1Formulas and methods
Mental health nursing
Method
- Decide whether there is an immediate risk: suicide, violence, a drug emergency or a physical illness.
- Act on safety first: observe, remove means, de-escalate, stop a harmful drug, get help.
- Choose the therapeutic response: acknowledge feelings, present reality, avoid false reassurance and “why” questions.
- Respect rights: the least restrictive option, consent and confidentiality with its limits.
2Practice problems
1.Mental health nursingMedium
Which monitoring is especially important for patients on second-generation antipsychotics such as olanzapine?
- AHearing and eyesight only, as these are most affected by the drug
- BPlatelet count only
- CBone density only
- DWeight, waist circumference, blood glucose and lipids
2.Mental health nursingHard
A man whose wife died a month ago is rude and angry with the nurses about small things. What is the best understanding of his behaviour?
- AHe does not care about his wife's death and is using it as an excuse to be rude
- BHe has antisocial personality disorder that was not noticed before
- CHe should be told that his behaviour is unacceptable and that visits will be stopped
- DHis anger may be part of grief, displaced onto staff, so she should not take it personally
3.Clinical psychologyMedium
Which is a main criticism of defining abnormality as deviation from social norms?
- AIt requires expensive brain scans
- BIt only applies to children
- CIt ignores how rare or statistically unusual a behaviour is
- DNorms vary across cultures and change over time
4.Clinical psychologyHard
The "scientist-practitioner" (Boulder) model in clinical psychology means that clinicians should:
- AAvoid research completely
- BPrescribe medication as their main treatment, following psychiatric guidelines closely
- CUse research evidence to guide practice and evaluate their own interventions
- DOnly conduct laboratory experiments
5.PharmacologyMedium
How can the absorption of oral iron be improved?
- ATake it at the same time as an antacid to protect the stomach
- BTake it with a cup of strong tea
- CTake it with vitamin C, such as orange juice, on an empty stomach
- DTake it with a glass of milk
6.PharmacologyHard
A ventilated ICU patient receives vecuronium, a neuromuscular blocker. Why must sedation and pain relief also be given?
- AVecuronium causes severe pain at the injection site
- BNeuromuscular blockers paralyse muscles but do not cause sedation or analgesia
- CVecuronium stops working unless a sedative is also given
- DSedatives are needed to prevent vecuronium from causing seizures and agitation
3Solutions
1.Mental health nursing
Answer: D · Weight, waist circumference, blood glucose and lipids
Why this is the answer
Many second-generation antipsychotics cause weight gain, insulin resistance and dyslipidaemia. Metabolic monitoring is done at baseline and regularly during treatment.
D · Weight, waist circumference, blood glucose and lipids
2.Mental health nursing
Answer: D · His anger may be part of grief, displaced onto staff, so she should not take it personally
Why this is the answer
Anger is a common part of grief and may be directed at staff who are safer targets. The nurse responds calmly, sets limits if needed and invites him to talk about his loss.
D · His anger may be part of grief, displaced onto staff, so she should not take it personally
3.Clinical psychology
Answer: D · Norms vary across cultures and change over time
Why this is the answer
Social norms are culture- and era-specific, so this definition can label harmless non-conformity as disorder and has been used to justify social control.
D · Norms vary across cultures and change over time
4.Clinical psychology
Answer: C · Use research evidence to guide practice and evaluate their own interventions
Why this is the answer
The Boulder model trains clinical psychologists to integrate scientific research and clinical practice, the basis of evidence-based practice.
C · Use research evidence to guide practice and evaluate their own interventions
5.Pharmacology
Answer: C · Take it with vitamin C, such as orange juice, on an empty stomach
Why this is the answer
Vitamin C keeps iron in its more absorbable ferrous form. Milk, antacids, tea and some antibiotics reduce iron absorption. If the stomach becomes upset, it may be taken with food, accepting lower absorption.
C · Take it with vitamin C, such as orange juice, on an empty stomach
6.Pharmacology
Answer: B · Neuromuscular blockers paralyse muscles but do not cause sedation or analgesia
Why this is the answer
Neuromuscular blockers cause paralysis but leave awareness and pain sensation intact. Without sedation and analgesia, the patient could be awake and in pain while unable to move.
B · Neuromuscular blockers paralyse muscles but do not cause sedation or analgesia