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

How should the nurse position herself when talking to an agitated patient?

  1. ABehind the patient and close to him, so that the patient does not feel threatened by eye contact
  2. BAt a safe distance, slightly to the side, with a clear exit available
  3. CBetween the patient and the wall, so the patient can leave easily
  4. DDirectly face to face, as close as possible, to show confidence
2.Mental health nursingHard

A patient with borderline personality disorder and frequent self-harm says, "I'm going to kill myself tonight," after an argument on the phone. A colleague says, "She always says that." What should the nurse do?

  1. ACarry out a full suicide risk assessment, as with any patient who expresses suicidal intent
  2. BAgree with the colleague and take no action at all
  3. CWait until the next morning to see if she still feels the same once the argument has settled down
  4. DTell the patient she is only seeking attention
3.Clinical psychologyMedium

Which statement best distinguishes obsessive-compulsive personality disorder (OCPD) from OCD?

  1. AOCPD always involves hand washing
  2. BOCPD is a psychotic disorder
  3. CIn OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self
  4. DIn OCPD, intrusive unwanted thoughts trigger rituals that the person recognises as excessive
4.Clinical psychologyHard

Comorbidity means that:

  1. AA disorder runs in families
  2. BA person meets criteria for two or more disorders at the same time
  3. CA disorder is caused by a physical illness that occurs at the same time
  4. DA symptom is shared by everyone in a group
5.PharmacologyMedium

Which assessment is most important during IV mannitol therapy?

  1. ABlood glucose before meals and signs of hypoglycaemia
  2. BLiver enzymes and signs of jaundice
  3. CPlatelet count and signs of bleeding
  4. DUrine output, electrolytes and signs of fluid overload
6.PharmacologyHard

The clearance of a drug falls to half because of kidney failure, while its volume of distribution stays the same. What happens to its half-life?

  1. AIt stays the same
  2. BIt halves
  3. CIt doubles
  4. DIt increases fourfold

3Solutions

1.Mental health nursing

Answer: B · At a safe distance, slightly to the side, with a clear exit available

Why this is the answer

Standing at an angle and outside arm's reach is less confrontational and safer. The nurse makes sure neither she nor the patient is trapped, so both have an exit.

Answer

B · At a safe distance, slightly to the side, with a clear exit available
2.Mental health nursing

Answer: A · Carry out a full suicide risk assessment, as with any patient who expresses suicidal intent

Why this is the answer

People with borderline personality disorder have a significantly raised risk of suicide. Every statement of suicidal intent must be assessed; labelling it as attention-seeking can lead to missed risk.

Answer

A · Carry out a full suicide risk assessment, as with any patient who expresses suicidal intent
3.Clinical psychology

Answer: C · In OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self

Why this is the answer

OCPD is a pervasive pattern of perfectionism, orderliness and control that the person sees as appropriate (ego-syntonic). OCD obsessions are unwanted and distressing (ego-dystonic).

Answer

C · In OCPD, perfectionism and rigidity are usually experienced as acceptable parts of the self
4.Clinical psychology

Answer: B · A person meets criteria for two or more disorders at the same time

Why this is the answer

Comorbidity is the co-occurrence of disorders in the same person, which complicates diagnosis and treatment and raises questions about categorical classification.

Answer

B · A person meets criteria for two or more disorders at the same time
5.Pharmacology

Answer: D · Urine output, electrolytes and signs of fluid overload

Why this is the answer

Mannitol draws fluid into the circulation before it is excreted, which can cause heart failure and pulmonary oedema. The large diuresis can cause dehydration and electrolyte imbalance, so output and electrolytes are monitored.

Answer

D · Urine output, electrolytes and signs of fluid overload
6.Pharmacology

Answer: C · It doubles

Why this is the answer

Half-life is proportional to Vd and inversely proportional to clearance. Halving clearance doubles the half-life, so the drug accumulates and takes longer to reach steady state.

Answer

C · It doubles

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