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 item is part of a safety plan for a person experiencing domestic violence?

  1. AAvoiding contact with friends and support services so as not to provoke him
  2. BTelling the abuser about plans to leave so that he can prepare
  3. CKeeping an emergency bag with documents, money and keys somewhere safe
  4. DKeeping all important documents in the shared house
2.Mental health nursingHard

A community nurse visits an older woman with hoarding disorder whose home is so cluttered that the exits are blocked. What is the most appropriate approach?

  1. AArrange for the whole house to be cleared while she is out
  2. BWork with her to clear the exits first, then agree a gradual plan together
  3. CIgnore the clutter, because it is her own home
  4. DTell her that she will be evicted unless everything is thrown away today
3.Clinical psychologyMedium

In suicide risk assessment, which factor is one of the strongest predictors of a future suicide attempt?

  1. AHaving a large circle of friends
  2. BTalking openly to a therapist
  3. CA previous suicide attempt
  4. DBeing a university student
4.Clinical psychologyHard

A man reports that his left arm became paralysed after a severe argument, but neurological examination shows findings inconsistent with any known neurological disease. Which DSM-5 diagnosis is most likely?

  1. ABody dysmorphic disorder
  2. BIllness anxiety disorder
  3. CFunctional neurological symptom disorder (conversion disorder)
  4. DMalingering
5.PharmacologyMedium

Which rule applies to intravenous potassium chloride?

  1. AIt is given as a rapid IV push to correct low levels quickly
  2. BIt must be diluted and given as an infusion, never as an IV push
  3. CIt is mixed into blood products to save time
  4. DIt may be given intramuscularly if there is no IV access
6.PharmacologyHard

An older patient on amlodipine develops ankle swelling and is prescribed furosemide. She then becomes dizzy and falls. What does this sequence illustrate?

  1. ADrug tolerance
  2. BA type B allergic reaction
  3. CEnzyme induction
  4. DA prescribing cascade

3Solutions

1.Mental health nursing

Answer: C · Keeping an emergency bag with documents, money and keys somewhere safe

Why this is the answer

A safety plan includes an escape bag, important documents, a safe place to go, emergency numbers and a code word with trusted people. The time of leaving can be the most dangerous period.

Answer

C · Keeping an emergency bag with documents, money and keys somewhere safe
2.Mental health nursing

Answer: B · Work with her to clear the exits first, then agree a gradual plan together

Why this is the answer

Forced clear-outs cause great distress and the clutter usually returns. Collaborative, gradual work focusing first on safety, such as fire exits and fall risks, with involvement of relevant services, is more effective.

Answer

B · Work with her to clear the exits first, then agree a gradual plan together
3.Clinical psychology

Answer: C · A previous suicide attempt

Why this is the answer

A history of suicide attempts is among the strongest risk factors. Asking directly about suicidal thoughts does not increase risk and is part of good assessment.

Answer

C · A previous suicide attempt
4.Clinical psychology

Answer: C · Functional neurological symptom disorder (conversion disorder)

Why this is the answer

Functional neurological symptom disorder involves motor or sensory symptoms incompatible with recognised neurological conditions. It does not require proof of a psychological cause or that the symptoms are feigned.

Answer

C · Functional neurological symptom disorder (conversion disorder)
5.Pharmacology

Answer: B · It must be diluted and given as an infusion, never as an IV push

Why this is the answer

Concentrated potassium given as a bolus can cause fatal cardiac arrhythmias. It is always diluted and given at a controlled rate, usually with an infusion pump.

Answer

B · It must be diluted and given as an infusion, never as an IV push
6.Pharmacology

Answer: D · A prescribing cascade

Why this is the answer

In a prescribing cascade, an adverse effect of one drug is mistaken for a new condition and treated with another drug, which brings new risks. Amlodipine oedema does not respond well to diuretics; reviewing the original drug is better.

Answer

D · A prescribing cascade

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