinical psychology

Answer: A · Genetic influences from the effects of the rearing environment

Why this is the answer

Adoption studies, such as Heston's and the Danish studies, separate genetic risk from family environment because the child is raised away from the biological parent.

Answer

A · Genetic influences from the effects of the rearing environment
5.Pharmacology

Answer: C · As a thin layer to the affected area only, as directed

Why this is the answer

Thin application to affected skin limits systemic absorption and skin atrophy. Occlusive dressings increase absorption and are used only when prescribed.

Answer

C · As a thin layer to the affected area only, as directed
6.Pharmacology

Answer: B · Weaker blood pressure control, kidney injury and high potassium

Why this is the answer

NSAIDs block prostaglandins that dilate the afferent arteriole and promote sodium loss. With an ACE inhibitor this can reduce blood pressure control and cause kidney injury and hyperkalaemia, especially if a diuretic is also used.

Answer

B · Weaker blood pressure control, kidney injury and high potassium

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