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 tool is widely used to screen for delirium at the bedside?

  1. AThe Abnormal Involuntary Movement Scale (AIMS)
  2. BThe CAGE questionnaire
  3. CThe Confusion Assessment Method (CAM)
  4. DThe CIWA-Ar
2.Mental health nursingHard

A man has odd beliefs about being able to read minds, dresses eccentrically and has few friends because others make him anxious. He has never had sustained hallucinations or delusions. Which diagnosis fits best?

  1. AHistrionic personality disorder with odd dress
  2. BSchizophrenia
  3. CSchizotypal personality disorder
  4. DAntisocial personality disorder
3.Clinical psychologyMedium

Which personality disorder is marked by instability in relationships, self-image and emotions, together with marked impulsivity?

  1. ABorderline personality disorder
  2. BSchizoid personality disorder
  3. CAvoidant personality disorder
  4. DNarcissistic personality disorder
4.Clinical psychologyHard

Why did DSM-5 replace "substance abuse" and "substance dependence" with a single "substance use disorder"?

  1. AAbuse was reclassified as a personality disorder, while dependence became a purely medical condition
  2. BThe WHO banned the terms
  3. CDependence was found not to exist
  4. DThe two categories were found to reflect one dimension better described by severity levels
5.PharmacologyMedium

1000 mL of IV fluid is to be given over 8 hours with a pump. What rate should be set?

  1. A80 mL/h
  2. B125 mL/h
  3. C100 mL/h
  4. D250 mL/h
6.PharmacologyHard

A teenager took a large overdose of diphenhydramine. He is agitated, hot, flushed and confused, with dry skin, dilated pupils and a full bladder. What is this pattern?

  1. ASerotonin syndrome
  2. BCholinergic toxidrome
  3. CAnticholinergic toxidrome
  4. DOpioid toxidrome

3Solutions

1.Mental health nursing

Answer: C · The Confusion Assessment Method (CAM)

Why this is the answer

The CAM checks for acute onset and fluctuating course, inattention, and either disorganised thinking or an altered level of consciousness. Other tools, such as the 4AT, are also used.

Answer

C · The Confusion Assessment Method (CAM)
2.Mental health nursing

Answer: C · Schizotypal personality disorder

Why this is the answer

Schizotypal personality disorder involves odd beliefs, magical thinking, eccentric behaviour and social anxiety. It lies on the schizophrenia spectrum, but without the sustained psychotic symptoms of schizophrenia.

Answer

C · Schizotypal personality disorder
3.Clinical psychology

Answer: A · Borderline personality disorder

Why this is the answer

Borderline personality disorder involves unstable relationships and identity, affective instability, fear of abandonment, impulsivity and recurrent self-harm. DBT is a well-supported treatment.

Answer

A · Borderline personality disorder
4.Clinical psychology

Answer: D · The two categories were found to reflect one dimension better described by severity levels

Why this is the answer

Research suggested that abuse and dependence criteria form a single continuum. DSM-5 merged them into one disorder rated by the number of criteria met.

Answer

D · The two categories were found to reflect one dimension better described by severity levels
5.Pharmacology

Answer: B · 125 mL/h

Why this is the answer

1000 mL ÷ 8 h = 125 mL/h. Infusion pumps are set in mL per hour.

Answer

B · 125 mL/h
6.Pharmacology

Answer: C · Anticholinergic toxidrome

Why this is the answer

Anticholinergic toxicity causes hyperthermia, dry flushed skin, mydriasis, urinary retention, tachycardia and delirium. Dry skin helps distinguish it from serotonin syndrome and sympathomimetic poisoning, which cause sweating.

Answer

C · Anticholinergic toxidrome

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