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 student avoids eating in the canteen and speaking in seminars because she fears others will judge her or see her blush. Which disorder does this suggest?

  1. AObsessive-compulsive disorder
  2. BGeneralised anxiety disorder
  3. CSocial anxiety disorder
  4. DAgoraphobia
2.Mental health nursingHard

A 15-year-old tells the school nurse she has been cutting herself and asks her not to tell her parents. What is the best response?

  1. APhone her parents at once without telling her
  2. BPromise never to tell anyone about it, so that she keeps trusting the school nurse
  3. CTell her that cutting is a phase that many teenagers go through and it needs no help
  4. DExplain that safety information must be shared, and involve her in how this is done
3.Clinical psychologyMedium

Which defence mechanism is shown when someone with strong hostile feelings towards a colleague acts in an excessively friendly way towards them?

  1. AReaction formation
  2. BDenial
  3. CDisplacement
  4. DRationalisation
4.Clinical psychologyHard

A chronic heavy drinker develops confusion, an unsteady gait and abnormal eye movements. Which deficiency must be treated urgently?

  1. AThiamine (vitamin B1)
  2. BVitamin C
  3. CVitamin D
  4. DIron
5.PharmacologyMedium

Which adverse effect of ciprofloxacin should a patient report at once?

  1. AA slightly bitter or metallic taste for a while after each dose
  2. BDarker stools than usual
  3. CPain or swelling in a tendon, such as the Achilles tendon
  4. DMild tiredness in the first few days
6.PharmacologyHard

A nurse gave a patient ten times the prescribed dose of hydromorphone. The patient is currently alert. What is the most appropriate sequence of actions?

  1. AGive another dose later to balance it out
  2. BChange the chart so that it shows the correct dose, and continue to monitor
  3. CSay nothing because the patient is alert
  4. DMonitor closely, have naloxone ready, inform the prescriber and report

3Solutions

1.Mental health nursing

Answer: C · Social anxiety disorder

Why this is the answer

Social anxiety disorder is a marked fear of social situations in which the person may be scrutinised, with fear of embarrassment or negative judgement, leading to avoidance or intense distress.

Answer

C · Social anxiety disorder
2.Mental health nursing

Answer: D · Explain that safety information must be shared, and involve her in how this is done

Why this is the answer

Confidentiality has limits when there is risk of harm. The nurse explains this honestly, assesses risk and works with the young person on how and with whom information is shared, in line with safeguarding policy.

Answer

D · Explain that safety information must be shared, and involve her in how this is done
3.Clinical psychology

Answer: A · Reaction formation

Why this is the answer

Reaction formation turns an unacceptable impulse into its opposite, often in an exaggerated form.

Answer

A · Reaction formation
4.Clinical psychology

Answer: A · Thiamine (vitamin B1)

Why this is the answer

Wernicke's encephalopathy results from thiamine deficiency and presents with confusion, ataxia and eye signs. Untreated, it can progress to Korsakoff syndrome with severe amnesia and confabulation.

Answer

A · Thiamine (vitamin B1)
5.Pharmacology

Answer: C · Pain or swelling in a tendon, such as the Achilles tendon

Why this is the answer

Fluoroquinolones can cause tendinitis and tendon rupture. Patients should stop exercise and report tendon pain promptly.

Answer

C · Pain or swelling in a tendon, such as the Achilles tendon
6.Pharmacology

Answer: D · Monitor closely, have naloxone ready, inform the prescriber and report

Why this is the answer

The patient may become sedated and develop respiratory depression later, so close monitoring and a ready antidote are needed. The prescriber is informed, the patient is told honestly, and the error is reported to improve the system.

Answer

D · Monitor closely, have naloxone ready, inform the prescriber and report

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