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 uses the word "glimpotrance" and explains that it means the force that controls his thoughts. What is this?

  1. AA neologism
  2. BCircumstantiality
  3. CEcholalia
  4. DA clang association
2.Mental health nursingHard

A child has been admitted several times with unexplained fevers that only happen when her mother is present. Staff see the mother tampering with the child's IV line. What is the priority action?

  1. AEnsure the child's safety and follow child protection procedures
  2. BDiscuss the matter with the mother alone and ask her to stop
  3. CDischarge the child home with the mother as soon as possible
  4. DDocument the event carefully in the notes and wait to see whether it happens again before telling anyone else
3.Clinical psychologyMedium

Reliability of a diagnosis refers to:

  1. AWhether the diagnosis is accepted by the patient
  2. BWhether the diagnosis accurately predicts the course and outcome of the illness
  3. CWhether the diagnosis uses medical tests
  4. DWhether different clinicians reach the same diagnosis for the same patient
4.Clinical psychologyHard

A study compares a new therapy with a waiting-list control and finds a large benefit. Why might this overestimate the therapy's specific effect?

  1. AA waiting list controls for time passing but not for attention, expectation or the alliance
  2. BWaiting lists remove the placebo effect completely, so any benefit must come from the therapy itself
  3. CWaiting-list controls always receive the same therapy
  4. DWaiting-list participants cannot be randomised
5.PharmacologyMedium

A woman taking tamoxifen should report which symptom promptly?

  1. AMild hot flushes, especially at night, in the first months
  2. BUnusual vaginal bleeding or a painful swollen leg
  3. CSlightly dry skin
  4. DMild tiredness in the afternoon
6.PharmacologyHard

A patient on adalimumab for rheumatoid arthritis has a fever and cough on the day of her next injection. What should the nurse advise?

  1. AWithhold the injection and get the infection assessed first
  2. BDouble the next dose to make up for the infection
  3. CStop the drug permanently without telling the prescriber
  4. DGive the injection, as it will help the fever

3Solutions

1.Mental health nursing

Answer: A · A neologism

Why this is the answer

Neologisms are invented words, or real words given a private meaning, and are a sign of disorganised thinking.

Answer

A · A neologism
2.Mental health nursing

Answer: A · Ensure the child's safety and follow child protection procedures

Why this is the answer

This suggests factitious disorder imposed on another, which is a form of child abuse. The nurse protects the child and reports through safeguarding procedures. Confronting the parent alone can increase the risk to the child.

Answer

A · Ensure the child's safety and follow child protection procedures
3.Clinical psychology

Answer: D · Whether different clinicians reach the same diagnosis for the same patient

Why this is the answer

Reliability is consistency of diagnosis between clinicians or over time. Validity is whether the diagnosis reflects a real, meaningful category.

Answer

D · Whether different clinicians reach the same diagnosis for the same patient
4.Clinical psychology

Answer: A · A waiting list controls for time passing but not for attention, expectation or the alliance

Why this is the answer

Waiting-list designs show that therapy beats no treatment, but common factors such as hope and therapist contact are not controlled. An active comparison or attention-placebo control is needed to test specific ingredients.

Answer

A · A waiting list controls for time passing but not for attention, expectation or the alliance
5.Pharmacology

Answer: B · Unusual vaginal bleeding or a painful swollen leg

Why this is the answer

Tamoxifen has oestrogen-like effects on the uterus and clotting, increasing the risk of endometrial cancer and venous thromboembolism. Hot flushes are common and expected.

Answer

B · Unusual vaginal bleeding or a painful swollen leg
6.Pharmacology

Answer: A · Withhold the injection and get the infection assessed first

Why this is the answer

TNF inhibitors increase the risk of serious infections and can mask their signs. Doses are usually withheld during an active infection until it has been assessed and treated.

Answer

A · Withhold the injection and get the infection assessed first

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