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

A severely depressed older patient says, "My insides have rotted away; I am already dead." Which type of delusion is this?

  1. AGrandiose
  2. BErotomanic
  3. CNihilistic
  4. DPersecutory
2.Mental health nursingHard

An 8-year-old with separation anxiety disorder has missed two weeks of school. What is the most helpful approach?

  1. ALet a parent stay with him in class every day for the rest of the year
  2. BSupport a gradual, planned return to school with a consistent goodbye routine
  3. CAllow him to stay at home until he wants to go back
  4. DTell him that he is being silly and must go
3.Clinical psychologyMedium

Which personality disorder is characterised by a pervasive pattern of disregard for the rights of others?

  1. AAntisocial personality disorder
  2. BBorderline personality disorder
  3. CDependent personality disorder
  4. DAvoidant personality disorder
4.Clinical psychologyHard

A therapist helps a client with panic disorder deliberately bring on dizziness by spinning in a chair, without using safety behaviours. What is this technique called and why is it used?

  1. AAversion therapy, so the client learns to associate panic with physical discomfort
  2. BFlooding, so the client forgets their trauma
  3. CFree association, so unconscious fears come to light
  4. DInteroceptive exposure, so the client learns bodily sensations are not dangerous
5.PharmacologyMedium

What does the clearance of a drug describe?

  1. AThe amount of drug removed by one dialysis session
  2. BThe volume of plasma cleared of the drug per unit of time
  3. CThe fraction of the dose that is absorbed
  4. DThe time needed for the drug to disappear completely from the plasma
6.PharmacologyHard

A patient on valproate becomes lethargic, starts vomiting and develops jaundice. Which adverse effect should be suspected first?

  1. AKidney stones
  2. BLiver toxicity
  3. CNormal start-up side effects
  4. DHypothyroidism

3Solutions

1.Mental health nursing

Answer: C · Nihilistic

Why this is the answer

Nihilistic delusions are beliefs that the self, the body or the world does not exist or has been destroyed. They can occur in psychotic depression and require urgent assessment, including of nutrition and suicide risk.

Answer

C · Nihilistic
2.Mental health nursing

Answer: B · Support a gradual, planned return to school with a consistent goodbye routine

Why this is the answer

Long-term avoidance strengthens anxiety. A gradual, planned return, short and predictable goodbyes, praise for brave behaviour and cooperation between parents and school, often with CBT, help the child cope.

Answer

B · Support a gradual, planned return to school with a consistent goodbye routine
3.Clinical psychology

Answer: A · Antisocial personality disorder

Why this is the answer

Antisocial personality disorder includes deceitfulness, impulsivity, aggression and lack of remorse, with evidence of conduct disorder in childhood.

Answer

A · Antisocial personality disorder
4.Clinical psychology

Answer: D · Interoceptive exposure, so the client learns bodily sensations are not dangerous

Why this is the answer

Interoceptive exposure provokes feared bodily sensations so the client can test catastrophic predictions and habituate. It is a core part of CBT for panic disorder.

Answer

D · Interoceptive exposure, so the client learns bodily sensations are not dangerous
5.Pharmacology

Answer: B · The volume of plasma cleared of the drug per unit of time

Why this is the answer

Clearance is the volume of plasma from which the drug is removed per unit of time. Together with the dosing rate it determines the steady-state concentration.

Answer

B · The volume of plasma cleared of the drug per unit of time
6.Pharmacology

Answer: B · Liver toxicity

Why this is the answer

Valproate can cause serious hepatotoxicity, especially in young children and early in treatment. Liver function tests are checked, and the drug may need to be stopped; pancreatitis is another serious risk.

Answer

B · Liver toxicity

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