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
What is the main advantage of a long-acting injectable antipsychotic?
- AIt cures schizophrenia after a fixed course of injections
- BIt works faster than any oral antipsychotic in an acute crisis
- CIt improves adherence because the patient does not need to take daily tablets
- DIt has no side effects, unlike the oral forms of the same antipsychotic drugs
2.Mental health nursingHard
On the day after hip surgery, a 58-year-old patient has a new tremor, sweating, anxiety and a fast pulse. He did not report any alcohol use on admission. What should the nurse do?
- AAssume he has post-operative pain and give extra analgesia only
- BAsk him and his family about his alcohol use and the time of his last drink, and report the findings
- CWait until the next day to see if the symptoms go away on their own once his pain is better controlled
- DTell him that his symptoms are normal after hip surgery
3.Clinical psychologyMedium
Which statement about the monoamine hypothesis of depression is most accurate?
- AIt has been fully confirmed by direct measurements of serotonin levels in the brains of living patients
- BIt links depression to low monoamine activity but struggles to explain the delayed drug response
- CIt predicts that antidepressants improve mood within a few hours of a dose
- DIt proves that depression is caused only by low dopamine in the frontal lobe
4.Clinical psychologyHard
The "Dodo bird verdict" in psychotherapy research refers to the finding that:
- ADifferent bona fide therapies often produce broadly similar outcomes
- BUntreated clients on waiting lists improve faster than treated clients
- CMedication always outperforms psychotherapy
- DOnly psychoanalysis is effective for depression
5.PharmacologyMedium
After a vaccination, why is a person asked to wait for a short time before leaving?
- ATo measure the person's temperature for fever
- BTo watch for anaphylaxis, which usually starts within minutes
- CTo make sure the injection site does not bruise
- DTo check that the vaccine has already created protective antibodies
6.PharmacologyHard
A patient develops a dry cough on an ACE inhibitor and is switched to losartan. Why is losartan less likely to cause cough?
- AIt is excreted faster by the kidney
- BIt does not block the breakdown of bradykinin
- CIt also acts as a bronchodilator
- DIt blocks histamine receptors in the airways
3Solutions
1.Mental health nursing
Answer: C · It improves adherence because the patient does not need to take daily tablets
Why this is the answer
Depot or long-acting injections are given every few weeks, so adherence can be checked and missed doses are noticed. They have the same kinds of side effects as the oral form of the drug.
C · It improves adherence because the patient does not need to take daily tablets
2.Mental health nursing
Answer: B · Ask him and his family about his alcohol use and the time of his last drink, and report the findings
Why this is the answer
Unexpected alcohol withdrawal is common in surgical patients. Asking about drinking, using a withdrawal scale and reporting early allows treatment before seizures or delirium tremens develop.
B · Ask him and his family about his alcohol use and the time of his last drink, and report the findings
3.Clinical psychology
Answer: B · It links depression to low monoamine activity but struggles to explain the delayed drug response
Why this is the answer
The hypothesis grew from the effects of drugs on monoamines. The delay of several weeks before benefit suggests that downstream changes, such as receptor adaptation, matter too.
B · It links depression to low monoamine activity but struggles to explain the delayed drug response
4.Clinical psychology
Answer: A · Different bona fide therapies often produce broadly similar outcomes
Why this is the answer
Meta-analyses often find small differences between established therapies, which has been taken to support common factors such as the alliance. Some disorders, such as OCD and phobias, show clear advantages for specific treatments like exposure.
A · Different bona fide therapies often produce broadly similar outcomes
5.Pharmacology
Answer: B · To watch for anaphylaxis, which usually starts within minutes
Why this is the answer
Anaphylaxis after vaccination is rare but usually begins soon after the injection. Staff and adrenaline must be available during the observation period.
B · To watch for anaphylaxis, which usually starts within minutes
6.Pharmacology
Answer: B · It does not block the breakdown of bradykinin
Why this is the answer
ACE (kininase II) breaks down bradykinin, so ACE inhibitors raise bradykinin, which can cause cough and angioedema. ARBs block the angiotensin II receptor without affecting bradykinin breakdown.
B · It does not block the breakdown of bradykinin