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

A patient is found unresponsive with a respiratory rate of 6/min and pinpoint pupils. What should the nurse do first?

  1. ACall for help, open the airway and support breathing, and give naloxone as prescribed or per protocol
  2. BGive flumazenil
  3. CPlace the patient in the recovery position and wait for the patient to wake up naturally before calling anyone
  4. DGive a large glass of water
3.Clinical psychologyMedium

A person avoids buses, shops, open car parks and queues because escape might be difficult if they panic. Which diagnosis fits best?

  1. AClaustrophobia as a specific phobia
  2. BGeneralised anxiety disorder
  3. CAgoraphobia
  4. DSocial anxiety disorder
4.Clinical psychologyHard

The dopamine hypothesis of schizophrenia is supported by the observation that:

  1. ADrugs that increase dopamine, such as amphetamines, can trigger psychotic symptoms
  2. BAll patients respond equally well to antidepressants
  3. CSerotonin levels alone predict symptoms
  4. DAntipsychotics increase dopamine activity in the mesolimbic pathway and reduce symptoms
5.PharmacologyMedium

A parent will give a liquid medicine to a child at home. Which advice is safest?

  1. AMix the dose into a full bottle of milk
  2. BUse any kitchen teaspoon
  3. CUse the oral syringe or measuring cup supplied with it
  4. DEstimate the dose by pouring the liquid into a small cup
6.PharmacologyHard

A patient develops a dry cough on an ACE inhibitor and is switched to losartan. Why is losartan less likely to cause cough?

  1. AIt does not block the breakdown of bradykinin
  2. BIt also acts as a bronchodilator
  3. CIt blocks histamine receptors in the airways
  4. DIt is excreted faster by the kidney

3Solutions

1.Mental health nursing

Answer: B · 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

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

Answer: A · Call for help, open the airway and support breathing, and give naloxone as prescribed or per protocol

Why this is the answer

Airway and breathing support come first, with naloxone given to reverse opioid effects. The patient is monitored closely because naloxone may wear off before the opioid.

Answer

A · Call for help, open the airway and support breathing, and give naloxone as prescribed or per protocol
3.Clinical psychology

Answer: C · Agoraphobia

Why this is the answer

Agoraphobia involves fear of at least two situations (public transport, open spaces, enclosed spaces, crowds or queues, being outside alone) because escape or help might be unavailable.

Answer

C · Agoraphobia
4.Clinical psychology

Answer: A · Drugs that increase dopamine, such as amphetamines, can trigger psychotic symptoms

Why this is the answer

Amphetamines can induce psychosis and D2-blocking antipsychotics reduce positive symptoms. Negative symptoms are less well explained, so the hypothesis has been revised.

Answer

A · Drugs that increase dopamine, such as amphetamines, can trigger psychotic symptoms
5.Pharmacology

Answer: C · Use the oral syringe or measuring cup supplied with it

Why this is the answer

Kitchen spoons are inaccurate and can cause under- or overdosing. Oral syringes in millilitres are the most accurate, and mixing doses into a whole bottle risks the child not getting the full dose.

Answer

C · Use the oral syringe or measuring cup supplied with it
6.Pharmacology

Answer: A · It does not block the breakdown of bradykinin

Why this is the answer

ACE (kininase II) breaks down bradykinin, so ACE inhibitors raise bradykinin, which can cause cough and angioedema. ARBs block the angiotensin II receptor without affecting bradykinin breakdown.

Answer

A · It does not block the breakdown of bradykinin

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