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 patient who started lithium 2 weeks ago has a fine tremor of the hands and is passing more urine than usual. Her level is within the therapeutic range. How should the nurse interpret this?

  1. AThese are signs of an allergic reaction, so she should never take lithium again
  2. BThese are definite signs of severe lithium toxicity, so emergency dialysis is needed straight away
  3. CThese symptoms mean that the lithium is not working, so the dose should be stopped and a new drug chosen
  4. DThese are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
2.Mental health nursingHard

A patient has just been placed in physical restraint after violent behaviour. Which assessment is the highest priority?

  1. ABreathing and circulation, with continuous observation
  2. BWhether the patient is ready to rejoin group activities
  3. CThe patient's dietary preferences
  4. DWhether the patient understands why restraint was used
3.Clinical psychologyMedium

A man is socially inhibited, feels inadequate and avoids jobs involving contact with people because he fears criticism, though he wants close relationships. Which disorder fits best?

  1. AHistrionic personality disorder
  2. BAvoidant personality disorder
  3. CSchizoid personality disorder
  4. DAntisocial personality disorder
4.Clinical psychologyHard

An interview that follows a fixed set of questions in a fixed order to reach a diagnosis is called:

  1. AA free association session
  2. BA projective test
  3. CA structured clinical interview
  4. DAn unstructured interview
5.PharmacologyMedium

A patient with insulin-treated diabetes is found unconscious with very low blood glucose. There is no IV access. Which drug can a trained helper give?

  1. AGlucagon by injection or nasal spray
  2. BRapid-acting insulin under the skin
  3. CIntramuscular adrenaline
  4. DOral glucose gel poured into the mouth
6.PharmacologyHard

A patient with severe liver cirrhosis needs a benzodiazepine for alcohol withdrawal. Why is lorazepam often chosen instead of diazepam?

  1. ALorazepam is excreted unchanged in the urine without any metabolism
  2. BLorazepam is a stronger anticonvulsant than all other benzodiazepines
  3. CLorazepam does not cause sedation in liver disease
  4. DLorazepam is cleared by simple conjugation and has no active metabolites

3Solutions

1.Mental health nursing

Answer: D · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored

Why this is the answer

Fine tremor, thirst, polyuria and mild nausea are common early effects of lithium. A coarse tremor, vomiting, diarrhoea, confusion or unsteadiness suggest toxicity.

Answer

D · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
2.Mental health nursing

Answer: A · Breathing and circulation, with continuous observation

Why this is the answer

Deaths during restraint are often caused by breathing problems. A debrief about the reasons comes later, when the patient is calm. Continuous monitoring of breathing, airway, circulation, skin and mental state is essential, and restraint ends as soon as it is safe.

Answer

A · Breathing and circulation, with continuous observation
3.Clinical psychology

Answer: B · Avoidant personality disorder

Why this is the answer

Avoidant personality disorder (Cluster C) involves hypersensitivity to negative evaluation and social inhibition. In schizoid personality disorder, the person shows little desire for close relationships.

Answer

B · Avoidant personality disorder
4.Clinical psychology

Answer: C · A structured clinical interview

Why this is the answer

Structured interviews such as the SCID ask standard questions tied to diagnostic criteria, increasing reliability compared with unstructured interviews.

Answer

C · A structured clinical interview
5.Pharmacology

Answer: A · Glucagon by injection or nasal spray

Why this is the answer

Glucagon breaks down liver glycogen and raises blood glucose. Nothing is given by mouth to an unconscious patient because of the risk of choking and aspiration.

Answer

A · Glucagon by injection or nasal spray
6.Pharmacology

Answer: D · Lorazepam is cleared by simple conjugation and has no active metabolites

Why this is the answer

Diazepam is metabolised by CYP enzymes into long-acting active metabolites, which accumulate in liver failure. Lorazepam, oxazepam and temazepam are glucuronidated, a process better preserved in liver disease.

Answer

D · Lorazepam is cleared by simple conjugation and has no active metabolites

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