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 on a mental health ward insists that he is a famous inventor whose ideas were stolen by the government. Which type of delusion is the main one here?

  1. AGrandiose
  2. BNihilistic
  3. CErotomanic
  4. DSomatic
2.Mental health nursingHard

A patient who has taken haloperidol for many years now has repeated lip smacking and tongue movements. Which action is most appropriate?

  1. AGive benztropine, because it reliably reverses these movements
  2. BIncrease the haloperidol dose, because a higher dose suppresses the abnormal movements of the mouth and tongue
  3. CReport the movements, assess them with a scale such as the AIMS and ask for a medication review
  4. DReassure the patient that the movements will soon stop on their own
3.Clinical psychologyMedium

The therapeutic alliance refers to:

  1. AA legal contract between a clinic and an insurer
  2. BA group of therapists who share referrals
  3. CThe collaborative bond and agreement on goals and tasks between therapist and client
  4. DThe client's diagnosis, as agreed independently by two psychiatrists at the initial assessment
4.Clinical psychologyHard

Research on cultural factors shows that the Japanese syndrome taijin kyofusho mainly involves fear of:

  1. AOffending or embarrassing others through one's appearance or behaviour
  2. BThe genitals retracting into the body
  3. CBeing possessed by spirits
  4. DLosing one's soul after a sudden fright, leading to weakness and loss of appetite
5.PharmacologyMedium

During an oxytocin infusion, contractions become very frequent and the fetal heart rate shows late decelerations. What is the nurse's first action?

  1. AIncrease the infusion to finish labour quickly
  2. BGive a second oxytocin bolus
  3. CPosition the woman flat on her back
  4. DStop the oxytocin infusion
6.PharmacologyHard

A heparin infusion contains 25,000 units in 500 mL. The order is 1,000 units per hour. What rate should be set on the pump?

  1. A20 mL/h
  2. B25 mL/h
  3. C10 mL/h
  4. D50 mL/h

3Solutions

1.Mental health nursing

Answer: A · Grandiose

Why this is the answer

Grandiose delusions are false beliefs about one's own importance, power or identity. They may combine with persecutory themes, as here, but the central belief is about being exceptional.

Answer

A · Grandiose
2.Mental health nursing

Answer: C · Report the movements, assess them with a scale such as the AIMS and ask for a medication review

Why this is the answer

These are signs of tardive dyskinesia, which can be permanent. Early detection and review of the antipsychotic are key; anticholinergic drugs do not treat tardive dyskinesia and may worsen it.

Answer

C · Report the movements, assess them with a scale such as the AIMS and ask for a medication review
3.Clinical psychology

Answer: C · The collaborative bond and agreement on goals and tasks between therapist and client

Why this is the answer

The therapeutic alliance consistently predicts therapy outcome across different approaches, which supports the importance of common factors in psychotherapy.

Answer

C · The collaborative bond and agreement on goals and tasks between therapist and client
4.Clinical psychology

Answer: A · Offending or embarrassing others through one's appearance or behaviour

Why this is the answer

Taijin kyofusho is a cultural concept of distress in which the person fears that their gaze, odour or appearance will offend others. It shows that culture shapes how anxiety is expressed.

Answer

A · Offending or embarrassing others through one's appearance or behaviour
5.Pharmacology

Answer: D · Stop the oxytocin infusion

Why this is the answer

Excessive contractions reduce placental blood flow and cause fetal distress. The oxytocin is stopped first, then the woman is turned on her side, IV fluids and oxygen are given as per protocol and the provider is informed.

Answer

D · Stop the oxytocin infusion
6.Pharmacology

Answer: A · 20 mL/h

Why this is the answer

25,000 units ÷ 500 mL = 50 units/mL, and 1,000 units/h ÷ 50 units/mL = 20 mL/h. Heparin is a high-alert drug, so the calculation and pump settings are independently double-checked.

Answer

A · 20 mL/h

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