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 on an antipsychotic paces constantly and says he cannot sit still. What is this called?

  1. ATardive dyskinesia
  2. BCatatonia
  3. CAkathisia
  4. DPseudoparkinsonism
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 acceptable because his name was not used
  3. CIt breaches confidentiality, because he could still be identified
  4. DIt is only a problem if the patient finds the post himself
3.Clinical psychologyMedium

Which treatment is recommended as first-line for chronic insomnia in adults?

  1. ACognitive behavioural therapy for insomnia (CBT-I)
  2. BElectroconvulsive therapy
  3. CLong-term daily benzodiazepines or other hypnotic drugs
  4. DPsychoanalysis
4.Clinical psychologyHard

A researcher finds that adoptees whose biological mothers had schizophrenia develop it more often than adoptees whose biological mothers did not, despite being raised by unaffected families. What does this design help to separate?

  1. APositive symptoms from negative symptoms
  2. BThe effects of antipsychotic medication from the effects of psychological therapy
  3. CGenetic influences from the effects of the rearing environment
  4. DDiagnosis by DSM from diagnosis by ICD
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 increases uric acid production to flush out crystals
  3. CIt works within an hour to relieve joint pain
  4. DIt lowers uric acid over time and does not relieve the pain of an acute attack
6.PharmacologyHard

A patient with epilepsy needs pain relief. Why is tramadol used with caution?

  1. AIt causes a sharp rise in blood glucose
  2. BIt always causes respiratory arrest in epilepsy
  3. CIt speeds up the metabolism of all antiepileptic drugs
  4. DIt lowers the seizure threshold

3Solutions

1.Mental health nursing

Answer: C · Akathisia

Why this is the answer

Akathisia is an inner restlessness with an urge to move. It is distressing, can be mistaken for agitation or anxiety and is linked to non-adherence and increased suicide risk.

Answer

C · Akathisia
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: A · Cognitive behavioural therapy for insomnia (CBT-I)

Why this is the answer

CBT-I combines sleep restriction, stimulus control, sleep hygiene and cognitive techniques. It has lasting effects and is recommended before hypnotic drugs.

Answer

A · Cognitive behavioural therapy for insomnia (CBT-I)
4.Clinical psychology

Answer: C · Genetic influences from the effects of the rearing environment

Why this is the answer

Adoption studies, such as Heston's and the Danish studies, separate genetic risk from family environment because the child is raised away from the biological parent.

Answer

C · Genetic influences from the effects of the rearing environment
5.Pharmacology

Answer: D · 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

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

Answer: D · It lowers the seizure threshold

Why this is the answer

Tramadol can cause seizures, especially at high doses or with other drugs that lower the seizure threshold. Its serotonergic action also raises the risk of serotonin syndrome.

Answer

D · It lowers the seizure threshold

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