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 with schizophrenia says, "The voices are telling me I'm evil." Which response is best?

  1. A"Let's not talk about the voices for now. Tell me about your family and your plans instead."
  2. B"I don't hear the voices, but I can see they are upsetting you. What are they saying to you?"
  3. C"The voices aren't real, so just ignore them."
  4. D"If you hear voices, you must be very ill."
2.Mental health nursingHard

On the fourth day after giving birth, a mother is tearful and moody but is caring for her baby, eating and sleeping when she can. What is the most appropriate nursing response?

  1. ATell her that antidepressants must be started at once
  2. BAdvise her to stop breastfeeding and let others feed the baby at night so that she can rest and recover
  3. CArrange an emergency psychiatric admission today
  4. DExplain that these "baby blues" are common, offer support and advise her to seek help if they last more than about 2 weeks
3.Clinical psychologyMedium

Which personality disorder is marked by instability in relationships, self-image and emotions, together with marked impulsivity?

  1. AAvoidant personality disorder
  2. BNarcissistic personality disorder
  3. CBorderline personality disorder
  4. DSchizoid personality disorder
4.Clinical psychologyHard

A student believes "If I'm not perfect, I'm worthless." In Beck's model, this belief is best classed as:

  1. AA defence mechanism called sublimation, which channels distress into socially valued work
  2. BA dysfunctional assumption or core belief that makes the person vulnerable
  3. CA negative symptom of schizophrenia
  4. DA hallucination that requires antipsychotics
5.PharmacologyMedium

A person who has never been vaccinated against tetanus has a deep, dirty wound. What is usually given?

  1. AOral antibiotics only
  2. BTetanus vaccine only, after the wound heals
  3. CTetanus vaccine and tetanus immunoglobulin
  4. DNo treatment unless symptoms appear
6.PharmacologyHard

A patient taking carbimazole or methimazole (thiamazole) for Graves' disease reports a sore throat and fever. What should the nurse suspect and do?

  1. AThyroid storm; double the next dose of the drug
  2. BHypothyroidism; add levothyroxine at once
  3. CAgranulocytosis; stop the drug and check the white cell count urgently
  4. DA common cold; advise rest and fluids and continue the drug as usual

3Solutions

1.Mental health nursing

Answer: B · "I don't hear the voices, but I can see they are upsetting you. What are they saying to you?"

Why this is the answer

The nurse does not argue or agree, but states their own reality, shows empathy and asks about the content, especially command hallucinations that could put the patient or others at risk.

Answer

B · "I don't hear the voices, but I can see they are upsetting you. What are they saying to you?"
2.Mental health nursing

Answer: D · Explain that these "baby blues" are common, offer support and advise her to seek help if they last more than about 2 weeks

Why this is the answer

Baby blues are common in the first days after birth and usually resolve within 2 weeks. Symptoms that last longer or are severe may indicate postpartum depression and need assessment.

Answer

D · Explain that these "baby blues" are common, offer support and advise her to seek help if they last more than about 2 weeks
3.Clinical psychology

Answer: C · Borderline personality disorder

Why this is the answer

Borderline personality disorder involves unstable relationships and identity, affective instability, fear of abandonment, impulsivity and recurrent self-harm. DBT is a well-supported treatment.

Answer

C · Borderline personality disorder
4.Clinical psychology

Answer: B · A dysfunctional assumption or core belief that makes the person vulnerable

Why this is the answer

Beck distinguished surface negative automatic thoughts from deeper schemas and conditional assumptions. Such beliefs remain dormant until activated by a matching stressor, such as failure.

Answer

B · A dysfunctional assumption or core belief that makes the person vulnerable
5.Pharmacology

Answer: C · Tetanus vaccine and tetanus immunoglobulin

Why this is the answer

Tetanus immunoglobulin gives immediate passive protection, while the vaccine starts active immunity. Thorough wound cleaning is also essential.

Answer

C · Tetanus vaccine and tetanus immunoglobulin
6.Pharmacology

Answer: C · Agranulocytosis; stop the drug and check the white cell count urgently

Why this is the answer

Thionamides can cause agranulocytosis, which leaves the patient unable to fight infection. Sore throat, fever or mouth ulcers need an urgent full blood count, and the drug is stopped while waiting.

Answer

C · Agranulocytosis; stop the drug and check the white cell count urgently

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