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

Flumazenil reverses benzodiazepine sedation. Why is it used with caution in patients who take benzodiazepines long-term?

  1. AIt causes permanent memory loss after a single dose
  2. BIt can cause sudden withdrawal and seizures
  3. CIt makes the benzodiazepine effect much stronger
  4. DIt causes a dangerous rise in blood sugar
2.Mental health nursingHard

A 50-year-old man has believed for a year that his wife is unfaithful. He works normally, his speech is organised and he has no hallucinations. Which diagnosis is most likely?

  1. ASchizophreniform disorder
  2. BBipolar I disorder
  3. CDelusional disorder
  4. DSchizophrenia
3.Clinical psychologyMedium

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

  1. ABody, mind and spirit
  2. BParents, friends and teachers
  3. COneself, the world and the future
  4. DOne's past, present and future only
4.Clinical psychologyHard

Comorbidity means that:

  1. AA person meets criteria for two or more disorders at the same time
  2. BA disorder runs in families
  3. CA symptom is shared by everyone in a group
  4. DA disorder is caused by a physical illness that occurs at the same time
5.PharmacologyMedium

Which signs suggest early lithium toxicity?

  1. AVery high blood pressure and a severe headache
  2. BHair loss and dark urine only
  3. CDiarrhoea, vomiting, coarse tremor and drowsiness
  4. DPinpoint pupils and slow breathing
6.PharmacologyHard

During general anaesthesia with a volatile agent and suxamethonium (succinylcholine), a patient develops muscle rigidity, rising end-tidal CO2 and a fast-rising temperature. Which drug is the specific treatment?

  1. AParacetamol
  2. BNeostigmine
  3. CNaloxone
  4. DDantrolene

3Solutions

1.Mental health nursing

Answer: B · It can cause sudden withdrawal and seizures

Why this is the answer

Flumazenil is a benzodiazepine antagonist. In dependent patients, or in mixed overdoses with drugs that lower the seizure threshold, it can trigger acute withdrawal and seizures.

Answer

B · It can cause sudden withdrawal and seizures
2.Mental health nursing

Answer: C · Delusional disorder

Why this is the answer

Delusional disorder involves one or more delusions for at least 1 month, without other prominent symptoms of schizophrenia, and functioning is not markedly impaired apart from the effects of the delusion. Jealous delusions are one recognised type.

Answer

C · Delusional disorder
3.Clinical psychology

Answer: C · 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

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

Answer: A · A person meets criteria for two or more disorders at the same time

Why this is the answer

Comorbidity is the co-occurrence of disorders in the same person, which complicates diagnosis and treatment and raises questions about categorical classification.

Answer

A · A person meets criteria for two or more disorders at the same time
5.Pharmacology

Answer: C · Diarrhoea, vomiting, coarse tremor and drowsiness

Why this is the answer

Early lithium toxicity causes GI upset, a coarse tremor, sluggishness and unsteadiness. Higher levels cause confusion, seizures and arrhythmias, so the drug is held and the level checked.

Answer

C · Diarrhoea, vomiting, coarse tremor and drowsiness
6.Pharmacology

Answer: D · Dantrolene

Why this is the answer

Malignant hyperthermia is caused by uncontrolled calcium release from the sarcoplasmic reticulum. Dantrolene blocks this release, and the triggering agents are stopped at once.

Answer

D · Dantrolene

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