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

Why is the nurse's body language important in therapeutic communication?

  1. ABody language matters only when patients cannot speak the same language
  2. BPatients often respond more to non-verbal messages than to the words used
  3. CIt is only important during the termination phase
  4. DPatients with mental illness cannot understand non-verbal signals
2.Mental health nursingHard

A woman with a severe intellectual disability and limited speech has started hitting her face and refusing food. What should the nurse consider first?

  1. AThat she is trying to manipulate the staff
  2. BThat the behaviour is part of her disability and needs no assessment
  3. CThat she needs an antipsychotic to control her behaviour
  4. DA physical cause such as dental pain, an ear infection or constipation
3.Clinical psychologyMedium

The diathesis–stress model proposes that mental disorders arise from:

  1. AGenes alone
  2. BPoor parenting alone
  3. CStress alone
  4. DAn underlying vulnerability combined with environmental stress
4.Clinical psychologyHard

Learned helplessness (Seligman) was proposed as a model for:

  1. ASpecific phobias
  2. BSchizophrenia
  3. CDepression
  4. DAutism spectrum disorder
5.PharmacologyMedium

A patient wants to stop paroxetine suddenly. What should the nurse explain?

  1. AIt can be stopped at any time, as antidepressants cause no withdrawal effects
  2. BStopping suddenly causes dangerous low blood sugar
  3. CStopping suddenly causes the drug to work better for a while
  4. DIt can cause dizziness, "electric shock" feelings and irritability
6.PharmacologyHard

A patient on heparin for 7 days has a platelet count that has fallen by more than half, and a new leg vein thrombosis. What is the most likely cause and the key action?

  1. ANormal dilution of platelets; continue and recheck in a week
  2. BWarfarin skin necrosis; switch from heparin to warfarin at once
  3. CVitamin K deficiency; give vitamin K and continue heparin
  4. DHeparin-induced thrombocytopenia; stop all heparin

3Solutions

1.Mental health nursing

Answer: B · Patients often respond more to non-verbal messages than to the words used

Why this is the answer

Posture, eye contact, facial expression and tone carry much of the message. When words and body language do not match, patients tend to believe the non-verbal message.

Answer

B · Patients often respond more to non-verbal messages than to the words used
2.Mental health nursing

Answer: D · A physical cause such as dental pain, an ear infection or constipation

Why this is the answer

People with limited communication may show pain or illness through changes in behaviour. A thorough physical assessment comes before deciding the behaviour is psychiatric or behavioural.

Answer

D · A physical cause such as dental pain, an ear infection or constipation
3.Clinical psychology

Answer: D · An underlying vulnerability combined with environmental stress

Why this is the answer

The model holds that a predisposition (biological or psychological) leads to disorder only when triggered by sufficient stress.

Answer

D · An underlying vulnerability combined with environmental stress
4.Clinical psychology

Answer: C · Depression

Why this is the answer

After uncontrollable aversive events, animals and people may stop trying even when escape becomes possible, resembling the passivity and hopelessness of depression.

Answer

C · Depression
5.Pharmacology

Answer: D · It can cause dizziness, "electric shock" feelings and irritability

Why this is the answer

Antidepressant discontinuation syndrome is common with short half-life drugs such as paroxetine and venlafaxine. The dose is tapered gradually under supervision.

Answer

D · It can cause dizziness, "electric shock" feelings and irritability
6.Pharmacology

Answer: D · Heparin-induced thrombocytopenia; stop all heparin

Why this is the answer

Heparin-induced thrombocytopenia (HIT) is caused by antibodies against heparin–platelet factor 4 complexes. It usually starts 5–10 days after heparin begins and causes thrombosis, so all heparin is stopped and a non-heparin anticoagulant is used.

Answer

D · Heparin-induced thrombocytopenia; stop all heparin

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