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 physical finding is common in bulimia nervosa?

  1. AVery low body weight with lanugo hair
  2. BSwelling of the salivary glands at the angle of the jaw
  3. CRaised blood pressure, a fast pulse and a high temperature
  4. DA high serum potassium level
2.Mental health nursingHard

A patient who believes he is a famous religious leader becomes upset when other patients laugh at him. What is the most appropriate nursing action?

  1. AProtect him from ridicule, avoid arguing and focus on real activities
  2. BAgree that he is the religious leader so that he feels respected
  3. CAsk him to prove his identity in front of the group, so that the laughing stops
  4. DEncourage the other patients to explain why the belief is wrong
3.Clinical psychologyMedium

A client says "I failed one test, so I will fail everything." Which cognitive distortion is this?

  1. AOvergeneralisation
  2. BMind reading
  3. CPersonalisation
  4. DEmotional reasoning
4.Clinical psychologyHard

A man who hears the word "thud" is admitted to hospital, then behaves normally. Staff record his note-taking as "engages in writing behaviour". In Rosenhan's study, what does this illustrate?

  1. APseudopatients developed real symptoms in hospital
  2. BNote-taking is a recognised symptom of schizophrenia, so the staff were right to record it as such
  3. CStaff deliberately falsified records
  4. DOnce a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
5.PharmacologyMedium

Patients on older MAO inhibitors are warned about foods rich in tyramine. What can happen?

  1. AAn allergic rash
  2. BSudden kidney failure
  3. CSevere hypoglycaemia
  4. DA hypertensive crisis
6.PharmacologyHard

How does aripiprazole differ from most other antipsychotics?

  1. AIt works by blocking the reuptake of serotonin only
  2. BIt has no effect on dopamine and acts only on histamine
  3. CIt is a full dopamine agonist that increases dopamine activity
  4. DIt is a partial agonist at dopamine D2 receptors

3Solutions

1.Mental health nursing

Answer: B · Swelling of the salivary glands at the angle of the jaw

Why this is the answer

Repeated vomiting can enlarge the parotid glands and erode tooth enamel. Patients with bulimia often have a normal weight, and purging tends to lower potassium.

Answer

B · Swelling of the salivary glands at the angle of the jaw
2.Mental health nursing

Answer: A · Protect him from ridicule, avoid arguing and focus on real activities

Why this is the answer

Arguing or agreeing strengthens a delusion. The nurse protects the patient's dignity, responds to his feelings and focuses on real, present activities and concerns.

Answer

A · Protect him from ridicule, avoid arguing and focus on real activities
3.Clinical psychology

Answer: A · Overgeneralisation

Why this is the answer

Overgeneralisation draws a sweeping conclusion from a single event. Beck's cognitive therapy teaches clients to notice and test such distortions.

Answer

A · Overgeneralisation
4.Clinical psychology

Answer: D · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder

Why this is the answer

Rosenhan argued that the label "schizophrenic" made staff see ordinary behaviour as pathological. Critics such as Spitzer argued the study did not prove diagnosis was invalid.

Answer

D · Once a label is applied, normal behaviour tends to be interpreted as a sign of the disorder
5.Pharmacology

Answer: D · A hypertensive crisis

Why this is the answer

MAO in the gut normally breaks down dietary tyramine. With MAO inhibited, tyramine from foods such as aged cheese reaches the circulation and releases noradrenaline, causing a dangerous rise in blood pressure.

Answer

D · A hypertensive crisis
6.Pharmacology

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

Why this is the answer

Aripiprazole is a D2 partial agonist, reducing dopamine activity where it is high and providing some where it is low. It causes less weight gain and prolactin rise than many antipsychotics, but akathisia is common.

Answer

D · It is a partial agonist at dopamine D2 receptors

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