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 lies awake in bed for hours worrying about not sleeping. Which stimulus control advice is correct?

  1. ALook at the clock often to check how much sleep is being lost
  2. BIf still awake after about 20 minutes, get up, do something calm and return when sleepy
  3. CStay in bed and watch television or use a phone until sleep finally comes
  4. DDo vigorous exercise in the bedroom until tired enough to fall asleep straight away
2.Mental health nursingHard

A patient in acute mania has slept for 2 hours in 3 nights, is losing weight and is pacing constantly. Which nursing concern is the priority?

  1. ALack of knowledge about the illness
  2. BRisk of physical exhaustion and injury
  3. CDisturbed relationships with her family
  4. DLow self-esteem
3.Clinical psychologyMedium

The therapeutic alliance refers to:

  1. AA group of therapists who share referrals
  2. BA legal contract between a clinic and an insurer
  3. CThe collaborative bond and agreement on goals and tasks between therapist and client
  4. DThe client's diagnosis, as agreed independently by two psychiatrists at the initial assessment
4.Clinical psychologyHard

A chronic heavy drinker develops confusion, an unsteady gait and abnormal eye movements. Which deficiency must be treated urgently?

  1. AIron
  2. BVitamin C
  3. CVitamin D
  4. DThiamine (vitamin B1)
5.PharmacologyMedium

Which blood test is commonly used to monitor a continuous infusion of unfractionated heparin?

  1. AINR (international normalised ratio, prothrombin time)
  2. BActivated partial thromboplastin time (aPTT)
  3. CSerum potassium
  4. DHaemoglobin A1c
6.PharmacologyHard

A drug with a short half-life is given at a dosing interval much longer than its half-life. What is the result at steady state?

  1. ASteady state is never reached
  2. BLarge swings between peak and trough levels
  3. CVery stable levels with almost no fluctuation
  4. DGradual accumulation to toxic levels

3Solutions

1.Mental health nursing

Answer: B · If still awake after about 20 minutes, get up, do something calm and return when sleepy

Why this is the answer

Stimulus control strengthens the bed as a cue for sleep. Getting up when unable to sleep, using the bed only for sleep and intimacy, and keeping a regular wake time are key parts.

Answer

B · If still awake after about 20 minutes, get up, do something calm and return when sleepy
2.Mental health nursing

Answer: B · Risk of physical exhaustion and injury

Why this is the answer

Severe mania can lead to dehydration, exhaustion, injury and even death if not managed. Physical safety, sleep, fluids and nutrition come before education or psychosocial issues.

Answer

B · Risk of physical exhaustion and injury
3.Clinical psychology

Answer: C · The collaborative bond and agreement on goals and tasks between therapist and client

Why this is the answer

The therapeutic alliance consistently predicts therapy outcome across different approaches, which supports the importance of common factors in psychotherapy.

Answer

C · The collaborative bond and agreement on goals and tasks between therapist and client
4.Clinical psychology

Answer: D · Thiamine (vitamin B1)

Why this is the answer

Wernicke's encephalopathy results from thiamine deficiency and presents with confusion, ataxia and eye signs. Untreated, it can progress to Korsakoff syndrome with severe amnesia and confabulation.

Answer

D · Thiamine (vitamin B1)
5.Pharmacology

Answer: B · Activated partial thromboplastin time (aPTT)

Why this is the answer

Unfractionated heparin is often monitored with the aPTT, and the infusion rate is adjusted according to a protocol. Low-molecular-weight heparins usually do not need routine aPTT checks.

Answer

B · Activated partial thromboplastin time (aPTT)
6.Pharmacology

Answer: B · Large swings between peak and trough levels

Why this is the answer

When the interval is long compared with the half-life, most of each dose is eliminated before the next one. Levels rise high after each dose and fall low before the next, so there may be toxic peaks or ineffective troughs.

Answer

B · Large swings between peak and trough levels

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