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 behaviour is a warning sign of possible suicidal intent in a depressed patient?

  1. AGiving away valued possessions and suddenly seeming calm
  2. BTalking about their favourite music
  3. CAsking for help with a job application for after discharge
  4. DMaking plans for a family holiday
2.Mental health nursingHard

A patient in alcohol withdrawal had a CIWA-Ar score of 8 four hours ago. It is now 22, and he is sweating heavily and very anxious. What should the nurse do?

  1. AReduce monitoring, because a higher score on this scale means that his withdrawal is improving
  2. BEncourage him to drink a large glass of wine to settle the symptoms
  3. CGive the prescribed symptom-triggered benzodiazepine, increase monitoring and inform the prescriber
  4. DWait for the next routine score in four hours before deciding
3.Clinical psychologyMedium

The therapeutic alliance refers to:

  1. AThe client's diagnosis, as agreed independently by two psychiatrists at the initial assessment
  2. BThe collaborative bond and agreement on goals and tasks between therapist and client
  3. CA group of therapists who share referrals
  4. DA legal contract between a clinic and an insurer
4.Clinical psychologyHard

A man says that a famous singer is secretly in love with him and sends him coded messages through her songs. Apart from this, his thinking and behaviour are normal, with no hallucinations. Which diagnosis fits best?

  1. ADelusional disorder, erotomanic type
  2. BBipolar disorder with mania
  3. CNarcissistic personality disorder
  4. DSchizophrenia, paranoid type
5.PharmacologyMedium

Which fraction of a drug in plasma can reach the receptor and produce an effect?

  1. AThe unbound (free) fraction
  2. BThe fraction bound to globulins
  3. CThe fraction stored in red blood cells
  4. DThe fraction bound to albumin
6.PharmacologyHard

Some receptors show activity even without an agonist. How does an inverse agonist differ from a neutral antagonist at such receptors?

  1. AIt has no effect when given alone
  2. BIt reduces activity below the baseline level
  3. CIt destroys the receptor permanently
  4. DIt increases activity above the baseline

3Solutions

1.Mental health nursing

Answer: A · Giving away valued possessions and suddenly seeming calm

Why this is the answer

Warning signs include talk of death, giving away possessions, saying goodbye, a sudden improvement in mood after deep depression, and searching for means.

Answer

A · Giving away valued possessions and suddenly seeming calm
2.Mental health nursing

Answer: C · Give the prescribed symptom-triggered benzodiazepine, increase monitoring and inform the prescriber

Why this is the answer

A rising CIWA-Ar score shows worsening withdrawal. Symptom-triggered benzodiazepine treatment, closer observation and medical review help prevent seizures and delirium tremens.

Answer

C · Give the prescribed symptom-triggered benzodiazepine, increase monitoring and inform the prescriber
3.Clinical psychology

Answer: B · The collaborative bond and agreement on goals and tasks between therapist and client

Why this is the answer

The therapeutic alliance consistently predicts therapy outcome across different approaches, which supports the importance of common factors in psychotherapy.

Answer

B · The collaborative bond and agreement on goals and tasks between therapist and client
4.Clinical psychology

Answer: A · Delusional disorder, erotomanic type

Why this is the answer

Delusional disorder involves one or more delusions for at least a month without meeting criteria for schizophrenia, and functioning is not markedly impaired apart from the delusion. Erotomanic delusions concern another person being in love with the patient.

Answer

A · Delusional disorder, erotomanic type
5.Pharmacology

Answer: A · The unbound (free) fraction

Why this is the answer

Only the free drug can diffuse into tissues, act on receptors and be metabolised or excreted. Protein-bound drug acts as a reservoir.

Answer

A · The unbound (free) fraction
6.Pharmacology

Answer: B · It reduces activity below the baseline level

Why this is the answer

A neutral antagonist simply blocks agonists and leaves baseline activity unchanged. An inverse agonist stabilises the inactive receptor state, so constitutive activity falls below baseline.

Answer

B · It reduces activity below the baseline level

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