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

Which signs are typical of opioid withdrawal?

  1. AHigh fever, lead-pipe rigidity and confusion within a day of the last dose
  2. BYawning, a runny nose, dilated pupils, goosebumps and diarrhoea
  3. CDeep sleep and constipation
  4. DPinpoint pupils and slow breathing
2.Mental health nursingHard

Five days after starting haloperidol, a patient has a temperature of 40 °C, rigid limbs, confusion, fluctuating blood pressure and sweating. What should the nurse do first?

  1. AGive paracetamol for the fever and recheck the observations in 4 hours
  2. BWithhold the antipsychotic and get urgent medical help
  3. CGive another dose of haloperidol to calm him
  4. DEncourage him to exercise to reduce stiffness
3.Clinical psychologyMedium

Validity scales on the MMPI are designed to detect:

  1. ABrain damage
  2. BWhich therapy will work best
  3. CInconsistent, exaggerated or defensive answering
  4. DThe client's intelligence level
4.Clinical psychologyHard

Dialectical behaviour therapy (DBT) was originally developed for:

  1. ADementia
  2. BBipolar disorder
  3. CBorderline personality disorder with self-harm
  4. DSpecific phobias
5.PharmacologyMedium

A patient refuses a prescribed oral medicine. What should the nurse do?

  1. AExplore the reason, respect the decision, document and inform the prescriber
  2. BRecord the medicine as given, so that the chart stays complete for the next shift
  3. CHide the tablet in the patient's food
  4. DLeave the tablet on the bedside table for later
6.PharmacologyHard

A patient on heparin for 7 days has a platelet count that has fallen by more than half, and a new leg vein thrombosis. What is the most likely cause and the key action?

  1. AWarfarin skin necrosis; switch from heparin to warfarin at once
  2. BNormal dilution of platelets; continue and recheck in a week
  3. CHeparin-induced thrombocytopenia; stop all heparin
  4. DVitamin K deficiency; give vitamin K and continue heparin

3Solutions

1.Mental health nursing

Answer: B · Yawning, a runny nose, dilated pupils, goosebumps and diarrhoea

Why this is the answer

Opioid withdrawal causes rhinorrhoea, lacrimation, yawning, mydriasis, piloerection, abdominal cramps, diarrhoea and anxiety. It is very unpleasant but rarely life-threatening in healthy adults.

Answer

B · Yawning, a runny nose, dilated pupils, goosebumps and diarrhoea
2.Mental health nursing

Answer: B · Withhold the antipsychotic and get urgent medical help

Why this is the answer

These findings suggest neuroleptic malignant syndrome. Stop the antipsychotic, call for urgent medical review, start cooling and supportive care, and monitor vital signs, kidney function and CK.

Answer

B · Withhold the antipsychotic and get urgent medical help
3.Clinical psychology

Answer: C · Inconsistent, exaggerated or defensive answering

Why this is the answer

Validity scales flag random responding, faking bad or faking good, so clinicians know whether the clinical scale profile can be interpreted.

Answer

C · Inconsistent, exaggerated or defensive answering
4.Clinical psychology

Answer: C · Borderline personality disorder with self-harm

Why this is the answer

DBT combines CBT with mindfulness, emotion regulation and distress tolerance skills, initially for people with borderline personality disorder and chronic suicidality.

Answer

C · Borderline personality disorder with self-harm
5.Pharmacology

Answer: A · Explore the reason, respect the decision, document and inform the prescriber

Why this is the answer

Competent patients may refuse treatment. The nurse explores concerns, explains the purpose and risks, documents the refusal and informs the prescriber; covert administration needs formal legal and clinical procedures.

Answer

A · Explore the reason, respect the decision, document and inform the prescriber
6.Pharmacology

Answer: C · Heparin-induced thrombocytopenia; stop all heparin

Why this is the answer

Heparin-induced thrombocytopenia (HIT) is caused by antibodies against heparin–platelet factor 4 complexes. It usually starts 5–10 days after heparin begins and causes thrombosis, so all heparin is stopped and a non-heparin anticoagulant is used.

Answer

C · Heparin-induced thrombocytopenia; stop all heparin

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