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 measurement should be monitored regularly in a patient taking venlafaxine?

  1. ASerum lithium level
  2. BPeak expiratory flow
  3. CBlood pressure
  4. DVisual acuity
2.Mental health nursingHard

A patient with borderline personality disorder and frequent self-harm says, "I'm going to kill myself tonight," after an argument on the phone. A colleague says, "She always says that." What should the nurse do?

  1. AAgree with the colleague and take no action at all
  2. BTell the patient she is only seeking attention
  3. CWait until the next morning to see if she still feels the same once the argument has settled down
  4. DCarry out a full suicide risk assessment, as with any patient who expresses suicidal intent
3.Clinical psychologyMedium

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

  1. ABeing a university student
  2. BTalking openly to a therapist
  3. CHaving a large circle of friends
  4. DA previous suicide attempt
4.Clinical psychologyHard

A soldier develops PTSD while most comrades exposed to the same battle do not. Which model best explains this difference?

  1. AThe statistical infrequency model
  2. BThe medical model of infection
  3. CThe token economy model
  4. DThe diathesis–stress model
5.PharmacologyMedium

Why is IV promethazine given with great caution?

  1. AIt causes a severe rise in blood pressure when it is given intravenously
  2. BIt can cause severe tissue injury if it leaks or enters an artery
  3. CIt causes immediate kidney failure
  4. DIt is a strong opioid that causes addiction
6.PharmacologyHard

Which heart failure drug improves symptoms and reduces hospital admissions but has not been shown to reduce mortality?

  1. ADigoxin
  2. BA mineralocorticoid receptor antagonist such as spironolactone
  3. CAn ACE inhibitor
  4. DA beta blocker such as bisoprolol

3Solutions

1.Mental health nursing

Answer: C · Blood pressure

Why this is the answer

Venlafaxine is an SNRI. By increasing noradrenaline, it can raise blood pressure, particularly at higher doses, so blood pressure is checked regularly.

Answer

C · Blood pressure
2.Mental health nursing

Answer: D · Carry out a full suicide risk assessment, as with any patient who expresses suicidal intent

Why this is the answer

People with borderline personality disorder have a significantly raised risk of suicide. Every statement of suicidal intent must be assessed; labelling it as attention-seeking can lead to missed risk.

Answer

D · Carry out a full suicide risk assessment, as with any patient who expresses suicidal intent
3.Clinical psychology

Answer: D · 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

D · A previous suicide attempt
4.Clinical psychology

Answer: D · The diathesis–stress model

Why this is the answer

The diathesis–stress model holds that a stressor causes disorder mainly in people with pre-existing vulnerabilities, such as genetic risk, prior trauma or poor social support.

Answer

D · The diathesis–stress model
5.Pharmacology

Answer: B · It can cause severe tissue injury if it leaks or enters an artery

Why this is the answer

Promethazine is a vesicant. Deep intramuscular injection is the preferred parenteral route, and if given IV it is diluted, given slowly into a well-running large vein, and stopped at once if the patient reports burning or pain.

Answer

B · It can cause severe tissue injury if it leaks or enters an artery
6.Pharmacology

Answer: A · Digoxin

Why this is the answer

ACE inhibitors (or ARBs/ARNI), beta blockers, mineralocorticoid antagonists and SGLT2 inhibitors reduce mortality in heart failure with reduced ejection fraction. Digoxin improves symptoms and reduces admissions without reducing mortality.

Answer

A · Digoxin

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