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 should the nurse position herself when talking to an agitated patient?

  1. ABetween the patient and the wall, so the patient can leave easily
  2. BAt a safe distance, slightly to the side, with a clear exit available
  3. CDirectly face to face, as close as possible, to show confidence
  4. DBehind the patient and close to him, so that the patient does not feel threatened by eye contact
2.Mental health nursingHard

A patient on daily methadone maintenance has had abdominal surgery. Which statement about his pain management is correct?

  1. AHe should get no opioids at all, because of his history
  2. BHis methadone should be stopped while he is in hospital
  3. CHis usual methadone should continue, and additional analgesia is usually needed for acute pain
  4. DHis usual methadone dose will fully control his post-operative pain, so no other analgesia should be given
3.Clinical psychologyMedium

Which defence mechanism is shown by someone who is angry with their boss but shouts at their partner at home?

  1. AProjection
  2. BReaction formation
  3. CDisplacement
  4. DSublimation
4.Clinical psychologyHard

Ayllon and Azrin introduced a token economy on a psychiatric ward. What was the main finding and limitation?

  1. ATarget behaviours increased, but gains often did not generalise outside the ward
  2. BThe method cured schizophrenia within weeks
  3. CPatients' hallucinations disappeared permanently, and the gains lasted after discharge
  4. DTokens had no effect on behaviour
5.PharmacologyMedium

How should a patient take oral alendronate?

  1. AWith milk at bedtime, then lying down straight away to aid absorption
  2. BCrushed into yoghurt with calcium supplements
  3. CWith plain water on an empty stomach, staying upright for 30 minutes
  4. DWith breakfast and coffee to protect the stomach
6.PharmacologyHard

A heparin infusion contains 25,000 units in 500 mL. The order is 1,000 units per hour. What rate should be set on the pump?

  1. A10 mL/h
  2. B20 mL/h
  3. C25 mL/h
  4. D50 mL/h

3Solutions

1.Mental health nursing

Answer: B · At a safe distance, slightly to the side, with a clear exit available

Why this is the answer

Standing at an angle and outside arm's reach is less confrontational and safer. The nurse makes sure neither she nor the patient is trapped, so both have an exit.

Answer

B · At a safe distance, slightly to the side, with a clear exit available
2.Mental health nursing

Answer: C · His usual methadone should continue, and additional analgesia is usually needed for acute pain

Why this is the answer

Maintenance methadone prevents withdrawal but does not treat acute pain. Patients with opioid tolerance often need more analgesia than usual. Withholding pain relief is unsafe and unethical.

Answer

C · His usual methadone should continue, and additional analgesia is usually needed for acute pain
3.Clinical psychology

Answer: C · Displacement

Why this is the answer

Displacement shifts an impulse from a threatening target to a less threatening one. Projection attributes one's own unacceptable feelings to others.

Answer

C · Displacement
4.Clinical psychology

Answer: A · Target behaviours increased, but gains often did not generalise outside the ward

Why this is the answer

Token economies increased self-care and work behaviours in long-stay patients, but changes tended to fade without reinforcement, and the approach raised ethical concerns about control.

Answer

A · Target behaviours increased, but gains often did not generalise outside the ward
5.Pharmacology

Answer: C · With plain water on an empty stomach, staying upright for 30 minutes

Why this is the answer

Alendronate is taken first thing in the morning with water only, before food or other drugs. Staying upright reduces the risk of oesophageal ulceration, and food or calcium blocks its absorption.

Answer

C · With plain water on an empty stomach, staying upright for 30 minutes
6.Pharmacology

Answer: B · 20 mL/h

Why this is the answer

25,000 units ÷ 500 mL = 50 units/mL, and 1,000 units/h ÷ 50 units/mL = 20 mL/h. Heparin is a high-alert drug, so the calculation and pump settings are independently double-checked.

Answer

B · 20 mL/h

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