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 7-year-old with autism is admitted to a children's ward. Which nursing action is most helpful?

  1. AKeep to his usual routines where possible and prepare him for any changes
  2. BPut him in a busy bay with lots of noise and activity to keep him stimulated
  3. CAvoid his parents' advice, because staff know best how to care for him
  4. DChange his daily routine often, to help him get used to change
2.Mental health nursingHard

Two days after surgery, a 79-year-old woman is quiet and drowsy, stares into space and gives muddled answers that vary through the day. Her daughter says she was sharp before. What is most likely?

  1. ADepression after surgery
  2. BAdvanced dementia
  3. CHypoactive delirium
  4. DNormal tiredness after anaesthesia
3.Clinical psychologyMedium

Selective serotonin reuptake inhibitors (SSRIs) increase serotonin in the synapse by:

  1. ASpeeding up the breakdown of serotonin by monoamine oxidase enzymes
  2. BDestroying serotonin receptors
  3. CBlocking dopamine release
  4. DBlocking the reuptake of serotonin into the presynaptic neuron
4.Clinical psychologyHard

Comorbidity means that:

  1. AA symptom is shared by everyone in a group
  2. BA disorder is caused by a physical illness that occurs at the same time
  3. CA disorder runs in families
  4. DA person meets criteria for two or more disorders at the same time
5.PharmacologyMedium

Why should NSAIDs be used with caution in some people with asthma?

  1. AThey block the anti-inflammatory effect of inhaled corticosteroids
  2. BThey increase the clearance of salbutamol
  3. CThey can trigger bronchospasm in aspirin-sensitive asthma
  4. DThey cause mucus plugs by drying the airways
6.PharmacologyHard

A patient with early aspirin (salicylate) overdose has tinnitus and is breathing fast. Which acid–base pattern is classic?

  1. AMetabolic alkalosis followed by respiratory acidosis
  2. BPure metabolic alkalosis
  3. CRespiratory alkalosis followed by metabolic acidosis
  4. DRespiratory acidosis with normal bicarbonate

3Solutions

1.Mental health nursing

Answer: A · Keep to his usual routines where possible and prepare him for any changes

Why this is the answer

Predictability reduces distress. Nurses keep routines, use clear and concrete language, reduce sensory stimulation, use visual supports and work closely with the parents, who know the child best.

Answer

A · Keep to his usual routines where possible and prepare him for any changes
2.Mental health nursing

Answer: C · Hypoactive delirium

Why this is the answer

Hypoactive delirium presents with drowsiness, slowness and reduced activity, and is often missed or mistaken for depression. Acute onset, fluctuating course and inattention point to delirium.

Answer

C · Hypoactive delirium
3.Clinical psychology

Answer: D · Blocking the reuptake of serotonin into the presynaptic neuron

Why this is the answer

SSRIs block the serotonin transporter, so serotonin stays longer in the synaptic cleft. Clinical effects usually take several weeks.

Answer

D · Blocking the reuptake of serotonin into the presynaptic neuron
4.Clinical psychology

Answer: D · 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.

Answer

D · A person meets criteria for two or more disorders at the same time
5.Pharmacology

Answer: C · They can trigger bronchospasm in aspirin-sensitive asthma

Why this is the answer

In aspirin-exacerbated respiratory disease, COX inhibition increases leukotriene production, causing bronchospasm. These patients should avoid aspirin and other non-selective NSAIDs.

Answer

C · They can trigger bronchospasm in aspirin-sensitive asthma
6.Pharmacology

Answer: C · Respiratory alkalosis followed by metabolic acidosis

Why this is the answer

Salicylates stimulate breathing, causing respiratory alkalosis early. They then disturb cell metabolism, causing a metabolic acidosis with a raised anion gap. Adults often show a mixed picture.

Answer

C · Respiratory alkalosis followed by metabolic acidosis

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