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 says, "I feel like I'm dying inside." Which nurse response best uses the technique of exploring?

  1. A"You shouldn't say things like that."
  2. B"Let's talk about something more cheerful."
  3. C"Everyone feels that way sometimes."
  4. D"Tell me more about what that feeling is like for you."
2.Mental health nursingHard

A patient with PTSD suddenly appears terrified, staring and breathing quickly, and says she is "back there". What should the nurse do first?

  1. ATouch her suddenly from behind to get her attention
  2. BLeave the room so she can calm down alone
  3. CAsk her to describe every detail of the trauma straight away so that she can process the memory
  4. DSpeak calmly, use her name and use grounding techniques to bring her attention to the present
3.Clinical psychologyMedium

Which of these is a positive symptom of schizophrenia?

  1. AFlat affect
  2. BSocial withdrawal
  3. CPoverty of speech
  4. DDelusions
4.Clinical psychologyHard

A 22-year-old has had hallucinations and delusions for two months, after which they fully resolve. No mood episode occurred. Which diagnosis fits best?

  1. ASchizophreniform disorder
  2. BSchizoaffective disorder
  3. CBrief psychotic disorder
  4. DSchizophrenia
5.PharmacologyMedium

Which side effects are most common when starting gabapentin?

  1. AHair loss and weight loss
  2. BDrowsiness and dizziness
  3. CCough and runny nose
  4. DInsomnia and agitation
6.PharmacologyHard

A patient with severe chronic hyponatraemia receives hypertonic saline. Why is the rate of correction strictly limited?

  1. AHypertonic saline is toxic to the liver at high rates
  2. BFast correction causes immediate kidney failure
  3. CRaising sodium too fast causes severe hypokalaemia and cardiac arrest
  4. DRaising sodium too fast can cause osmotic demyelination in the brain

3Solutions

1.Mental health nursing

Answer: D · "Tell me more about what that feeling is like for you."

Why this is the answer

Exploring asks the patient to describe an experience in more detail. Generalising, disapproving and changing the subject block the patient from talking.

Answer

D · "Tell me more about what that feeling is like for you."
2.Mental health nursing

Answer: D · Speak calmly, use her name and use grounding techniques to bring her attention to the present

Why this is the answer

During a flashback, grounding (orienting to the present, using the senses, calm reassurance) helps the patient regain contact with reality. Detailed trauma work belongs in planned therapy, and sudden touch can be frightening.

Answer

D · Speak calmly, use her name and use grounding techniques to bring her attention to the present
3.Clinical psychology

Answer: D · Delusions

Why this is the answer

Positive symptoms are additions (hallucinations, delusions, disorganised speech). Negative symptoms are losses (flat affect, avolition, alogia).

Answer

D · Delusions
4.Clinical psychology

Answer: A · Schizophreniform disorder

Why this is the answer

Schizophreniform disorder has the symptoms of schizophrenia but lasts between one and six months. Duration is the main feature separating it from brief psychotic disorder and schizophrenia.

Answer

A · Schizophreniform disorder
5.Pharmacology

Answer: B · Drowsiness and dizziness

Why this is the answer

Gabapentin and pregabalin commonly cause sedation, dizziness and unsteadiness, which raise the risk of falls. They also increase sedation when combined with opioids.

Answer

B · Drowsiness and dizziness
6.Pharmacology

Answer: D · Raising sodium too fast can cause osmotic demyelination in the brain

Why this is the answer

In chronic hyponatraemia the brain adapts to low osmolality. Correcting sodium too rapidly shrinks brain cells and can cause osmotic demyelination (central pontine myelinolysis), so sodium is checked often.

Answer

D · Raising sodium too fast can cause osmotic demyelination in the brain

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