Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.
2Soalan latihan
1.Kejururawatan kesihatan mentalSederhana
A patient at high risk of suicide is placed on constant (one-to-one) observation. What does this mean?
AThe patient can be left alone while asleep
BA staff member stays with the patient at all times, at the distance set by policy, including in the bathroom
CThe patient is seen once a shift by the nurse in charge, and otherwise checked by camera from the office when staff are free
DThe patient is checked every hour during the day only
2.Kejururawatan kesihatan mentalSukar
A patient with long-standing schizophrenia is often seen drinking from the taps. Today he is confused, has a headache and his serum sodium is 124 mmol/L (124 mEq/L). What is the most likely problem?
AA worsening of his psychosis that needs a higher dose of antipsychotic
BNeuroleptic malignant syndrome from his antipsychotic medicine
CWater intoxication from psychogenic polydipsia
DDehydration caused by anticholinergic side effects
3.Psikologi klinikalSederhana
Pakatan terapeutik (therapeutic alliance) merujuk kepada:
AIkatan kolaboratif dan persetujuan tentang matlamat dan tugasan antara ahli terapi dan klien
BKumpulan ahli terapi yang berkongsi rujukan
CKontrak undang-undang antara klinik dan syarikat insurans
DDiagnosis klien, seperti yang dipersetujui secara bebas oleh dua pakar psikiatri semasa penilaian awal
4.Psikologi klinikalSukar
Seorang berumur 22 tahun mengalami halusinasi dan delusi selama dua bulan, selepas itu ia pulih sepenuhnya. Tiada episod mood berlaku. Diagnosis manakah yang paling sesuai?
AGangguan skizofreniform
BGangguan psikotik singkat
CSkizofrenia
DGangguan skizoafektif
5.FarmakologiSederhana
A patient taking levodopa finds that the drug works poorly after large meals. Which advice is most appropriate?
ATake every dose with a large glass of milk and a protein snack
BDouble the dose after each meal
CTake the drug only at bedtime
DAvoid taking doses at the same time as high-protein meals
6.FarmakologiSukar
A patient with Parkinson's disease has nausea. Why should metoclopramide be avoided?
AIt causes severe diarrhoea in Parkinson's disease
BIt blocks dopamine receptors in the brain and can worsen the parkinsonism
CIt increases dopamine levels in the brain too much and causes psychosis
DIt inhibits the absorption of all oral drugs
3Larutan
1.Kejururawatan kesihatan mental
Jawapan: B · A staff member stays with the patient at all times, at the distance set by policy, including in the bathroom
Mengapa ini jawapannya
Constant observation means a member of staff is always with the patient, at a distance set by policy, so they can intervene immediately. It is reviewed regularly and stepped down as risk reduces.
Jawapan
B · A staff member stays with the patient at all times, at the distance set by policy, including in the bathroom
2.Kejururawatan kesihatan mental
Jawapan: C · Water intoxication from psychogenic polydipsia
Mengapa ini jawapannya
Some patients with chronic psychosis drink excessive water, which dilutes sodium and can cause confusion, seizures and coma. The nurse reports the result, monitors neurological status and follows orders for fluid restriction and regular weights.
Jawapan
C · Water intoxication from psychogenic polydipsia
3.Psikologi klinikal
Jawapan: A · Ikatan kolaboratif dan persetujuan tentang matlamat dan tugasan antara ahli terapi dan klien
Mengapa ini jawapannya
Pakatan terapeutik secara konsisten meramalkan hasil terapi merentasi pendekatan yang berbeza, yang menyokong kepentingan faktor sepunya dalam psikoterapi.
Jawapan
A · Ikatan kolaboratif dan persetujuan tentang matlamat dan tugasan antara ahli terapi dan klien
4.Psikologi klinikal
Jawapan: A · Gangguan skizofreniform
Mengapa ini jawapannya
Gangguan skizofreniform mempunyai gejala skizofrenia tetapi berlangsung antara satu hingga enam bulan. Tempoh ialah ciri utama yang membezakannya daripada gangguan psikotik singkat dan skizofrenia.
Jawapan
A · Gangguan skizofreniform
5.Farmakologi
Jawapan: D · Avoid taking doses at the same time as high-protein meals
Mengapa ini jawapannya
Dietary amino acids compete with levodopa for absorption in the gut and transport into the brain. Spreading protein through the day or timing doses away from high-protein meals improves the effect.
Jawapan
D · Avoid taking doses at the same time as high-protein meals
6.Farmakologi
Jawapan: B · It blocks dopamine receptors in the brain and can worsen the parkinsonism
Mengapa ini jawapannya
Metoclopramide crosses the blood–brain barrier and antagonises D2 receptors. In Parkinson's disease this worsens rigidity and bradykinesia, so antiemetics that do not block central dopamine receptors are preferred.
Jawapan
B · It blocks dopamine receptors in the brain and can worsen the parkinsonism