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 who has just been admitted says, "I don't want to talk to anyone." What is the best initial nursing approach?

  1. AAsk a series of direct questions until he answers
  2. BLeave the patient alone until he asks to talk
  3. CTell the patient that talking is required to be discharged
  4. DSpend short, regular periods with the patient without forcing conversation
2.Mental health nursingHard

Shortly after receiving haloperidol, a patient's head is twisted to one side, his eyes are fixed upwards and he complains that his throat feels tight. What should the nurse do first?

  1. AReassure him that this is anxiety about the new drug and leave him to rest quietly on his own
  2. BGet urgent medical help and give the prescribed anticholinergic, watching the airway
  3. CEncourage him to stretch his neck
  4. DGive a further dose of haloperidol
3.Clinical psychologyMedium

A person spends hours daily worrying that a small mark on their nose is ugly, checks mirrors constantly, and others see nothing wrong. Which diagnosis fits?

  1. AAnorexia nervosa
  2. BIllness anxiety disorder
  3. CBody dysmorphic disorder
  4. DSocial anxiety disorder
4.Clinical psychologyHard

A therapist helps a client with panic disorder deliberately bring on dizziness by spinning in a chair, without using safety behaviours. What is this technique called and why is it used?

  1. AInteroceptive exposure, so the client learns bodily sensations are not dangerous
  2. BAversion therapy, so the client learns to associate panic with physical discomfort
  3. CFlooding, so the client forgets their trauma
  4. DFree association, so unconscious fears come to light
5.PharmacologyMedium

An Rh-negative mother gives birth to an Rh-positive baby. When is anti-D immunoglobulin usually given?

  1. AIt is not needed if the baby is Rh-positive
  2. BWithin 72 hours after the birth
  3. COnly at the start of the next pregnancy
  4. DAt least two weeks after the birth
6.PharmacologyHard

Codeine is converted to morphine by CYP2D6. What happens in a patient who is a CYP2D6 ultra-rapid metaboliser?

  1. ACodeine is excreted unchanged in the urine
  2. BCodeine is converted to an inactive compound only
  3. CMore morphine is formed, increasing the risk of opioid toxicity
  4. DCodeine gives almost no pain relief because little morphine is formed

3Solutions

1.Mental health nursing

Answer: D · Spend short, regular periods with the patient without forcing conversation

Why this is the answer

Short, frequent, predictable contacts show acceptance and help build trust. Forcing conversation increases anxiety, while leaving the patient alone can reinforce withdrawal.

Answer

D · Spend short, regular periods with the patient without forcing conversation
2.Mental health nursing

Answer: B · Get urgent medical help and give the prescribed anticholinergic, watching the airway

Why this is the answer

Acute dystonia can involve the larynx and be life-threatening. An anticholinergic such as benztropine or procyclidine, or diphenhydramine, is given as ordered (often parenterally), and the airway is monitored.

Answer

B · Get urgent medical help and give the prescribed anticholinergic, watching the airway
3.Clinical psychology

Answer: C · Body dysmorphic disorder

Why this is the answer

Body dysmorphic disorder is preoccupation with perceived flaws in appearance that are slight or not observable, with repetitive behaviours such as mirror checking or seeking reassurance.

Answer

C · Body dysmorphic disorder
4.Clinical psychology

Answer: A · Interoceptive exposure, so the client learns bodily sensations are not dangerous

Why this is the answer

Interoceptive exposure provokes feared bodily sensations so the client can test catastrophic predictions and habituate. It is a core part of CBT for panic disorder.

Answer

A · Interoceptive exposure, so the client learns bodily sensations are not dangerous
5.Pharmacology

Answer: B · Within 72 hours after the birth

Why this is the answer

Anti-D is given within 72 hours of birth to an Rh-negative mother of an Rh-positive baby. It is also given after events such as miscarriage or abdominal trauma, and often routinely during pregnancy.

Answer

B · Within 72 hours after the birth
6.Pharmacology

Answer: C · More morphine is formed, increasing the risk of opioid toxicity

Why this is the answer

Ultra-rapid metabolisers convert more codeine to morphine, which can cause respiratory depression. Poor metabolisers form little morphine and get poor pain relief. This is a classic example of pharmacogenetics.

Answer

C · More morphine is formed, increasing the risk of opioid toxicity

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