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

How should a nurse screen a patient for intimate partner violence?

  1. AAsk in front of the partner to see how he reacts
  2. BOnly ask patients who have visible injuries
  3. CAsk in private, without the partner or family present
  4. DAsk the partner instead of the patient
2.Kejururawatan kesihatan mentalSukar

An 80-year-old patient taking a benzodiazepine for sleep fell at night on the way to the toilet. After checking her for injury, what is the most appropriate next step?

  1. AGive an extra dose so that she sleeps through the night without getting up
  2. BUse bed rails and a restraint every night to keep her safely in bed until the morning
  3. CReport the fall, put falls precautions in place and ask for a review of her sleep medicine
  4. DDo nothing more, because falls are normal in older people
3.Psikologi klinikalSederhana

Dalam model ABC Ellis, apakah maksud "B"?

  1. ALatar belakang (Background) klien
  2. BSensasi badan (Bodily sensations) semasa tekanan
  3. CTingkah laku (Behaviour) yang mengikuti peristiwa
  4. DKepercayaan (Beliefs) tentang peristiwa pencetus
4.Psikologi klinikalSukar

Penemuan manakah yang paling menyokong peranan serotonin dan monoamina lain, bukan keadaan semata-mata, dalam kemurungan?

  1. AKemurungan tidak pernah berlaku dalam keluarga
  2. BUbat yang bertindak pada sistem monoamina mengurangkan gejala kemurungan lebih daripada plasebo dalam ujian rawak
  3. CKadar kemurungan sama di semua negara, walaupun terdapat perbezaan besar dalam keadaan sosial dan ekonomi
  4. DSemua orang yang mengalami kehilangan menjadi murung
5.FarmakologiSederhana

Why are benzodiazepines used with great caution in older people?

  1. AThey cause permanent hearing loss in older people
  2. BThey are not absorbed from the gut after age 65
  3. CThey raise the risk of confusion, falls and fractures
  4. DThey cause severe high blood pressure in older people
6.FarmakologiSukar

Why are tetracyclines usually avoided in pregnancy and in young children (under 8 years in US guidance, under 12 years in the UK)?

  1. AThey cause grey baby syndrome in infants
  2. BThey cause severe hearing loss in children
  3. CThey bind to growing teeth and bone and stain the teeth permanently
  4. DThey block the action of growth hormone and stunt the child's growth

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: C · Ask in private, without the partner or family present

Mengapa ini jawapannya

Screening should be done privately, using direct, non-judgemental questions. Abuse occurs in all groups, so routine screening is better than asking only those with obvious injuries.

Jawapan

C · Ask in private, without the partner or family present
2.Kejururawatan kesihatan mental

Jawapan: C · Report the fall, put falls precautions in place and ask for a review of her sleep medicine

Mengapa ini jawapannya

Benzodiazepines increase the risk of falls in older adults. After a fall, the nurse reports it, reduces risks such as poor lighting and the distance to the toilet, and asks for a medication review.

Jawapan

C · Report the fall, put falls precautions in place and ask for a review of her sleep medicine
3.Psikologi klinikal

Jawapan: D · Kepercayaan (Beliefs) tentang peristiwa pencetus

Mengapa ini jawapannya

Dalam model ABC, peristiwa Pencetus (Activating event) membawa kepada Akibat (Consequences) emosi melalui Kepercayaan (Beliefs) seseorang. Mengubah kepercayaan yang tidak rasional mengubah akibatnya.

Jawapan

D · Kepercayaan (Beliefs) tentang peristiwa pencetus
4.Psikologi klinikal

Jawapan: B · Ubat yang bertindak pada sistem monoamina mengurangkan gejala kemurungan lebih daripada plasebo dalam ujian rawak

Mengapa ini jawapannya

Antidepresan yang menyasarkan monoamina mengatasi plasebo secara purata, walaupun dengan margin sederhana. Ini menyokong sumbangan biologi tetapi tidak menunjukkan bahawa serotonin rendah sahaja menyebabkan kemurungan.

Jawapan

B · Ubat yang bertindak pada sistem monoamina mengurangkan gejala kemurungan lebih daripada plasebo dalam ujian rawak
5.Farmakologi

Jawapan: C · They raise the risk of confusion, falls and fractures

Mengapa ini jawapannya

Older people are more sensitive to benzodiazepines and often eliminate them more slowly. Sedation, unsteadiness and confusion raise the risk of falls and fractures.

Jawapan

C · They raise the risk of confusion, falls and fractures
6.Farmakologi

Jawapan: C · They bind to growing teeth and bone and stain the teeth permanently

Mengapa ini jawapannya

Tetracyclines chelate calcium and are deposited in growing teeth and bones. This can cause permanent yellow-brown staining of the teeth and may affect bone growth. Short courses of doxycycline are sometimes still used in younger children for specific serious infections.

Jawapan

C · They bind to growing teeth and bone and stain the teeth permanently

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