精神看護学：直前対策パック

公式集、全トピックの解法の要点、6 問の演習問題。完全な解答は巻末にあります。

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1公式と解法

精神看護

解き方

  1. 差し迫ったリスクがあるかを判断します：自殺、暴力、薬物による緊急事態、身体疾患。
  2. まず安全を確保します：観察する、手段を取り除く、鎮静化（デエスカレーション）を図る、有害な薬を中止する、助けを呼ぶ。
  3. 治療的な応答を選びます：感情を受け止め、現実を伝え、根拠のない安心づけや「なぜ」という質問は避けます。
  4. 権利を尊重します：最も制限の少ない方法、同意、そして限界のある守秘義務。

2演習問題

1.精神看護ふつう

How should a patient take sublingual buprenorphine-naloxone tablets?

  1. ALet the tablet dissolve completely under the tongue without chewing or swallowing it
  2. BSwallow the tablet whole with a large glass of water
  3. CCrush the tablet and mix it with a spoonful of soft food such as yoghurt
  4. DChew the tablet quickly and then swallow it with juice so that it reaches the stomach faster
2.精神看護むずかしい

A patient's mood changes several times a day, usually after conflicts with others. She has chronic feelings of emptiness and a strong fear of being abandoned. Which diagnosis is most likely?

  1. ABorderline personality disorder
  2. BSchizoid personality disorder with low mood
  3. CBipolar I disorder
  4. DPersistent depressive disorder
3.臨床心理学ふつう

次のうち統合失調症の陽性症状はどれですか？

  1. A妄想
  2. B会話の貧困
  3. C社会的引きこもり
  4. D感情の平板化
4.臨床心理学むずかしい

統合失調症のドーパミン仮説を支持する観察はどれですか？

  1. Aアンフェタミンなどドーパミンを増やす薬物が精神病症状を引き起こしうる
  2. B抗精神病薬は中脳辺縁系経路のドーパミン活動を高め、症状を軽減する
  3. Cセロトニン濃度だけで症状を予測できる
  4. Dすべての患者が抗うつ薬に同じようによく反応する
5.薬理学ふつう

During a rapid infusion of vancomycin, a patient develops flushing and a red rash on the face, neck and upper body. What is the most likely cause and action?

  1. AAcute kidney failure; stop all IV fluids and antibiotics at once
  2. BAn infusion reaction; stop or slow the infusion and inform the prescriber
  3. CA normal effect; increase the infusion rate to finish sooner
  4. DA sign that the infection is spreading; give a second dose
6.薬理学むずかしい

A patient with type 2 diabetes starts a high dose of prednisolone for a flare of COPD. Which change should the nurse expect?

  1. ALower potassium only, with no effect on glucose
  2. BLower blood glucose, so the diabetes medicines should be stopped
  3. CNo change in glucose, as steroids act only in the lungs
  4. DHigher blood glucose, so more frequent glucose checks are needed

3溶液

1.精神看護

答え: A · Let the tablet dissolve completely under the tongue without chewing or swallowing it

これが答えになる理由

Buprenorphine is poorly absorbed if swallowed, so it is dissolved under the tongue. Naloxone is added to discourage injection, because it is poorly absorbed sublingually but active if injected.

答え

A · Let the tablet dissolve completely under the tongue without chewing or swallowing it
2.精神看護

答え: A · Borderline personality disorder

これが答えになる理由

In borderline personality disorder, mood shifts are short-lived, often hours, and are usually triggered by interpersonal events. Bipolar episodes last days to weeks and are not mainly reactive to relationships.

答え

A · Borderline personality disorder
3.臨床心理学

答え: A · 妄想

これが答えになる理由

陽性症状は付け加わるもの（幻覚、妄想、まとまりのない会話）で、陰性症状は失われるもの（感情の平板化、意欲低下、思考の貧困）です。

答え

A · 妄想
4.臨床心理学

答え: A · アンフェタミンなどドーパミンを増やす薬物が精神病症状を引き起こしうる

これが答えになる理由

アンフェタミンは精神病を誘発することがあり、D2 を遮断する抗精神病薬は陽性症状を減らします。陰性症状はうまく説明できないため、仮説は修正されてきました。

答え

A · アンフェタミンなどドーパミンを増やす薬物が精神病症状を引き起こしうる
5.薬理学

答え: B · An infusion reaction; stop or slow the infusion and inform the prescriber

これが答えになる理由

Rapid vancomycin infusion releases histamine, causing flushing and itching of the upper body (formerly called "red man syndrome"). It is managed by stopping or slowing the infusion, and sometimes with an antihistamine.

答え

B · An infusion reaction; stop or slow the infusion and inform the prescriber
6.薬理学

答え: D · Higher blood glucose, so more frequent glucose checks are needed

これが答えになる理由

Glucocorticoids raise blood glucose by increasing liver glucose production and insulin resistance. Glucose is monitored more often, and diabetes treatment may need to be increased during the course.

答え

D · Higher blood glucose, so more frequent glucose checks are needed

ExamProblems · examproblems.com/courses/mental-health-nursing