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

How does memantine work in Alzheimer's disease?

  1. AIt inhibits the breakdown of acetylcholine
  2. BIt blocks NMDA glutamate receptors
  3. CIt blocks dopamine D2 receptors
  4. DIt increases serotonin by blocking its reuptake
2.Mental health nursingHard

A patient who took a high-dose benzodiazepine daily for a year tells you she stopped it suddenly 2 days ago. What is the main risk?

  1. AWeight gain
  2. BHypoglycaemia
  3. CHair loss
  4. DWithdrawal seizures
3.Clinical psychologyMedium

Which feature distinguishes generalised anxiety disorder from panic disorder?

  1. APersistent, excessive worry about many everyday matters
  2. BSudden attacks of intense fear peaking within minutes
  3. CFear of a single specific object, such as spiders or heights
  4. DRepetitive rituals
4.Clinical psychologyHard

A man who hears the word "thud" is admitted to hospital, then behaves normally. Staff record his note-taking as "engages in writing behaviour". In Rosenhan's study, what does this illustrate?

  1. AOnce a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
  2. BNote-taking is a recognised symptom of schizophrenia, so the staff were right to record it as such
  3. CPseudopatients developed real symptoms in hospital
  4. DStaff deliberately falsified records
5.PharmacologyMedium

Why is aspirin avoided in children and teenagers with viral illnesses such as flu or chickenpox?

  1. AIt causes severe, permanent hearing loss in young children
  2. BIt stops the vaccine from working
  3. CIt is linked to Reye's syndrome, which harms the liver and brain
  4. DIt causes grey baby syndrome
6.PharmacologyHard

Lithium taken in the first trimester of pregnancy has been linked to which type of birth defect?

  1. ACleft lip and palate only
  2. BNeural tube defects such as spina bifida
  3. CHeart malformations, such as Ebstein's anomaly
  4. DLimb defects similar to thalidomide

3Solutions

1.Mental health nursing

Answer: B · It blocks NMDA glutamate receptors

Why this is the answer

Memantine is an NMDA receptor antagonist used in moderate to severe Alzheimer's disease. It may be combined with a cholinesterase inhibitor.

Answer

B · It blocks NMDA glutamate receptors
2.Mental health nursing

Answer: D · Withdrawal seizures

Why this is the answer

Abrupt withdrawal after long-term high-dose use can cause severe anxiety, tremor, perceptual disturbances and seizures. The prescriber should be informed and a supervised taper considered.

Answer

D · Withdrawal seizures
3.Clinical psychology

Answer: A · Persistent, excessive worry about many everyday matters

Why this is the answer

GAD involves ongoing, hard-to-control worry about various topics for at least six months. Panic disorder involves recurrent unexpected panic attacks.

Answer

A · Persistent, excessive worry about many everyday matters
4.Clinical psychology

Answer: A · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder

Why this is the answer

Rosenhan argued that the label "schizophrenic" made staff see ordinary behaviour as pathological. Critics such as Spitzer argued the study did not prove diagnosis was invalid.

Answer

A · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
5.Pharmacology

Answer: C · It is linked to Reye's syndrome, which harms the liver and brain

Why this is the answer

Aspirin given during viral infections in young people is associated with Reye's syndrome, causing acute encephalopathy and liver failure. Paracetamol or ibuprofen is used for fever instead.

Answer

C · It is linked to Reye's syndrome, which harms the liver and brain
6.Pharmacology

Answer: C · Heart malformations, such as Ebstein's anomaly

Why this is the answer

First-trimester lithium is associated with a small increased risk of cardiac malformations, classically Ebstein's anomaly. Women of childbearing age need counselling and specialist planning before pregnancy.

Answer

C · Heart malformations, such as Ebstein's anomaly

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