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 with psychosis says, "There's a man standing in the corner." The nurse sees no one there. Which response uses presenting reality?

  1. A"What does the man in the corner look like?"
  2. B"The man will go away if you ignore him."
  3. C"That's just your illness talking, so there's nothing to worry about. Try to think of something else."
  4. D"I don't see anyone in the corner, but I know it seems real to you."
2.Mental health nursingHard

A patient taking lithium has had vomiting and diarrhoea for 2 days. She now has a coarse tremor and is confused. What should the nurse do first?

  1. AGive the next dose with extra water
  2. BHold the next dose and notify the prescriber urgently so a lithium level can be taken
  3. CEncourage a low-salt diet
  4. DGive an antidiarrhoeal and continue the lithium as normal, with extra salt in her diet
3.Clinical psychologyMedium

A patient feels intense anxiety about having a serious illness despite having few or no bodily symptoms and repeated normal tests. Which diagnosis fits best?

  1. AIllness anxiety disorder
  2. BSomatic symptom disorder
  3. CFunctional neurological symptom disorder
  4. DFactitious disorder
4.Clinical psychologyHard

Which statement about the placebo effect in antidepressant trials is most accurate?

  1. APlacebo effects never occur in depression
  2. BPlacebo response is so strong that antidepressants have never shown any benefit over it in trials
  3. CPlacebos work only in physical illnesses
  4. DPlacebo response rates are substantial, so trials need control groups to show drug effects
5.PharmacologyMedium

A patient given haloperidol develops a sudden painful twisting of the neck and the eyes roll upward. Which drug is usually given?

  1. AAn anticholinergic such as benzatropine (benztropine)
  2. BDantrolene by mouth to relax the twisted neck muscles
  3. CA second dose of haloperidol
  4. DNaloxone
6.PharmacologyHard

A breastfeeding mother needs a mild analgesic. Which drug is generally considered compatible with breastfeeding?

  1. ACodeine (as co-codamol)
  2. BParacetamol (acetaminophen)
  3. CPethidine (meperidine)
  4. DAspirin

3Solutions

1.Mental health nursing

Answer: D · "I don't see anyone in the corner, but I know it seems real to you."

Why this is the answer

Presenting reality calmly states the nurse's own perception while accepting that the experience feels real to the patient. It neither confirms the hallucination nor argues with the patient.

Answer

D · "I don't see anyone in the corner, but I know it seems real to you."
2.Mental health nursing

Answer: B · Hold the next dose and notify the prescriber urgently so a lithium level can be taken

Why this is the answer

Dehydration and sodium loss reduce lithium clearance. Coarse tremor and confusion suggest toxicity. Withhold lithium, get an urgent level, kidney function and electrolytes, and arrange medical review.

Answer

B · Hold the next dose and notify the prescriber urgently so a lithium level can be taken
3.Clinical psychology

Answer: A · Illness anxiety disorder

Why this is the answer

Illness anxiety disorder involves preoccupation with having or acquiring a serious illness with minimal somatic symptoms. Somatic symptom disorder centres on distressing symptoms and excessive thoughts about them.

Answer

A · Illness anxiety disorder
4.Clinical psychology

Answer: D · Placebo response rates are substantial, so trials need control groups to show drug effects

Why this is the answer

Placebo response in depression trials is often 30–40%, so randomised placebo-controlled designs are needed to show the specific effect of a drug.

Answer

D · Placebo response rates are substantial, so trials need control groups to show drug effects
5.Pharmacology

Answer: A · An anticholinergic such as benzatropine (benztropine)

Why this is the answer

Acute dystonia is caused by dopamine blockade, which leaves acetylcholine activity relatively high. An IM or IV anticholinergic usually relieves it within minutes.

Answer

A · An anticholinergic such as benzatropine (benztropine)
6.Pharmacology

Answer: B · Paracetamol (acetaminophen)

Why this is the answer

Paracetamol passes into milk in small amounts and is widely regarded as safe. Codeine can cause dangerous opioid levels in babies of ultra-rapid metaboliser mothers, aspirin carries a Reye's risk and pethidine's metabolite accumulates in infants.

Answer

B · Paracetamol (acetaminophen)

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