1Formulas and methods
Mental health nursing
Method
- Decide whether there is an immediate risk: suicide, violence, a drug emergency or a physical illness.
- Act on safety first: observe, remove means, de-escalate, stop a harmful drug, get help.
- Choose the therapeutic response: acknowledge feelings, present reality, avoid false reassurance and “why” questions.
- Respect rights: the least restrictive option, consent and confidentiality with its limits.
2Practice problems
1.Mental health nursingMedium
How does conduct disorder differ from oppositional defiant disorder?
- AThe two disorders are exactly the same and differ only in the age at which they are diagnosed
- BConduct disorder involves only arguing with adults and losing one's temper
- CConduct disorder involves violating others' rights, such as cruelty, theft or fire setting
- DOppositional defiant disorder includes serious physical aggression towards animals
2.Mental health nursingHard
A teenager says she cuts herself "to feel better, not to die." Which statement about this is correct?
- ANon-suicidal self-injury still increases the long-term risk of suicide, so risk is assessed each time
- BSelf-injury without suicidal intent never needs any assessment
- CSelf-injury without suicidal intent shows that she has no mental health problems that need any treatment
- DShe should be told that cutting is only attention-seeking behaviour
3.Clinical psychologyMedium
Reliability of a diagnosis refers to:
- AWhether the diagnosis accurately predicts the course and outcome of the illness
- BWhether the diagnosis uses medical tests
- CWhether different clinicians reach the same diagnosis for the same patient
- DWhether the diagnosis is accepted by the patient
4.Clinical psychologyHard
A clinician considers whether a categorical or dimensional approach to personality disorders is better. Which point favours a dimensional approach?
- APersonality traits are either fully present or fully absent in any one person
- BDimensional models cannot be measured with questionnaires or interviews
- CTraits vary continuously, and categories overlap with arbitrary cut-offs
- DCategories have been shown to give perfect inter-rater reliability
5.PharmacologyMedium
Which is a well-known adverse effect of long-term oral corticosteroids?
- AHypoglycaemia
- BLow blood pressure
- CWeight loss
- DOsteoporosis
6.PharmacologyHard
Why is clavulanic acid combined with amoxicillin (co-amoxiclav)?
- AIt reduces the risk of penicillin allergy
- BIt slows the kidney excretion of amoxicillin
- CIt makes amoxicillin cross the blood–brain barrier more easily
- DIt inhibits beta-lactamase enzymes that would destroy amoxicillin
3Solutions
1.Mental health nursing
Answer: C · Conduct disorder involves violating others' rights, such as cruelty, theft or fire setting
Why this is the answer
Oppositional defiant disorder involves angry, argumentative and defiant behaviour. Conduct disorder is more serious, with aggression, destruction of property, deceit, theft or serious violation of rules.
C · Conduct disorder involves violating others' rights, such as cruelty, theft or fire setting
2.Mental health nursing
Answer: A · Non-suicidal self-injury still increases the long-term risk of suicide, so risk is assessed each time
Why this is the answer
Self-harm is a strong predictor of later suicide, even when the person does not intend to die. Each episode needs a compassionate assessment of risk, triggers and the function of the behaviour.
A · Non-suicidal self-injury still increases the long-term risk of suicide, so risk is assessed each time
3.Clinical psychology
Answer: C · Whether different clinicians reach the same diagnosis for the same patient
Why this is the answer
Reliability is consistency of diagnosis between clinicians or over time. Validity is whether the diagnosis reflects a real, meaningful category.
C · Whether different clinicians reach the same diagnosis for the same patient
4.Clinical psychology
Answer: C · Traits vary continuously, and categories overlap with arbitrary cut-offs
Why this is the answer
Categorical diagnoses overlap heavily and treat a continuum as present/absent. DSM-5 Section III and ICD-11 therefore offer trait-based dimensional models of personality disorder.
C · Traits vary continuously, and categories overlap with arbitrary cut-offs
5.Pharmacology
Answer: D · Osteoporosis
Why this is the answer
Long-term corticosteroids reduce bone formation and raise fracture risk. They also cause weight gain, high blood glucose, hypertension and a higher infection risk.
6.Pharmacology
Answer: D · It inhibits beta-lactamase enzymes that would destroy amoxicillin
Why this is the answer
Many bacteria produce beta-lactamases that inactivate penicillins. Clavulanic acid inhibits these enzymes, so amoxicillin can work against these organisms.
D · It inhibits beta-lactamase enzymes that would destroy amoxicillin