1Formulas and methods
Mental health nursing
Method
- Decide whether there is an immediate risk: suicide, violence, a drug emergency or a physical illness.
- Act on safety first: observe, remove means, de-escalate, stop a harmful drug, get help.
- Choose the therapeutic response: acknowledge feelings, present reality, avoid false reassurance and “why” questions.
- Respect rights: the least restrictive option, consent and confidentiality with its limits.
2Practice problems
1.Mental health nursingMedium
A patient lies awake in bed for hours worrying about not sleeping. Which stimulus control advice is correct?
- ADo vigorous exercise in the bedroom until tired enough to fall asleep straight away
- BStay in bed and watch television or use a phone until sleep finally comes
- CIf still awake after about 20 minutes, get up, do something calm and return when sleepy
- DLook at the clock often to check how much sleep is being lost
2.Mental health nursingHard
A patient who had been abstinent from alcohol for 6 months has started drinking again. He says, "I've failed completely. There's no point in trying." What is the most helpful response?
- A"You obviously weren't serious about stopping."
- B"Yes, I'm afraid you've wasted all of your hard work over the last six months."
- C"You'll have to start a completely new treatment from the beginning."
- D"Relapse is common in recovery. Let's look at what led to it and what you learned."
3.Clinical psychologyMedium
A woman has had a depressed mood most of the day, on most days, for three years, though not severe enough for major depression. Which DSM-5 diagnosis fits best?
- APersistent depressive disorder (dysthymia)
- BAdjustment disorder with depressed mood
- CBipolar II disorder
- DCyclothymic disorder
4.Clinical psychologyHard
Comorbidity means that:
- AA disorder runs in families
- BA disorder is caused by a physical illness that occurs at the same time
- CA person meets criteria for two or more disorders at the same time
- DA symptom is shared by everyone in a group
5.PharmacologyMedium
A patient takes isoniazid. Which advice is most important?
- AExpect the urine to turn orange
- BAvoid alcohol and report jaundice, dark urine or poor appetite
- CTake it with antacids to protect the stomach from irritation
- DStop the drug when the cough improves
6.PharmacologyHard
How does levonorgestrel emergency contraception mainly work?
- AIt causes an immediate period
- BIt kills sperm in the vagina
- CIt delays or prevents ovulation
- DIt ends an established pregnancy
3Solutions
1.Mental health nursing
Answer: C · If still awake after about 20 minutes, get up, do something calm and return when sleepy
Why this is the answer
Stimulus control strengthens the bed as a cue for sleep. Getting up when unable to sleep, using the bed only for sleep and intimacy, and keeping a regular wake time are key parts.
C · If still awake after about 20 minutes, get up, do something calm and return when sleepy
2.Mental health nursing
Answer: D · "Relapse is common in recovery. Let's look at what led to it and what you learned."
Why this is the answer
Relapse is common and does not mean failure. Treating it as a learning opportunity, reviewing triggers and coping strategies and returning to the plan supports the person's motivation.
D · "Relapse is common in recovery. Let's look at what led to it and what you learned."
3.Clinical psychology
Answer: A · Persistent depressive disorder (dysthymia)
Why this is the answer
Persistent depressive disorder requires depressed mood for at least two years in adults, with additional symptoms such as poor appetite, low energy or hopelessness.
A · Persistent depressive disorder (dysthymia)
4.Clinical psychology
Answer: C · A person meets criteria for two or more disorders at the same time
Why this is the answer
Comorbidity is the co-occurrence of disorders in the same person, which complicates diagnosis and treatment and raises questions about categorical classification.
C · A person meets criteria for two or more disorders at the same time
5.Pharmacology
Answer: B · Avoid alcohol and report jaundice, dark urine or poor appetite
Why this is the answer
Isoniazid can cause hepatitis, and alcohol increases the risk. Signs of liver injury are reported at once, and liver tests may be checked.
B · Avoid alcohol and report jaundice, dark urine or poor appetite
6.Pharmacology
Answer: C · It delays or prevents ovulation
Why this is the answer
Levonorgestrel emergency contraception mainly prevents or delays ovulation and does not disrupt an implanted pregnancy. Its effectiveness falls the longer it is delayed after unprotected sex.
C · It delays or prevents ovulation