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 information is essential when documenting the use of physical restraint?

  1. AThe nurse's personal opinion of the patient's character and attitude
  2. BOnly the time the restraint started and the name of the nurse in charge of the shift
  3. CThe full names of the other patients who saw the incident
  4. DThe reason for it, alternatives tried, start and end times, and the observations made
2.Mental health nursingHard

A patient taking lithium has had vomiting and diarrhoea for 2 days. She now has a coarse tremor and is confused. What should the nurse do first?

  1. AGive the next dose with extra water
  2. BEncourage a low-salt diet
  3. CGive an antidiarrhoeal and continue the lithium as normal, with extra salt in her diet
  4. DHold the next dose and notify the prescriber urgently so a lithium level can be taken
3.Clinical psychologyMedium

In Beck's cognitive model of depression, the "cognitive triad" consists of negative views about:

  1. AOneself, the world and the future
  2. BBody, mind and spirit
  3. CParents, friends and teachers
  4. DOne's past, present and future only
4.Clinical psychologyHard

Watson and Rayner's "Little Albert" study is often cited as evidence that:

  1. AFear can be acquired through classical conditioning
  2. BFear is learned only by watching others
  3. CPhobias are mainly inherited
  4. DPhobias are caused by repressed unconscious conflicts
5.PharmacologyMedium

After several years of levodopa treatment, which problem is common?

  1. APermanent hearing loss
  2. BDyskinesias and "on–off" fluctuations in response
  3. CComplete and permanent loss of all Parkinson's symptoms
  4. DSevere hypoglycaemia after each dose
6.PharmacologyHard

Why is glibenclamide (glyburide) generally avoided in older adults?

  1. AIt causes high blood glucose in older adults
  2. BIt is not absorbed in people over 65
  3. CIt is long-acting and can cause prolonged, severe hypoglycaemia
  4. DIt causes severe weight loss and muscle wasting in older people

3Solutions

1.Mental health nursing

Answer: D · The reason for it, alternatives tried, start and end times, and the observations made

Why this is the answer

Documentation records the reason, alternatives tried, who authorised and carried out the restraint, when it started and ended, the observations made and any injuries. This supports safety and accountability.

Answer

D · The reason for it, alternatives tried, start and end times, and the observations made
2.Mental health nursing

Answer: D · Hold the next dose and notify the prescriber urgently so a lithium level can be taken

Why this is the answer

Dehydration and sodium loss reduce lithium clearance. Coarse tremor and confusion suggest toxicity. Withhold lithium, get an urgent level, kidney function and electrolytes, and arrange medical review.

Answer

D · Hold the next dose and notify the prescriber urgently so a lithium level can be taken
3.Clinical psychology

Answer: A · Oneself, the world and the future

Why this is the answer

Beck proposed that depressed people hold negative views of the self, the world (or experiences) and the future, maintained by cognitive distortions.

Answer

A · Oneself, the world and the future
4.Clinical psychology

Answer: A · Fear can be acquired through classical conditioning

Why this is the answer

Albert came to fear a white rat after it was repeatedly paired with a loud noise, and the fear generalised to similar objects. The study is now criticised on ethical and methodological grounds.

Answer

A · Fear can be acquired through classical conditioning
5.Pharmacology

Answer: B · Dyskinesias and "on–off" fluctuations in response

Why this is the answer

Long-term levodopa use often leads to motor fluctuations, with periods of good control and periods of stiffness, and to dyskinesias at peak dose. Dose timing and add-on drugs are adjusted to manage this.

Answer

B · Dyskinesias and "on–off" fluctuations in response
6.Pharmacology

Answer: C · It is long-acting and can cause prolonged, severe hypoglycaemia

Why this is the answer

Glibenclamide has a long action and active metabolites that accumulate when kidney function declines. Older adults are at high risk of prolonged hypoglycaemia, so shorter-acting agents or other drug classes are preferred.

Answer

C · It is long-acting and can cause prolonged, severe hypoglycaemia

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