Kejururawatan Kesihatan Mental: pek ulang kaji kilat

Lembaran formula, langkah kaedah utama untuk setiap topik dan 6 soalan latihan, dengan penyelesaian penuh di bahagian belakang.

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1Formula dan kaedah

Kejururawatan kesihatan mental

Kaedah

  1. Tentukan sama ada terdapat risiko segera: bunuh diri, keganasan, kecemasan akibat ubat atau penyakit fizikal.
  2. Bertindak untuk keselamatan dahulu: perhatikan, alihkan alat yang boleh digunakan, redakan ketegangan, hentikan ubat yang berbahaya, dapatkan bantuan.
  3. Pilih respons terapeutik: akui perasaan, kemukakan realiti, elakkan jaminan palsu dan soalan “mengapa”.
  4. Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.

2Soalan latihan

1.Kejururawatan kesihatan mentalSederhana

What should a patient starting zolpidem for insomnia be taught to report?

  1. ADoing things while not fully awake, such as sleepwalking or driving, with no memory of it
  2. BSleeping through the night without waking up
  3. CFeeling sleepy about 30 minutes after taking it at bedtime
  4. DFeeling slightly more rested and alert the next morning than before starting the medicine
2.Kejururawatan kesihatan mentalSukar

On a mental health ward, which task is most appropriate for the nurse to delegate to a healthcare assistant?

  1. AAccompanying a stable patient to the dining room and recording his food intake
  2. BEvaluating whether a PRN medicine given an hour ago has worked
  3. CCarrying out the full admission suicide risk assessment of a newly admitted patient
  4. DTeaching a patient about the side effects of lithium
3.Psikologi klinikalSederhana

Pengaktifan tingkah laku merawat kemurungan terutamanya dengan:

  1. AMeneroka konflik zaman kanak-kanak secara terperinci
  2. BMendedahkan seseorang kepada sensasi badan yang ditakuti secara berperingkat
  3. CMeningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
  4. DMenetapkan tempoh rehat sepenuhnya
4.Psikologi klinikalSukar

Seorang ahli terapi membantu klien dengan gangguan panik sengaja mencetuskan pening dengan berpusing di atas kerusi, tanpa menggunakan tingkah laku keselamatan. Apakah nama teknik ini dan mengapa ia digunakan?

  1. AAsosiasi bebas, supaya ketakutan tidak sedar terdedah
  2. BPendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya
  3. CTerapi aversi, supaya klien belajar mengaitkan panik dengan ketidakselesaan fizikal
  4. DFlooding, supaya klien melupakan traumanya
5.FarmakologiSederhana

A patient uses two different eye drops at the same time of day. What should the nurse advise?

  1. APut both drops in at exactly the same moment
  2. BWait at least 5 minutes between the two drops
  3. CUse only one of them each day
  4. DMix the drops in one bottle first
6.FarmakologiSukar

A patient with heart failure on furosemide is also given metolazone, a thiazide-like diuretic. Which risk increases most?

  1. AHypoglycaemia and weight gain
  2. BSevere hypokalaemia, hyponatraemia and dehydration
  3. CSevere hypertension, tachycardia and fluid retention
  4. DHyperkalaemia and fluid overload

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: A · Doing things while not fully awake, such as sleepwalking or driving, with no memory of it

Mengapa ini jawapannya

Zolpidem and similar "Z-drugs" can cause complex sleep behaviours, such as sleep-walking, sleep-driving or cooking while not fully awake, which can cause serious injury. These must be reported and the drug stopped.

Jawapan

A · Doing things while not fully awake, such as sleepwalking or driving, with no memory of it
2.Kejururawatan kesihatan mental

Jawapan: A · Accompanying a stable patient to the dining room and recording his food intake

Mengapa ini jawapannya

Routine, predictable tasks with stable patients, such as escorting and recording intake, can be delegated. Assessment, care planning, teaching and evaluation require the nurse's judgement.

Jawapan

A · Accompanying a stable patient to the dining room and recording his food intake
3.Psikologi klinikal

Jawapan: C · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai

Mengapa ini jawapannya

Pengaktifan tingkah laku menjadualkan aktiviti yang mendatangkan keseronokan atau penguasaan, memutuskan kitaran penarikan diri dan peneguhan rendah. Ia rawatan berasaskan bukti untuk kemurungan.

Jawapan

C · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
4.Psikologi klinikal

Jawapan: B · Pendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya

Mengapa ini jawapannya

Pendedahan interoseptif mencetuskan sensasi badan yang ditakuti supaya klien dapat menguji ramalan bencana dan menjadi terbiasa. Ia bahagian teras CBT untuk gangguan panik.

Jawapan

B · Pendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya
5.Farmakologi

Jawapan: B · Wait at least 5 minutes between the two drops

Mengapa ini jawapannya

Waiting several minutes allows the first drop to be absorbed before the next is applied. Eye ointments are usually applied last.

Jawapan

B · Wait at least 5 minutes between the two drops
6.Farmakologi

Jawapan: B · Severe hypokalaemia, hyponatraemia and dehydration

Mengapa ini jawapannya

Combining a loop and a thiazide diuretic gives a strong synergistic diuresis. This can cause marked electrolyte loss and volume depletion, so weight, electrolytes and kidney function are monitored closely.

Jawapan

B · Severe hypokalaemia, hyponatraemia and dehydration

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