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

An 80-year-old man often talks about his life and his achievements. According to Erikson, which task is he working on?

  1. AIntimacy versus isolation
  2. BGenerativity versus stagnation
  3. CIdentity versus role confusion
  4. DIntegrity versus despair
2.Mental health nursingHard

A patient who has taken clozapine for a year stops smoking cigarettes. Why does this matter?

  1. AClozapine levels may rise, increasing the risk of side effects such as sedation and seizures
  2. BClozapine stops working completely
  3. CIt does not matter at all
  4. DClozapine levels fall sharply, so the dose usually has to be doubled to prevent a psychotic relapse
3.Clinical psychologyMedium

A person avoids buses, shops, open car parks and queues because escape might be difficult if they panic. Which diagnosis fits best?

  1. AClaustrophobia as a specific phobia
  2. BAgoraphobia
  3. CGeneralised anxiety disorder
  4. DSocial anxiety disorder
4.Clinical psychologyHard

A study compares a new therapy with a waiting-list control and finds a large benefit. Why might this overestimate the therapy's specific effect?

  1. AWaiting lists remove the placebo effect completely, so any benefit must come from the therapy itself
  2. BWaiting-list controls always receive the same therapy
  3. CWaiting-list participants cannot be randomised
  4. DA waiting list controls for time passing but not for attention, expectation or the alliance
5.PharmacologyMedium

After naloxone reverses an opioid overdose, why must the patient be watched closely?

  1. ANaloxone itself causes respiratory depression at high doses
  2. BNaloxone may wear off before the opioid does, so breathing can slow again
  3. CNaloxone makes the opioid stay longer in the body
  4. DNaloxone often causes severe low blood glucose a few hours after the dose
6.PharmacologyHard

A patient on simvastatin is prescribed gemfibrozil. What is the main concern?

  1. AA sharp rise in LDL cholesterol and triglycerides
  2. BLoss of all lipid-lowering effect
  3. CSevere hypoglycaemia
  4. DA much higher risk of myopathy and rhabdomyolysis

3Solutions

1.Mental health nursing

Answer: D · Integrity versus despair

Why this is the answer

In later life, the task is to look back and find meaning in one's life. Reminiscence supports a sense of integrity; failure leads to regret and despair.

Answer

D · Integrity versus despair
2.Mental health nursing

Answer: A · Clozapine levels may rise, increasing the risk of side effects such as sedation and seizures

Why this is the answer

Smoke induces the liver enzyme CYP1A2, which metabolises clozapine. After stopping smoking, levels can rise substantially, so the prescriber should be informed and levels and side effects monitored.

Answer

A · Clozapine levels may rise, increasing the risk of side effects such as sedation and seizures
3.Clinical psychology

Answer: B · Agoraphobia

Why this is the answer

Agoraphobia involves fear of at least two situations (public transport, open spaces, enclosed spaces, crowds or queues, being outside alone) because escape or help might be unavailable.

Answer

B · Agoraphobia
4.Clinical psychology

Answer: D · A waiting list controls for time passing but not for attention, expectation or the alliance

Why this is the answer

Waiting-list designs show that therapy beats no treatment, but common factors such as hope and therapist contact are not controlled. An active comparison or attention-placebo control is needed to test specific ingredients.

Answer

D · A waiting list controls for time passing but not for attention, expectation or the alliance
5.Pharmacology

Answer: B · Naloxone may wear off before the opioid does, so breathing can slow again

Why this is the answer

Naloxone acts for a shorter time than many opioids, especially long-acting and slow-release ones. Repeated doses or an infusion may be needed.

Answer

B · Naloxone may wear off before the opioid does, so breathing can slow again
6.Pharmacology

Answer: D · A much higher risk of myopathy and rhabdomyolysis

Why this is the answer

Gemfibrozil reduces statin clearance and adds its own muscle toxicity. The combination greatly increases the risk of rhabdomyolysis and is generally avoided.

Answer

D · A much higher risk of myopathy and rhabdomyolysis

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