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

The wife of a man with alcohol dependence organises her life around his drinking, hides it from others and neglects her own needs. What does this pattern suggest?

  1. ADelirium tremens
  2. BCodependency
  3. CEnabling by the healthcare team
  4. DLearned helplessness in the patient
2.Mental health nursingHard

A patient taking valproate has severe abdominal pain spreading to her back, with nausea and vomiting. What should the nurse suspect?

  1. ALithium toxicity
  2. BSimple indigestion
  3. CPancreatitis
  4. DSerotonin syndrome
3.Clinical psychologyMedium

Behavioural activation treats depression mainly by:

  1. AExploring childhood conflicts in detail
  2. BExposing the person to feared bodily sensations in a graded way
  3. CIncreasing engagement in rewarding and valued activities
  4. DPrescribing a period of complete rest
4.Clinical psychologyHard

A student believes "If I'm not perfect, I'm worthless." In Beck's model, this belief is best classed as:

  1. AA hallucination that requires antipsychotics
  2. BA negative symptom of schizophrenia
  3. CA defence mechanism called sublimation, which channels distress into socially valued work
  4. DA dysfunctional assumption or core belief that makes the person vulnerable
5.PharmacologyMedium

Which factor increases the risk of lithium toxicity?

  1. AA high-salt diet
  2. BTaking the dose with food
  3. CDrinking extra water
  4. DDehydration
6.PharmacologyHard

A patient taking sertraline starts St John's wort for low mood. What is the main concern?

  1. ASerotonin syndrome from combined serotonergic effects
  2. BBleeding from vitamin K deficiency
  3. CSevere low blood pressure from blocked alpha receptors
  4. DA hypertensive crisis from tyramine

3Solutions

1.Mental health nursing

Answer: B · Codependency

Why this is the answer

Codependency describes a family member whose life becomes centred on the other person's addiction, often with caretaking, covering up and neglect of self. Support groups such as Al-Anon can help.

Answer

B · Codependency
2.Mental health nursing

Answer: C · Pancreatitis

Why this is the answer

Valproate can cause acute pancreatitis, which can be life-threatening. Severe abdominal pain with vomiting must be reported promptly so the drug can be stopped and the patient assessed.

Answer

C · Pancreatitis
3.Clinical psychology

Answer: C · Increasing engagement in rewarding and valued activities

Why this is the answer

Behavioural activation schedules activities that bring pleasure or mastery, breaking the cycle of withdrawal and low reinforcement. It is an evidence-based treatment for depression.

Answer

C · Increasing engagement in rewarding and valued activities
4.Clinical psychology

Answer: D · A dysfunctional assumption or core belief that makes the person vulnerable

Why this is the answer

Beck distinguished surface negative automatic thoughts from deeper schemas and conditional assumptions. Such beliefs remain dormant until activated by a matching stressor, such as failure.

Answer

D · A dysfunctional assumption or core belief that makes the person vulnerable
5.Pharmacology

Answer: D · Dehydration

Why this is the answer

When the body is short of water or sodium, the kidney reabsorbs more lithium, so its level rises. Thiazides, ACE inhibitors and NSAIDs can have the same effect.

Answer

D · Dehydration
6.Pharmacology

Answer: A · Serotonin syndrome from combined serotonergic effects

Why this is the answer

St John's wort has serotonergic effects, so it can cause serotonin syndrome with SSRIs. It also induces liver enzymes and can reduce levels of drugs such as the combined pill, warfarin and ciclosporin.

Answer

A · Serotonin syndrome from combined serotonergic effects

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