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

How does aripiprazole differ from most other antipsychotics?

  1. AIt is a partial agonist at dopamine D2 receptors
  2. BIt has no effect on dopamine at all
  3. CIt is a benzodiazepine with antipsychotic effects
  4. DIt needs weekly white blood cell counts for safety
2.Mental health nursingHard

After a serious bus accident, the nurse is helping uninjured survivors. Which action reflects psychological first aid?

  1. AProvide safety, comfort and practical help, and connect people with their families and support
  2. BAsk each survivor to describe the accident in full detail straight away
  3. CGive every survivor a benzodiazepine at the scene to prevent long-term psychological problems from developing
  4. DTell survivors that they will definitely develop PTSD
3.Clinical psychologyMedium

Which personality disorder is characterised by a pervasive pattern of disregard for the rights of others?

  1. ADependent personality disorder
  2. BAntisocial personality disorder
  3. CBorderline personality disorder
  4. DAvoidant personality disorder
4.Clinical psychologyHard

Dialectical behaviour therapy (DBT) was originally developed for:

  1. ADementia
  2. BSpecific phobias
  3. CBipolar disorder
  4. DBorderline personality disorder with self-harm
5.PharmacologyMedium

An adult patient is due to receive digoxin. The apical pulse, counted for a full minute, is 52 beats per minute. What should the nurse do?

  1. AGive half the dose and document the pulse
  2. BGive the dose and recheck the pulse in one hour
  3. CGive the dose with food to slow absorption
  4. DWithhold the dose and notify the prescriber
6.PharmacologyHard

A man taking spironolactone for heart failure develops painful breast enlargement. Which change may be considered?

  1. AAdding testosterone injections
  2. BDoubling the spironolactone dose to overcome the side effect
  3. CSwitching to potassium chloride tablets
  4. DSwitching to eplerenone, which has fewer anti-androgen effects

3Solutions

1.Mental health nursing

Answer: A · It is a partial agonist at dopamine D2 receptors

Why this is the answer

As a partial agonist, aripiprazole lowers dopamine activity where it is high and supports it where it is low. It is less likely to raise prolactin or cause sedation, but akathisia is a common side effect.

Answer

A · It is a partial agonist at dopamine D2 receptors
2.Mental health nursing

Answer: A · Provide safety, comfort and practical help, and connect people with their families and support

Why this is the answer

Psychological first aid focuses on safety, calming, practical needs, connection with others and information about support. Forcing people to describe the trauma in detail early on is not recommended.

Answer

A · Provide safety, comfort and practical help, and connect people with their families and support
3.Clinical psychology

Answer: B · Antisocial personality disorder

Why this is the answer

Antisocial personality disorder includes deceitfulness, impulsivity, aggression and lack of remorse, with evidence of conduct disorder in childhood.

Answer

B · Antisocial personality disorder
4.Clinical psychology

Answer: D · Borderline personality disorder with self-harm

Why this is the answer

DBT combines CBT with mindfulness, emotion regulation and distress tolerance skills, initially for people with borderline personality disorder and chronic suicidality.

Answer

D · Borderline personality disorder with self-harm
5.Pharmacology

Answer: D · Withhold the dose and notify the prescriber

Why this is the answer

Digoxin is usually withheld in adults if the apical pulse is below 60 per minute, and the prescriber is informed. Bradycardia may be an early sign of toxicity.

Answer

D · Withhold the dose and notify the prescriber
6.Pharmacology

Answer: D · Switching to eplerenone, which has fewer anti-androgen effects

Why this is the answer

Spironolactone has anti-androgenic and progestogenic effects that can cause gynaecomastia. Eplerenone is a more selective mineralocorticoid antagonist with a much lower risk of this effect.

Answer

D · Switching to eplerenone, which has fewer anti-androgen effects

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