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 statement about benzodiazepines in anxiety disorders is correct?

  1. AThey are safe to stop suddenly after many months of daily use
  2. BThey take 4–6 weeks to have any effect on anxiety, like antidepressants
  3. CThey give rapid relief but are generally used only short-term because of tolerance and dependence
  4. DThey are the preferred long-term treatment for generalised anxiety disorder
2.Mental health nursingHard

On the second day after his last drink, a patient has a marked tremor, sees insects on the walls, a heart rate of 124/min, a blood pressure of 170/100 mmHg and heavy sweating. What is the priority?

  1. ATreat it as possible delirium tremens: get urgent medical help, give benzodiazepines as prescribed and keep him safe
  2. BGive him a small amount of alcohol to settle the symptoms, then let him sleep it off in a quiet side room with the door closed
  3. CRestrict his fluid intake
  4. DExplain that the insects are not real and leave him to rest
3.Clinical psychologyMedium

In Beck's cognitive model of depression, the "cognitive triad" consists of negative views about:

  1. AParents, friends and teachers
  2. BOneself, the world and the future
  3. COne's past, present and future only
  4. DBody, mind and spirit
4.Clinical psychologyHard

A therapist says: "Rather than fighting the thought 'I'm a failure', notice it as just a thought, and act on what matters to you." Which therapy does this best represent?

  1. AAcceptance and commitment therapy (ACT)
  2. BClassical psychoanalysis
  3. CRational emotive behaviour therapy
  4. DSystematic desensitisation
5.PharmacologyMedium

What makes an overdose of tricyclic antidepressants such as amitriptyline especially dangerous?

  1. ASevere liver failure within hours
  2. BSudden high blood glucose
  3. CCardiac arrhythmias and seizures
  4. DKidney stones
6.PharmacologyHard

A patient taking co-trimoxazole develops fever, a spreading blistering rash and painful mouth sores. What is the most likely diagnosis?

  1. AOral thrush; start an antifungal and continue the antibiotic
  2. BA mild rash that will settle; continue the drug and give moisturiser
  3. CStevens–Johnson syndrome; stop the drug and get urgent medical care
  4. DSunburn caused by the drug; advise sunscreen only

3Solutions

1.Mental health nursing

Answer: C · They give rapid relief but are generally used only short-term because of tolerance and dependence

Why this is the answer

Benzodiazepines act quickly by enhancing GABA, but long-term use leads to tolerance, dependence and withdrawal. SSRIs and psychological therapy are first-line long-term treatments for most anxiety disorders.

Answer

C · They give rapid relief but are generally used only short-term because of tolerance and dependence
2.Mental health nursing

Answer: A · Treat it as possible delirium tremens: get urgent medical help, give benzodiazepines as prescribed and keep him safe

Why this is the answer

Hallucinations, autonomic instability and tremor 48–96 hours after the last drink suggest delirium tremens, a medical emergency. Treatment includes benzodiazepines, fluids, thiamine, close monitoring and a safe, calm environment.

Answer

A · Treat it as possible delirium tremens: get urgent medical help, give benzodiazepines as prescribed and keep him safe
3.Clinical psychology

Answer: B · Oneself, the world and the future

Why this is the answer

Beck proposed that depressed people hold negative views of the self, the world (or experiences) and the future, maintained by cognitive distortions.

Answer

B · Oneself, the world and the future
4.Clinical psychology

Answer: A · Acceptance and commitment therapy (ACT)

Why this is the answer

ACT (Hayes) uses acceptance, cognitive defusion and values-based action. Unlike traditional cognitive therapy, it does not try to dispute the content of thoughts.

Answer

A · Acceptance and commitment therapy (ACT)
5.Pharmacology

Answer: C · Cardiac arrhythmias and seizures

Why this is the answer

Tricyclics block cardiac sodium channels (widening the QRS complex) and have anticholinergic effects. In overdose they cause arrhythmias, hypotension, seizures and coma.

Answer

C · Cardiac arrhythmias and seizures
6.Pharmacology

Answer: C · Stevens–Johnson syndrome; stop the drug and get urgent medical care

Why this is the answer

Stevens–Johnson syndrome is a severe drug reaction with skin blistering and mucosal involvement. Sulfonamides are a common cause, and the drug must be stopped immediately.

Answer

C · Stevens–Johnson syndrome; stop the drug and get urgent medical care

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