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 a high-dose corticosteroid (prednisolone or prednisone) a week ago is now euphoric, sleeping little and talking very fast. What should the nurse suspect?

  1. AMood changes caused by the corticosteroid
  2. BA normal reaction to feeling better from the treatment
  3. CLithium toxicity
  4. DAlcohol withdrawal
2.Mental health nursingHard

The parent of a child recently diagnosed with autism asks, "Did his vaccines cause this?" What is the most accurate response?

  1. A"Large studies have found no link between vaccines and autism."
  2. B"Yes, the MMR vaccine is a proven cause of autism."
  3. C"We don't know, so it is best to stop all of his other vaccines."
  4. D"Autism is caused by cold and distant parenting styles in early childhood."
3.Clinical psychologyMedium

Behavioural activation treats depression mainly by:

  1. AExploring childhood conflicts in detail
  2. BPrescribing a period of complete rest
  3. CIncreasing engagement in rewarding and valued activities
  4. DExposing the person to feared bodily sensations in a graded way
4.Clinical psychologyHard

The "Dodo bird verdict" in psychotherapy research refers to the finding that:

  1. AMedication always outperforms psychotherapy
  2. BOnly psychoanalysis is effective for depression
  3. CUntreated clients on waiting lists improve faster than treated clients
  4. DDifferent bona fide therapies often produce broadly similar outcomes
5.PharmacologyMedium

Which assessment is most important during IV mannitol therapy?

  1. ALiver enzymes and signs of jaundice
  2. BBlood glucose before meals and signs of hypoglycaemia
  3. CPlatelet count and signs of bleeding
  4. DUrine output, electrolytes and signs of fluid overload
6.PharmacologyHard

A patient has received a sodium nitroprusside infusion for several days. He becomes confused and develops a metabolic acidosis. What should be suspected?

  1. ACyanide toxicity from nitroprusside breakdown
  2. BHypoglycaemia from nitroprusside
  3. CAn allergic reaction to the plastic of the infusion bag
  4. DHyperkalaemia from the infusion

3Solutions

1.Mental health nursing

Answer: A · Mood changes caused by the corticosteroid

Why this is the answer

High-dose corticosteroids can cause mood changes, including mania, depression and psychosis. The nurse reports the change so the prescriber can review the dose and treatment.

Answer

A · Mood changes caused by the corticosteroid
2.Mental health nursing

Answer: A · "Large studies have found no link between vaccines and autism."

Why this is the answer

Large, well-conducted studies have found no link between vaccines and autism, and the paper that first claimed a link was retracted. Autism is a neurodevelopmental condition with strong genetic contributions.

Answer

A · "Large studies have found no link between vaccines and autism."
3.Clinical psychology

Answer: C · Increasing engagement in rewarding and valued activities

Why this is the answer

Behavioural activation schedules activities that bring pleasure or mastery, breaking the cycle of withdrawal and low reinforcement. It is an evidence-based treatment for depression.

Answer

C · Increasing engagement in rewarding and valued activities
4.Clinical psychology

Answer: D · Different bona fide therapies often produce broadly similar outcomes

Why this is the answer

Meta-analyses often find small differences between established therapies, which has been taken to support common factors such as the alliance. Some disorders, such as OCD and phobias, show clear advantages for specific treatments like exposure.

Answer

D · Different bona fide therapies often produce broadly similar outcomes
5.Pharmacology

Answer: D · Urine output, electrolytes and signs of fluid overload

Why this is the answer

Mannitol draws fluid into the circulation before it is excreted, which can cause heart failure and pulmonary oedema. The large diuresis can cause dehydration and electrolyte imbalance, so output and electrolytes are monitored.

Answer

D · Urine output, electrolytes and signs of fluid overload
6.Pharmacology

Answer: A · Cyanide toxicity from nitroprusside breakdown

Why this is the answer

Nitroprusside releases cyanide, which is normally converted to thiocyanate. With high doses, long infusions or poor organ function, cyanide and thiocyanate can accumulate; the infusion is also protected from light.

Answer

A · Cyanide toxicity from nitroprusside breakdown

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