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 does obsessive-compulsive personality disorder differ from obsessive-compulsive disorder?

  1. AIt always involves repeated hand washing and checking rituals
  2. BIt is a lasting pattern of perfectionism and control without true obsessions and compulsions
  3. CIt starts suddenly in later life after a stressful event and goes away on its own within a few months
  4. DPeople with it always feel that their behaviour is senseless and unwanted
2.Mental health nursingHard

A patient is pacing, has clenched fists and is shouting at staff. What is the most appropriate first approach?

  1. AUse calm verbal de-escalation, keep a safe distance and make sure both of you have an exit
  2. BTurn your back and ignore the behaviour
  3. CRestrain the patient immediately
  4. DStand close to the patient and raise your voice so that you clearly take control of the situation
3.Clinical psychologyMedium

Mindfulness-based cognitive therapy (MBCT) has best evidence for:

  1. APreventing relapse in people with recurrent depression
  2. BTreating attention problems in young children with ADHD
  3. CTreating acute psychosis
  4. DCuring dementia
4.Clinical psychologyHard

A man says that a famous singer is secretly in love with him and sends him coded messages through her songs. Apart from this, his thinking and behaviour are normal, with no hallucinations. Which diagnosis fits best?

  1. ASchizophrenia, paranoid type
  2. BNarcissistic personality disorder
  3. CBipolar disorder with mania
  4. DDelusional disorder, erotomanic type
5.PharmacologyMedium

Which common side effect is typical of ACE inhibitors?

  1. ABradycardia
  2. BAnkle swelling caused by vasodilation
  3. CDry cough
  4. DHypoglycaemia
6.PharmacologyHard

A man taking doxazosin for hypertension starts sildenafil for erectile dysfunction. What is the main risk?

  1. ASevere hypertension and a pounding headache
  2. BSymptomatic low blood pressure and fainting
  3. CBronchospasm
  4. DHyperkalaemia

3Solutions

1.Mental health nursing

Answer: B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions

Why this is the answer

In OCPD, rigid perfectionism, orderliness and control are part of the personality and usually feel right to the person. In OCD, the person has intrusive obsessions and compulsions that they usually find distressing.

Answer

B · It is a lasting pattern of perfectionism and control without true obsessions and compulsions
2.Mental health nursing

Answer: A · Use calm verbal de-escalation, keep a safe distance and make sure both of you have an exit

Why this is the answer

De-escalation uses a calm voice, simple language, active listening and offering choices, while keeping a safe distance and an exit route. Restraint is a last resort if there is imminent danger.

Answer

A · Use calm verbal de-escalation, keep a safe distance and make sure both of you have an exit
3.Clinical psychology

Answer: A · Preventing relapse in people with recurrent depression

Why this is the answer

MBCT combines mindfulness practice with cognitive therapy. Trials show it reduces relapse in people with three or more previous depressive episodes.

Answer

A · Preventing relapse in people with recurrent depression
4.Clinical psychology

Answer: D · Delusional disorder, erotomanic type

Why this is the answer

Delusional disorder involves one or more delusions for at least a month without meeting criteria for schizophrenia, and functioning is not markedly impaired apart from the delusion. Erotomanic delusions concern another person being in love with the patient.

Answer

D · Delusional disorder, erotomanic type
5.Pharmacology

Answer: C · Dry cough

Why this is the answer

ACE also breaks down bradykinin. When it is inhibited, bradykinin accumulates in the airways and causes a persistent dry cough in some patients.

Answer

C · Dry cough
6.Pharmacology

Answer: B · Symptomatic low blood pressure and fainting

Why this is the answer

Alpha blockers and PDE5 inhibitors both cause vasodilation, so together they can cause marked hypotension. Patients should be stable on the alpha blocker, and the PDE5 inhibitor is started at a low dose.

Answer

B · Symptomatic low blood pressure and fainting

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