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 taking fluoxetine says she has started taking St John's wort to feel even better. What is the main risk?

  1. ASerotonin syndrome
  2. BAgranulocytosis
  3. CHypertensive crisis from tyramine
  4. DLithium toxicity
2.Mental health nursingHard

A patient who has worked well with the nurse for three weeks becomes angry and refuses to attend their sessions after being told that discharge is planned for next week. What is the best interpretation?

  1. AThe patient has developed a new psychotic illness
  2. BThe patient no longer needs the sessions and should be discharged at once
  3. CThe patient is reacting to the coming end of the relationship
  4. DThe nurse has made an error and should cancel the discharge
3.Clinical psychologyMedium

Patients taking monoamine oxidase inhibitors (MAOIs) must avoid foods rich in tyramine because:

  1. ATyramine blocks the antidepressant effect of MAOIs completely
  2. BThe combination causes tardive dyskinesia
  3. CTyramine causes severe weight loss
  4. DThe combination can cause a dangerous rise in blood pressure
4.Clinical psychologyHard

Comorbidity means that:

  1. AA symptom is shared by everyone in a group
  2. BA person meets criteria for two or more disorders at the same time
  3. CA disorder is caused by a physical illness that occurs at the same time
  4. DA disorder runs in families
5.PharmacologyMedium

Typical antipsychotics such as haloperidol work mainly by blocking:

  1. AGABA-A receptors
  2. BDopamine D2 receptors
  3. CSerotonin reuptake
  4. DAcetylcholinesterase
6.PharmacologyHard

A patient took a doxycycline tablet with a sip of water just before lying down. Now swallowing is very painful. What is the most likely cause?

  1. AGastric ulcer caused by doxycycline
  2. BOral candidiasis from the antibiotic
  3. CPill-induced oesophagitis
  4. DAn allergic reaction to the tablet coating

3Solutions

1.Mental health nursing

Answer: A · Serotonin syndrome

Why this is the answer

St John's wort has serotonergic effects, so combining it with an SSRI can cause serotonin syndrome. It also induces liver enzymes and interacts with many other drugs, so patients should tell the prescriber about herbal products.

Answer

A · Serotonin syndrome
2.Mental health nursing

Answer: C · The patient is reacting to the coming end of the relationship

Why this is the answer

Anger, withdrawal or return of symptoms are common responses to termination. The nurse acknowledges the feelings, reviews progress and helps the patient prepare for the ending.

Answer

C · The patient is reacting to the coming end of the relationship
3.Clinical psychology

Answer: D · The combination can cause a dangerous rise in blood pressure

Why this is the answer

MAO normally breaks down dietary tyramine. When it is inhibited, tyramine can trigger a hypertensive crisis, which is why MAOIs require dietary restrictions.

Answer

D · The combination can cause a dangerous rise in blood pressure
4.Clinical psychology

Answer: B · A person meets criteria for two or more disorders at the same time

Why this is the answer

Comorbidity is the co-occurrence of disorders in the same person, which complicates diagnosis and treatment and raises questions about categorical classification.

Answer

B · A person meets criteria for two or more disorders at the same time
5.Pharmacology

Answer: B · Dopamine D2 receptors

Why this is the answer

Haloperidol blocks D2 receptors in the mesolimbic pathway, reducing positive symptoms. Blocking D2 in other pathways causes extrapyramidal effects and raised prolactin.

Answer

B · Dopamine D2 receptors
6.Pharmacology

Answer: C · Pill-induced oesophagitis

Why this is the answer

Doxycycline can cause oesophageal ulceration if it stays in the oesophagus. It is taken with a full glass of water while upright, and the patient stays upright for at least 30 minutes.

Answer

C · Pill-induced oesophagitis

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