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

The nurse notices that she is spending much longer with one patient than with the others and feels she is the only one who can help him. What does this most likely indicate?

  1. AAn ideal therapeutic relationship
  2. BThat the patient needs to be transferred to another unit
  3. CTransference by the patient towards the nurse, which is never the nurse's concern
  4. DPossible boundary problems that she should discuss in supervision
2.Mental health nursingHard

A mother with suspected postpartum psychosis says her newborn baby is "evil" and "must be stopped". What is the priority?

  1. AKeep the baby safe, never alone with her, and arrange urgent assessment
  2. BPlan a routine follow-up appointment with the health visitor in 2 weeks
  3. CEncourage her to spend more time alone with the baby so that they can bond
  4. DReassure her that all new mothers feel this way
3.Clinical psychologyMedium

According to the duty established in the Tarasoff case in California, a therapist may need to:

  1. ATake steps to protect an identifiable person whom a client seriously threatens
  2. BReport every client who expresses anger
  3. CRefuse to treat clients with a history of violence
  4. DKeep all information confidential under every circumstance, whatever the risk to others
4.Clinical psychologyHard

An interview that follows a fixed set of questions in a fixed order to reach a diagnosis is called:

  1. AAn unstructured interview
  2. BA free association session
  3. CA projective test
  4. DA structured clinical interview
5.PharmacologyMedium

How does clopidogrel reduce platelet aggregation?

  1. AIt inhibits platelet COX-1
  2. BIt blocks the glycoprotein IIb/IIIa receptor directly
  3. CIt activates antithrombin
  4. DIt blocks the platelet P2Y12 receptor for ADP
6.PharmacologyHard

A patient has received a sodium nitroprusside infusion for several days. He becomes confused and develops a metabolic acidosis. What should be suspected?

  1. AHyperkalaemia from the infusion
  2. BAn allergic reaction to the plastic of the infusion bag
  3. CHypoglycaemia from nitroprusside
  4. DCyanide toxicity from nitroprusside breakdown

3Solutions

1.Mental health nursing

Answer: D · Possible boundary problems that she should discuss in supervision

Why this is the answer

Feeling special or indispensable to one patient, and giving them extra time, are warning signs of over-involvement. Discussing this in clinical supervision helps the nurse keep a therapeutic relationship.

Answer

D · Possible boundary problems that she should discuss in supervision
2.Mental health nursing

Answer: A · Keep the baby safe, never alone with her, and arrange urgent assessment

Why this is the answer

Postpartum psychosis with delusions about the baby carries a risk of harm to the infant and to the mother. The baby must be kept safe and the mother assessed urgently, usually with admission.

Answer

A · Keep the baby safe, never alone with her, and arrange urgent assessment
3.Clinical psychology

Answer: A · Take steps to protect an identifiable person whom a client seriously threatens

Why this is the answer

The Tarasoff rulings held that when a client poses a serious danger of violence to an identifiable victim, the therapist has a duty to take reasonable steps to protect that person.

Answer

A · Take steps to protect an identifiable person whom a client seriously threatens
4.Clinical psychology

Answer: D · A structured clinical interview

Why this is the answer

Structured interviews such as the SCID ask standard questions tied to diagnostic criteria, increasing reliability compared with unstructured interviews.

Answer

D · A structured clinical interview
5.Pharmacology

Answer: D · It blocks the platelet P2Y12 receptor for ADP

Why this is the answer

Clopidogrel is activated in the liver and irreversibly blocks the P2Y12 ADP receptor on platelets. It is often combined with aspirin after a heart attack or stent.

Answer

D · It blocks the platelet P2Y12 receptor for ADP
6.Pharmacology

Answer: D · Cyanide toxicity from nitroprusside breakdown

Why this is the answer

Nitroprusside releases cyanide, which is normally converted to thiocyanate. With high doses, long infusions or poor organ function, cyanide and thiocyanate can accumulate; the infusion is also protected from light.

Answer

D · Cyanide toxicity from nitroprusside breakdown

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