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 who is detained under mental health legislation does not return from escorted leave. What should the nurse do?

  1. ARemove his name from the ward list and give his bed to a new patient who is waiting for admission
  2. BDo nothing, because patients are allowed to leave whenever they want
  3. CStart the missing patient procedure at once, informing the team and, if required, the police
  4. DWait until the next day, because he will probably return on his own
2.Mental health nursingHard

A voluntary patient asks to leave the ward now. While talking, he says he plans to jump from a bridge on the way home. What should the nurse do?

  1. AStay with him and inform the team at once, so he can be urgently assessed under mental health law
  2. BTell him to go home now and come back tomorrow morning when he feels calmer and safer
  3. CLet him leave, because voluntary patients can always go when they want
  4. DAsk him to promise that he will not jump, and then let him go home on his own
3.Clinical psychologyMedium

Which criterion of abnormality judges behaviour as abnormal when it is rare in the population?

  1. ADeviation from ideal mental health
  2. BStatistical infrequency
  3. CDeviation from social norms
  4. DFailure to function adequately
4.Clinical psychologyHard

Research on cultural factors shows that the Japanese syndrome taijin kyofusho mainly involves fear of:

  1. AThe genitals retracting into the body
  2. BBeing possessed by spirits
  3. CLosing one's soul after a sudden fright, leading to weakness and loss of appetite
  4. DOffending or embarrassing others through one's appearance or behaviour
5.PharmacologyMedium

A patient with suspected sepsis has blood cultures ordered and a first antibiotic dose due. What should the nurse do?

  1. AGive the antibiotic first, then take blood cultures the next day
  2. BWait for the culture results before giving any antibiotic
  3. CTake the blood cultures first, then give the antibiotic at once
  4. DGive the antibiotic only if the temperature is above 40 °C (104 °F)
6.PharmacologyHard

A patient with early aspirin (salicylate) overdose has tinnitus and is breathing fast. Which acid–base pattern is classic?

  1. ARespiratory acidosis with normal bicarbonate
  2. BRespiratory alkalosis followed by metabolic acidosis
  3. CMetabolic alkalosis followed by respiratory acidosis
  4. DPure metabolic alkalosis

3Solutions

1.Mental health nursing

Answer: C · Start the missing patient procedure at once, informing the team and, if required, the police

Why this is the answer

A detained patient who is absent without leave may be a risk to themselves or others. Missing patient procedures are started immediately, including a risk assessment and informing the responsible clinician and relevant authorities.

Answer

C · Start the missing patient procedure at once, informing the team and, if required, the police
2.Mental health nursing

Answer: A · Stay with him and inform the team at once, so he can be urgently assessed under mental health law

Why this is the answer

A voluntary patient who shows immediate serious risk may need urgent assessment under mental health legislation, which often includes short-term holding powers for nurses. The nurse acts quickly to keep him safe.

Answer

A · Stay with him and inform the team at once, so he can be urgently assessed under mental health law
3.Clinical psychology

Answer: B · Statistical infrequency

Why this is the answer

Statistical infrequency defines abnormality as behaviour far from the average. Its weakness is that some rare traits, such as very high IQ, are desirable.

Answer

B · Statistical infrequency
4.Clinical psychology

Answer: D · Offending or embarrassing others through one's appearance or behaviour

Why this is the answer

Taijin kyofusho is a cultural concept of distress in which the person fears that their gaze, odour or appearance will offend others. It shows that culture shapes how anxiety is expressed.

Answer

D · Offending or embarrassing others through one's appearance or behaviour
5.Pharmacology

Answer: C · Take the blood cultures first, then give the antibiotic at once

Why this is the answer

Cultures are taken before antibiotics so the organism can be identified, but antibiotics must not be delayed in sepsis. Taking cultures quickly and then giving the antibiotic meets both aims.

Answer

C · Take the blood cultures first, then give the antibiotic at once
6.Pharmacology

Answer: B · Respiratory alkalosis followed by metabolic acidosis

Why this is the answer

Salicylates stimulate breathing, causing respiratory alkalosis early. They then disturb cell metabolism, causing a metabolic acidosis with a raised anion gap. Adults often show a mixed picture.

Answer

B · Respiratory alkalosis followed by metabolic acidosis

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