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

The nurse notices that she is spending much longer with one patient than with the others and feels she is the only one who can help him. What does this most likely indicate?

  1. AAn ideal therapeutic relationship
  2. BPossible boundary problems that she should discuss in supervision
  3. CThat the patient needs to be transferred to another unit
  4. DTransference by the patient towards the nurse, which is never the nurse's concern
2.Mental health nursingHard

A patient with OCD asks the nurse many times an hour, "Are you sure the door is locked?" What is the most helpful approach in his care plan?

  1. AAnswer once, then follow the agreed plan to limit repeated reassurance
  2. BLock and unlock the door in front of him each time he asks
  3. CTell him firmly that if he asks about the door again, he will lose his privileges on the ward for the day
  4. DReassure him every time he asks, as often as he needs
3.Clinical psychologyMedium

Which defence mechanism is shown when someone with strong hostile feelings towards a colleague acts in an excessively friendly way towards them?

  1. ADenial
  2. BDisplacement
  3. CRationalisation
  4. DReaction formation
4.Clinical psychologyHard

A study compares a new therapy with a waiting-list control and finds a large benefit. Why might this overestimate the therapy's specific effect?

  1. AA waiting list controls for time passing but not for attention, expectation or the alliance
  2. BWaiting-list controls always receive the same therapy
  3. CWaiting-list participants cannot be randomised
  4. DWaiting lists remove the placebo effect completely, so any benefit must come from the therapy itself
5.PharmacologyMedium

How should a patient take oral alendronate?

  1. AWith plain water on an empty stomach, staying upright for 30 minutes
  2. BWith breakfast and coffee to protect the stomach
  3. CCrushed into yoghurt with calcium supplements
  4. DWith milk at bedtime, then lying down straight away to aid absorption
6.PharmacologyHard

Newborns given chloramphenicol can develop "grey baby syndrome". What is the main reason?

  1. AImmature glucuronidation in the liver lets the drug accumulate
  2. BThe newborn kidney excretes the drug too quickly, so higher doses are given
  3. CNewborns produce antibodies against the drug
  4. DChloramphenicol is converted to vitamin K in neonates

3Solutions

1.Mental health nursing

Answer: B · Possible boundary problems that she should discuss in supervision

Why this is the answer

Feeling special or indispensable to one patient, and giving them extra time, are warning signs of over-involvement. Discussing this in clinical supervision helps the nurse keep a therapeutic relationship.

Answer

B · Possible boundary problems that she should discuss in supervision
2.Mental health nursing

Answer: A · Answer once, then follow the agreed plan to limit repeated reassurance

Why this is the answer

Seeking reassurance relieves anxiety only briefly and keeps the OCD cycle going. In line with exposure and response prevention, the team agrees to limit reassurance and support the patient to tolerate the anxiety.

Answer

A · Answer once, then follow the agreed plan to limit repeated reassurance
3.Clinical psychology

Answer: D · Reaction formation

Why this is the answer

Reaction formation turns an unacceptable impulse into its opposite, often in an exaggerated form.

Answer

D · Reaction formation
4.Clinical psychology

Answer: A · A waiting list controls for time passing but not for attention, expectation or the alliance

Why this is the answer

Waiting-list designs show that therapy beats no treatment, but common factors such as hope and therapist contact are not controlled. An active comparison or attention-placebo control is needed to test specific ingredients.

Answer

A · A waiting list controls for time passing but not for attention, expectation or the alliance
5.Pharmacology

Answer: A · With plain water on an empty stomach, staying upright for 30 minutes

Why this is the answer

Alendronate is taken first thing in the morning with water only, before food or other drugs. Staying upright reduces the risk of oesophageal ulceration, and food or calcium blocks its absorption.

Answer

A · With plain water on an empty stomach, staying upright for 30 minutes
6.Pharmacology

Answer: A · Immature glucuronidation in the liver lets the drug accumulate

Why this is the answer

Neonates have low glucuronyl transferase activity, so chloramphenicol is not conjugated and builds up. High levels cause circulatory collapse with grey skin. It shows how organ immaturity changes pharmacokinetics.

Answer

A · Immature glucuronidation in the liver lets the drug accumulate

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