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

In DSM-5-TR, prolonged grief disorder in adults requires that at least how long has passed since the death?

  1. A12 months
  2. B6 weeks
  3. C2 weeks
  4. D3 years
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. AAdvise her to stop breastfeeding and let others feed the baby at night so that she can rest and recover
  2. BArrange an emergency psychiatric admission today
  3. CTell her that antidepressants must be started at once
  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 defence mechanism is shown by someone who is angry with their boss but shouts at their partner at home?

  1. ADisplacement
  2. BSublimation
  3. CReaction formation
  4. DProjection
4.Clinical psychologyHard

Which evidence best supports CBT as a treatment for anxiety disorders, rather than a placebo effect?

  1. AClients say they like their therapists
  2. BCBT is cheaper than medication
  3. CCBT has been used for over fifty years
  4. DRandomised trials show CBT outperforms credible attention-placebo control conditions
5.PharmacologyMedium

After several years of levodopa treatment, which problem is common?

  1. ASevere hypoglycaemia after each dose
  2. BComplete and permanent loss of all Parkinson's symptoms
  3. CPermanent hearing loss
  4. DDyskinesias and "on–off" fluctuations in response
6.PharmacologyHard

A patient taking metoprolol is also started on verapamil. Which adverse effect is most likely?

  1. AHyperkalaemia and muscle weakness
  2. BHypoglycaemia and weight gain
  3. CSevere bradycardia and heart block
  4. DRebound tachycardia and hypertension

3Solutions

1.Mental health nursing

Answer: A · 12 months

Why this is the answer

In adults, prolonged grief disorder requires at least 12 months since the loss (6 months for children and adolescents), with intense yearning or preoccupation that impairs functioning. ICD-11 uses a shorter minimum of 6 months.

Answer

A · 12 months
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: A · Displacement

Why this is the answer

Displacement shifts an impulse from a threatening target to a less threatening one. Projection attributes one's own unacceptable feelings to others.

Answer

A · Displacement
4.Clinical psychology

Answer: D · Randomised trials show CBT outperforms credible attention-placebo control conditions

Why this is the answer

Showing superiority over a credible placebo control rules out non-specific factors as the only explanation. Many trials and meta-analyses report this for CBT in anxiety disorders.

Answer

D · Randomised trials show CBT outperforms credible attention-placebo control conditions
5.Pharmacology

Answer: D · Dyskinesias and "on–off" fluctuations in response

Why this is the answer

Long-term levodopa use often leads to motor fluctuations, with periods of good control and periods of stiffness, and to dyskinesias at peak dose. Dose timing and add-on drugs are adjusted to manage this.

Answer

D · Dyskinesias and "on–off" fluctuations in response
6.Pharmacology

Answer: C · Severe bradycardia and heart block

Why this is the answer

Beta blockers and non-dihydropyridine calcium channel blockers (verapamil, diltiazem) both slow heart rate and AV conduction. Together they can cause severe bradycardia, heart block and heart failure.

Answer

C · Severe bradycardia and heart block

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