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

Why is giving approval, such as saying "That's good" about a patient's decision, considered non-therapeutic?

  1. AIt always makes the patient angry and more likely to become aggressive towards staff
  2. BIt shows that the nurse is not listening at all
  3. CIt suggests that the patient's choices are judged against the nurse's standards
  4. DIt is against the law in mental health settings
2.Mental health nursingHard

A patient who has worked well with the nurse for three weeks becomes angry and refuses to attend their sessions after being told that discharge is planned for next week. What is the best interpretation?

  1. AThe nurse has made an error and should cancel the discharge
  2. BThe patient is reacting to the coming end of the relationship
  3. CThe patient no longer needs the sessions and should be discharged at once
  4. DThe patient has developed a new psychotic illness
3.Clinical psychologyMedium

Rosenhan's study "On being sane in insane places" raised concerns about:

  1. AThe validity of psychiatric diagnosis
  2. BThe effectiveness of CBT
  3. CThe ethics of animal research
  4. DThe safety of antidepressants
4.Clinical psychologyHard

A man reports that his left arm became paralysed after a severe argument, but neurological examination shows findings inconsistent with any known neurological disease. Which DSM-5 diagnosis is most likely?

  1. AIllness anxiety disorder
  2. BMalingering
  3. CBody dysmorphic disorder
  4. DFunctional neurological symptom disorder (conversion disorder)
5.PharmacologyMedium

A transplant patient takes tacrolimus. Which monitoring is most important?

  1. ABlood drug levels and kidney function
  2. BSerum amylase
  3. CThyroid function and bone density
  4. DPeak expiratory flow
6.PharmacologyHard

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

  1. AHypoglycaemia and weight gain
  2. BHyperkalaemia and muscle weakness
  3. CRebound tachycardia and hypertension
  4. DSevere bradycardia and heart block

3Solutions

1.Mental health nursing

Answer: C · It suggests that the patient's choices are judged against the nurse's standards

Why this is the answer

Approval can make the patient try to please the nurse rather than make their own decisions, and may suggest that the opposite choice would be "bad". Giving recognition or exploring the decision is preferred.

Answer

C · It suggests that the patient's choices are judged against the nurse's standards
2.Mental health nursing

Answer: B · The patient is reacting to the coming end of the relationship

Why this is the answer

Anger, withdrawal or return of symptoms are common responses to termination. The nurse acknowledges the feelings, reviews progress and helps the patient prepare for the ending.

Answer

B · The patient is reacting to the coming end of the relationship
3.Clinical psychology

Answer: A · The validity of psychiatric diagnosis

Why this is the answer

Pseudopatients who reported hearing a single word were admitted and kept for weeks, suggesting diagnosis was influenced by context. The study's methods have been questioned since.

Answer

A · The validity of psychiatric diagnosis
4.Clinical psychology

Answer: D · Functional neurological symptom disorder (conversion disorder)

Why this is the answer

Functional neurological symptom disorder involves motor or sensory symptoms incompatible with recognised neurological conditions. It does not require proof of a psychological cause or that the symptoms are feigned.

Answer

D · Functional neurological symptom disorder (conversion disorder)
5.Pharmacology

Answer: A · Blood drug levels and kidney function

Why this is the answer

Tacrolimus levels are kept in a target range to prevent rejection and toxicity. Kidney damage, hyperkalaemia, high glucose and tremor are adverse effects, and interacting drugs and grapefruit are avoided.

Answer

A · Blood drug levels and kidney function
6.Pharmacology

Answer: D · 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

D · Severe bradycardia and heart block

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