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 finding in a patient with anorexia nervosa is most concerning?

  1. AFeeling cold in a warm room
  2. BConstipation for the past few days
  3. CDry skin and brittle hair
  4. DA resting heart rate of 38/min
2.Mental health nursingHard

A nurse posts on social media about a "funny" patient on her ward, without giving his name. What is correct?

  1. AIt is acceptable if the post is set to "friends only"
  2. BIt is only a problem if the patient finds the post himself
  3. CIt breaches confidentiality, because he could still be identified
  4. DIt is acceptable because his name was not used
3.Clinical psychologyMedium

Which statement best distinguishes obsessive-compulsive personality disorder (OCPD) from OCD?

  1. AIn OCPD, intrusive unwanted thoughts trigger rituals that the person recognises as excessive
  2. BIn OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self
  3. COCPD always involves hand washing
  4. DOCPD is a psychotic disorder
4.Clinical psychologyHard

A clinician considers whether a categorical or dimensional approach to personality disorders is better. Which point favours a dimensional approach?

  1. APersonality traits are either fully present or fully absent in any one person
  2. BCategories have been shown to give perfect inter-rater reliability
  3. CDimensional models cannot be measured with questionnaires or interviews
  4. DTraits vary continuously, and categories overlap with arbitrary cut-offs
5.PharmacologyMedium

Which statement about allopurinol is correct?

  1. AIt is taken only during an acute attack and stopped as soon as the pain settles
  2. BIt lowers uric acid over time and does not relieve the pain of an acute attack
  3. CIt works within an hour to relieve joint pain
  4. DIt increases uric acid production to flush out crystals
6.PharmacologyHard

An older patient on amlodipine develops ankle swelling and is prescribed furosemide. She then becomes dizzy and falls. What does this sequence illustrate?

  1. AA type B allergic reaction
  2. BEnzyme induction
  3. CA prescribing cascade
  4. DDrug tolerance

3Solutions

1.Mental health nursing

Answer: D · A resting heart rate of 38/min

Why this is the answer

Severe bradycardia suggests cardiovascular compromise from starvation and can lead to dangerous arrhythmias. It is a common reason for urgent medical admission.

Answer

D · A resting heart rate of 38/min
2.Mental health nursing

Answer: C · It breaches confidentiality, because he could still be identified

Why this is the answer

Sharing patient information on social media, even without a name, can identify the patient and breaches confidentiality and dignity. Professional codes prohibit it.

Answer

C · It breaches confidentiality, because he could still be identified
3.Clinical psychology

Answer: B · In OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self

Why this is the answer

OCPD is a pervasive pattern of perfectionism, orderliness and control that the person sees as appropriate (ego-syntonic). OCD obsessions are unwanted and distressing (ego-dystonic).

Answer

B · In OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self
4.Clinical psychology

Answer: D · Traits vary continuously, and categories overlap with arbitrary cut-offs

Why this is the answer

Categorical diagnoses overlap heavily and treat a continuum as present/absent. DSM-5 Section III and ICD-11 therefore offer trait-based dimensional models of personality disorder.

Answer

D · Traits vary continuously, and categories overlap with arbitrary cut-offs
5.Pharmacology

Answer: B · It lowers uric acid over time and does not relieve the pain of an acute attack

Why this is the answer

Allopurinol reduces urate production and is taken daily to prevent attacks. Acute attacks are treated with NSAIDs, colchicine or corticosteroids, and a new rash on allopurinol must be reported.

Answer

B · It lowers uric acid over time and does not relieve the pain of an acute attack
6.Pharmacology

Answer: C · A prescribing cascade

Why this is the answer

In a prescribing cascade, an adverse effect of one drug is mistaken for a new condition and treated with another drug, which brings new risks. Amlodipine oedema does not respond well to diuretics; reviewing the original drug is better.

Answer

C · A prescribing cascade

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