Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.
2Soalan latihan
1.Kejururawatan kesihatan mentalSederhana
A patient in a manic episode makes repeated sexual comments to a nurse. What is the most appropriate response?
AAvoid the patient for the rest of the shift
BRespond with similar comments to build rapport
CLaugh at the comments so he does not feel rejected
DCalmly say that the comments are not acceptable and redirect him
2.Kejururawatan kesihatan mentalSukar
A community nurse visits an older woman with hoarding disorder whose home is so cluttered that the exits are blocked. What is the most appropriate approach?
AWork with her to clear the exits first, then agree a gradual plan together
BTell her that she will be evicted unless everything is thrown away today
CIgnore the clutter, because it is her own home
DArrange for the whole house to be cleared while she is out
3.Psikologi klinikalSederhana
Yang manakah gejala positif skizofrenia?
APenarikan diri sosial
BAfek tumpul
CDelusi
DKemiskinan pertuturan
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?
AFlooding, supaya klien melupakan traumanya
BPendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya
CAsosiasi bebas, supaya ketakutan tidak sedar terdedah
DTerapi aversi, supaya klien belajar mengaitkan panik dengan ketidakselesaan fizikal
5.FarmakologiSederhana
After a vaccination, why is a person asked to wait for a short time before leaving?
ATo make sure the injection site does not bruise
BTo measure the person's temperature for fever
CTo watch for anaphylaxis, which usually starts within minutes
DTo check that the vaccine has already created protective antibodies
6.FarmakologiSukar
A patient receiving frequent salbutamol (albuterol) nebulisers develops a fine tremor and a heart rate of 120 per minute. What is the best explanation?
AAt high doses it also stimulates beta receptors in skeletal muscle and the heart
BSalbutamol blocks muscarinic receptors in the heart
CSalbutamol causes high potassium, which speeds the heart and causes muscle twitching
DThe patient is allergic to salbutamol and needs adrenaline
3Larutan
1.Kejururawatan kesihatan mental
Jawapan: D · Calmly say that the comments are not acceptable and redirect him
Mengapa ini jawapannya
Disinhibition is common in mania. Clear, calm limit setting and redirection protect both staff and patient and maintain boundaries without punishing him.
Jawapan
D · Calmly say that the comments are not acceptable and redirect him
2.Kejururawatan kesihatan mental
Jawapan: A · Work with her to clear the exits first, then agree a gradual plan together
Mengapa ini jawapannya
Forced clear-outs cause great distress and the clutter usually returns. Collaborative, gradual work focusing first on safety, such as fire exits and fall risks, with involvement of relevant services, is more effective.
Jawapan
A · Work with her to clear the exits first, then agree a gradual plan together
3.Psikologi klinikal
Jawapan: C · Delusi
Mengapa ini jawapannya
Gejala positif ialah tambahan (halusinasi, delusi, pertuturan tidak teratur). Gejala negatif ialah kehilangan (afek tumpul, avolisi, alogia).
Jawapan
C · Delusi
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: C · To watch for anaphylaxis, which usually starts within minutes
Mengapa ini jawapannya
Anaphylaxis after vaccination is rare but usually begins soon after the injection. Staff and adrenaline must be available during the observation period.
Jawapan
C · To watch for anaphylaxis, which usually starts within minutes
6.Farmakologi
Jawapan: A · At high doses it also stimulates beta receptors in skeletal muscle and the heart
Mengapa ini jawapannya
Tremor comes from beta-2 stimulation of skeletal muscle. Tachycardia comes from some beta-1 (and cardiac beta-2) stimulation and a reflex response to vasodilation. High doses also shift potassium into cells and can cause hypokalaemia.
Jawapan
A · At high doses it also stimulates beta receptors in skeletal muscle and the heart