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

Which US legal case is associated with the duty of mental health professionals to protect people who are threatened by a patient?

  1. ARoe v Wade
  2. BBrown v Board of Education
  3. CTarasoff v Regents of the University of California
  4. DMiranda v Arizona
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

Exposure and response prevention is the main psychological treatment for:

  1. ABipolar disorder
  2. BADHD
  3. COCD
  4. DInsomnia
4.Clinical psychologyHard

A man who hears the word "thud" is admitted to hospital, then behaves normally. Staff record his note-taking as "engages in writing behaviour". In Rosenhan's study, what does this illustrate?

  1. AOnce a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
  2. BPseudopatients developed real symptoms in hospital
  3. CStaff deliberately falsified records
  4. DNote-taking is a recognised symptom of schizophrenia, so the staff were right to record it as such
5.PharmacologyMedium

Which group of effects would the nurse expect after a dose of an anticholinergic drug such as atropine?

  1. AHeavy salivation, slow heart rate and small pupils
  2. BDiarrhoea, frequent urination and sweating
  3. CBronchial secretions, wheeze and tearing of the eyes
  4. DDry mouth, faster heart rate and dilated pupils
6.PharmacologyHard

Why is gentamicin often given once daily instead of in several small doses?

  1. AIt has a very long half-life of several days
  2. BIts killing depends on high peak levels, with a post-antibiotic effect
  3. CIts killing depends only on the time the level stays above the MIC
  4. DIt is absorbed slowly from the muscle over 24 hours

3Solutions

1.Mental health nursing

Answer: C · Tarasoff v Regents of the University of California

Why this is the answer

In Tarasoff (California, 1976), the court held that therapists have a duty to take reasonable steps to protect an identifiable person from a serious threat made by a patient. Similar principles exist in many jurisdictions.

Answer

C · Tarasoff v Regents of the University of California
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: C · OCD

Why this is the answer

ERP exposes patients to obsessional triggers while preventing compulsions, so anxiety falls without the ritual.

Answer

C · OCD
4.Clinical psychology

Answer: A · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder

Why this is the answer

Rosenhan argued that the label "schizophrenic" made staff see ordinary behaviour as pathological. Critics such as Spitzer argued the study did not prove diagnosis was invalid.

Answer

A · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
5.Pharmacology

Answer: D · Dry mouth, faster heart rate and dilated pupils

Why this is the answer

Anticholinergic drugs block muscarinic receptors, so parasympathetic effects are reduced. This gives dry mouth, tachycardia, dilated pupils, constipation and urinary retention.

Answer

D · Dry mouth, faster heart rate and dilated pupils
6.Pharmacology

Answer: B · Its killing depends on high peak levels, with a post-antibiotic effect

Why this is the answer

Aminoglycosides show concentration-dependent killing and a post-antibiotic effect. Once-daily dosing gives high peaks and a low trough, which may also reduce kidney and ear toxicity.

Answer

B · Its killing depends on high peak levels, with a post-antibiotic effect

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