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 with PTSD begins to dissociate during a conversation. Which grounding technique can the nurse use?

  1. AAsk her to name things she can see, hear and touch in the room right now
  2. BAsk her to describe the traumatic event in as much detail as she can
  3. CLeave her alone until the episode has passed on its own
  4. DAsk her to close her eyes and think back to the worst moment of the trauma
2.Mental health nursingHard

A voluntary patient who has no immediate risk of harm wants to leave the ward against medical advice. What is the correct general approach?

  1. ATell the patient that staff will restrain them and bring them back to the ward if they try to leave without the doctor's permission
  2. BLock the door to stop the patient leaving
  3. CExplain the risks, inform the team, document the discussion and respect their right to leave according to the law and policy
  4. DHide the patient's belongings
3.Clinical psychologyMedium

A man is socially inhibited, feels inadequate and avoids jobs involving contact with people because he fears criticism, though he wants close relationships. Which disorder fits best?

  1. AAvoidant personality disorder
  2. BAntisocial personality disorder
  3. CSchizoid personality disorder
  4. DHistrionic personality disorder
4.Clinical psychologyHard

A patient has had psychotic symptoms for a year; for several weeks they had hallucinations without any mood episode, while at other times psychosis occurred during major depressive episodes. Which diagnosis is most likely?

  1. ADelusional disorder
  2. BMajor depressive disorder with psychotic features
  3. CSchizoaffective disorder
  4. DBipolar I disorder
5.PharmacologyMedium

How does metformin mainly lower blood glucose?

  1. AIt replaces missing insulin
  2. BIt blocks glucose absorption in the kidney
  3. CIt stimulates insulin release from the pancreas
  4. DIt reduces glucose production by the liver
6.PharmacologyHard

Which property makes a drug more likely to cross the blood–brain barrier?

  1. AHigh lipid solubility and small size
  2. BPositive charge at physiological pH
  3. CLarge molecular weight and strong protein binding
  4. DHigh water solubility and strong ionisation

3Solutions

1.Mental health nursing

Answer: A · Ask her to name things she can see, hear and touch in the room right now

Why this is the answer

Grounding techniques use the senses to bring the person back to the here and now. Asking for details of the trauma during dissociation can deepen distress.

Answer

A · Ask her to name things she can see, hear and touch in the room right now
2.Mental health nursing

Answer: C · Explain the risks, inform the team, document the discussion and respect their right to leave according to the law and policy

Why this is the answer

Voluntary patients can usually leave, although they may be asked to wait while their risk is assessed. Detaining someone needs legal authority. The nurse informs the team, assesses risk and documents.

Answer

C · Explain the risks, inform the team, document the discussion and respect their right to leave according to the law and policy
3.Clinical psychology

Answer: A · Avoidant personality disorder

Why this is the answer

Avoidant personality disorder (Cluster C) involves hypersensitivity to negative evaluation and social inhibition. In schizoid personality disorder, the person shows little desire for close relationships.

Answer

A · Avoidant personality disorder
4.Clinical psychology

Answer: C · Schizoaffective disorder

Why this is the answer

Schizoaffective disorder involves a mood episode together with schizophrenia symptoms, plus at least two weeks of psychosis without a mood episode. In psychotic depression, psychosis occurs only during the mood episode.

Answer

C · Schizoaffective disorder
5.Pharmacology

Answer: D · It reduces glucose production by the liver

Why this is the answer

Metformin mainly reduces hepatic gluconeogenesis and improves insulin sensitivity. Because it does not stimulate insulin release, hypoglycaemia is rare when used alone.

Answer

D · It reduces glucose production by the liver
6.Pharmacology

Answer: A · High lipid solubility and small size

Why this is the answer

Small, lipophilic, non-ionised molecules diffuse across endothelial cell membranes. Charged or large, protein-bound drugs mostly stay out.

Answer

A · High lipid solubility and small size

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