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
Which findings suggest recent cannabis use?
- ASlow heart rate, constricted pupils, drooling and watery eyes
- BRed eyes, increased appetite, dry mouth and a fast heart rate
- CDilated pupils, high fever and severe muscle rigidity
- DPinpoint pupils, slow breathing and drowsiness
2.Mental health nursingHard
A new nurse delegates several tasks to a healthcare assistant. Which delegation shows a need for further teaching?
- AAsking the assistant to help a patient with personal hygiene
- BAsking the assistant to take routine vital signs of a stable patient
- CAsking the assistant to decide whether a patient needs a second dose of a PRN sedative
- DAsking the assistant to sit with a calm patient during a group art activity and report any concerns
3.Clinical psychologyMedium
Selective serotonin reuptake inhibitors (SSRIs) increase serotonin in the synapse by:
- ABlocking dopamine release
- BSpeeding up the breakdown of serotonin by monoamine oxidase enzymes
- CBlocking the reuptake of serotonin into the presynaptic neuron
- DDestroying serotonin receptors
4.Clinical psychologyHard
A therapist helps a client with panic disorder deliberately bring on dizziness by spinning in a chair, without using safety behaviours. What is this technique called and why is it used?
- AInteroceptive exposure, so the client learns bodily sensations are not dangerous
- BFree association, so unconscious fears come to light
- CAversion therapy, so the client learns to associate panic with physical discomfort
- DFlooding, so the client forgets their trauma
5.PharmacologyMedium
What should the nurse teach a patient about taking levothyroxine?
- ATake it with milk at dinner, as calcium protects the stomach lining
- BTake it together with the iron tablet to save time
- CTake it only on days when feeling tired
- DTake it on an empty stomach, 30–60 minutes before breakfast
6.PharmacologyHard
Which regimen is standard for eradicating Helicobacter pylori?
- AAn antacid alone, taken after meals and at bedtime for six months
- BAn H2 blocker taken only when pain occurs
- CA single dose of an antibiotic given intravenously
- DAcid suppression plus at least two antibiotics, often with bismuth, for 14 days
3Solutions
1.Mental health nursing
Answer: B · Red eyes, increased appetite, dry mouth and a fast heart rate
Why this is the answer
Cannabis intoxication typically causes conjunctival injection, increased appetite, dry mouth, tachycardia, impaired coordination and altered perception of time. High doses can cause anxiety or psychosis.
B · Red eyes, increased appetite, dry mouth and a fast heart rate
2.Mental health nursing
Answer: C · Asking the assistant to decide whether a patient needs a second dose of a PRN sedative
Why this is the answer
Evaluating the effect of a medicine and deciding on further doses require clinical assessment and cannot be delegated. The other tasks are routine and suitable for a trained assistant.
C · Asking the assistant to decide whether a patient needs a second dose of a PRN sedative
3.Clinical psychology
Answer: C · Blocking the reuptake of serotonin into the presynaptic neuron
Why this is the answer
SSRIs block the serotonin transporter, so serotonin stays longer in the synaptic cleft. Clinical effects usually take several weeks.
C · Blocking the reuptake of serotonin into the presynaptic neuron
4.Clinical psychology
Answer: A · Interoceptive exposure, so the client learns bodily sensations are not dangerous
Why this is the answer
Interoceptive exposure provokes feared bodily sensations so the client can test catastrophic predictions and habituate. It is a core part of CBT for panic disorder.
A · Interoceptive exposure, so the client learns bodily sensations are not dangerous
5.Pharmacology
Answer: D · Take it on an empty stomach, 30–60 minutes before breakfast
Why this is the answer
Levothyroxine is best absorbed on an empty stomach, and calcium, iron and antacids should be taken some hours apart. It is taken every day, usually for life.
D · Take it on an empty stomach, 30–60 minutes before breakfast
6.Pharmacology
Answer: D · Acid suppression plus at least two antibiotics, often with bismuth, for 14 days
Why this is the answer
Eradication combines acid suppression (usually a PPI) with at least two antibiotics; bismuth quadruple therapy for 14 days is now often first-line because clarithromycin resistance makes older triple therapy fail. Taking every dose matters, and cure is confirmed with a breath or stool test.
D · Acid suppression plus at least two antibiotics, often with bismuth, for 14 days