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

When are delirium tremens most likely to start after the last drink?

  1. AAfter 2 months
  2. BAfter 2 weeks
  3. CAbout 2 to 4 days (48 to 96 hours)
  4. DWithin 1 to 2 hours
2.Mental health nursingHard

While caring for a highly anxious patient, a nurse notices her own heart racing and her speech getting faster. What is most important?

  1. AMatch the patient's level of anxiety to show empathy
  2. BIgnore her own reaction, because the nurse's feelings do not matter in patient care
  3. CLeave the patient immediately and not return
  4. DRecognise that anxiety spreads between people, and calm herself first
3.Clinical psychologyMedium

Which pattern defines bipolar II disorder?

  1. AAt least one full manic episode with psychotic features
  2. BAt least one hypomanic episode and at least one major depressive episode
  3. CMajor depressive episodes only, with no elevated mood
  4. DNumerous mild mood swings over at least two years without full mood episodes
4.Clinical psychologyHard

Ayllon and Azrin introduced a token economy on a psychiatric ward. What was the main finding and limitation?

  1. APatients' hallucinations disappeared permanently, and the gains lasted after discharge
  2. BTarget behaviours increased, but gains often did not generalise outside the ward
  3. CTokens had no effect on behaviour
  4. DThe method cured schizophrenia within weeks
5.PharmacologyMedium

Patients on older MAO inhibitors are warned about foods rich in tyramine. What can happen?

  1. ASevere hypoglycaemia
  2. BSudden kidney failure
  3. CAn allergic rash
  4. DA hypertensive crisis
6.PharmacologyHard

A non-competitive (irreversible) antagonist changes a dose–response curve by:

  1. AShifting the curve to the left
  2. BShifting the curve to the right with the same maximum
  3. CLowering the maximum response
  4. DMaking the curve steeper without other changes

3Solutions

1.Mental health nursing

Answer: C · About 2 to 4 days (48 to 96 hours)

Why this is the answer

Typical timing: tremor and anxiety from about 6–24 hours, withdrawal seizures from about 12–48 hours and delirium tremens from about 48–96 hours. Timing varies between patients.

Answer

C · About 2 to 4 days (48 to 96 hours)
2.Mental health nursing

Answer: D · Recognise that anxiety spreads between people, and calm herself first

Why this is the answer

Anxiety can be communicated between people. A nurse who notices and manages her own anxiety can provide a calm, steady presence that helps reduce the patient's anxiety.

Answer

D · Recognise that anxiety spreads between people, and calm herself first
3.Clinical psychology

Answer: B · At least one hypomanic episode and at least one major depressive episode

Why this is the answer

Bipolar II requires hypomanic and major depressive episodes but no manic episode. A single manic episode leads to a bipolar I diagnosis.

Answer

B · At least one hypomanic episode and at least one major depressive episode
4.Clinical psychology

Answer: B · Target behaviours increased, but gains often did not generalise outside the ward

Why this is the answer

Token economies increased self-care and work behaviours in long-stay patients, but changes tended to fade without reinforcement, and the approach raised ethical concerns about control.

Answer

B · Target behaviours increased, but gains often did not generalise outside the ward
5.Pharmacology

Answer: D · A hypertensive crisis

Why this is the answer

MAO in the gut normally breaks down dietary tyramine. With MAO inhibited, tyramine from foods such as aged cheese reaches the circulation and releases noradrenaline, causing a dangerous rise in blood pressure.

Answer

D · A hypertensive crisis
6.Pharmacology

Answer: C · Lowering the maximum response

Why this is the answer

A competitive antagonist shifts the curve to the right but higher agonist doses reach the same maximum. A non-competitive antagonist reduces the maximum response.

Answer

C · Lowering the maximum response

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