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

The nurse notices that she is spending much longer with one patient than with the others and feels she is the only one who can help him. What does this most likely indicate?

  1. APossible boundary problems that she should discuss in supervision
  2. BTransference by the patient towards the nurse, which is never the nurse's concern
  3. CAn ideal therapeutic relationship
  4. DThat the patient needs to be transferred to another unit
2.Kejururawatan kesihatan mentalSukar

A 15-year-old tells the school nurse she has been cutting herself and asks her not to tell her parents. What is the best response?

  1. ATell her that cutting is a phase that many teenagers go through and it needs no help
  2. BExplain that safety information must be shared, and involve her in how this is done
  3. CPromise never to tell anyone about it, so that she keeps trusting the school nurse
  4. DPhone her parents at once without telling her
3.Psikologi klinikalSederhana

Kajian Rosenhan "On being sane in insane places" menimbulkan kebimbangan tentang:

  1. AKeberkesanan CBT
  2. BKeselamatan antidepresan
  3. CKesahan diagnosis psikiatri
  4. DEtika penyelidikan haiwan
4.Psikologi klinikalSukar

Model "saintis-pengamal" (Boulder) dalam psikologi klinikal bermaksud bahawa pengamal klinikal harus:

  1. AMenetapkan ubat sebagai rawatan utama mereka, dengan mengikuti garis panduan psikiatri dengan teliti
  2. BMengelak penyelidikan sepenuhnya
  3. CHanya menjalankan eksperimen makmal
  4. DMenggunakan bukti penyelidikan untuk memandu amalan dan menilai intervensi mereka sendiri
5.FarmakologiSederhana

After naloxone reverses an opioid overdose, why must the patient be watched closely?

  1. ANaloxone makes the opioid stay longer in the body
  2. BNaloxone itself causes respiratory depression at high doses
  3. CNaloxone may wear off before the opioid does, so breathing can slow again
  4. DNaloxone often causes severe low blood glucose a few hours after the dose
6.FarmakologiSukar

A patient has SIADH with mild hyponatraemia and no neurological symptoms. What is usually the first-line treatment?

  1. AA rapid bolus of hypertonic saline
  2. BFluid restriction
  3. CLarge volumes of IV glucose 5%
  4. DDesmopressin

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: A · Possible boundary problems that she should discuss in supervision

Mengapa ini jawapannya

Feeling special or indispensable to one patient, and giving them extra time, are warning signs of over-involvement. Discussing this in clinical supervision helps the nurse keep a therapeutic relationship.

Jawapan

A · Possible boundary problems that she should discuss in supervision
2.Kejururawatan kesihatan mental

Jawapan: B · Explain that safety information must be shared, and involve her in how this is done

Mengapa ini jawapannya

Confidentiality has limits when there is risk of harm. The nurse explains this honestly, assesses risk and works with the young person on how and with whom information is shared, in line with safeguarding policy.

Jawapan

B · Explain that safety information must be shared, and involve her in how this is done
3.Psikologi klinikal

Jawapan: C · Kesahan diagnosis psikiatri

Mengapa ini jawapannya

Pseudopesakit yang melaporkan mendengar satu perkataan telah dimasukkan dan ditahan selama berminggu-minggu, menunjukkan diagnosis dipengaruhi oleh konteks. Kaedah kajian ini telah dipersoalkan sejak itu.

Jawapan

C · Kesahan diagnosis psikiatri
4.Psikologi klinikal

Jawapan: D · Menggunakan bukti penyelidikan untuk memandu amalan dan menilai intervensi mereka sendiri

Mengapa ini jawapannya

Model Boulder melatih ahli psikologi klinikal untuk mengintegrasikan penyelidikan saintifik dengan amalan klinikal, asas amalan berasaskan bukti.

Jawapan

D · Menggunakan bukti penyelidikan untuk memandu amalan dan menilai intervensi mereka sendiri
5.Farmakologi

Jawapan: C · Naloxone may wear off before the opioid does, so breathing can slow again

Mengapa ini jawapannya

Naloxone acts for a shorter time than many opioids, especially long-acting and slow-release ones. Repeated doses or an infusion may be needed.

Jawapan

C · Naloxone may wear off before the opioid does, so breathing can slow again
6.Farmakologi

Jawapan: B · Fluid restriction

Mengapa ini jawapannya

In SIADH, excess ADH makes the kidneys retain water. Restricting fluid intake raises sodium gradually; hypertonic saline is kept for severe symptomatic cases, and hypotonic fluids and desmopressin would worsen it.

Jawapan

B · Fluid restriction

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