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

A 24-year-old woman with bipolar disorder is starting valproate. What is the most important teaching point?

  1. AIt must be taken with grapefruit juice to be absorbed
  2. BIt is safe in pregnancy and needs no special precautions
  3. CIt can seriously harm an unborn baby, so effective contraception and specialist advice are essential
  4. DIt will cause her to lose weight quickly, so she should eat extra meals and snacks every day
2.Kejururawatan kesihatan mentalSukar

A 50-year-old man has believed for a year that his wife is unfaithful. He works normally, his speech is organised and he has no hallucinations. Which diagnosis is most likely?

  1. ABipolar I disorder
  2. BSchizophrenia
  3. CSchizophreniform disorder
  4. DDelusional disorder
3.Psikologi klinikalSederhana

Pernyataan manakah tentang hipotesis monoamina kemurungan yang paling tepat?

  1. AIa telah disahkan sepenuhnya melalui pengukuran langsung tahap serotonin dalam otak pesakit yang hidup
  2. BIa mengaitkan kemurungan dengan aktiviti monoamina yang rendah tetapi sukar menerangkan tindak balas ubat yang tertangguh
  3. CIa meramalkan bahawa antidepresan memperbaiki mood dalam beberapa jam selepas satu dos
  4. DIa membuktikan bahawa kemurungan hanya disebabkan oleh dopamin rendah dalam lobus frontal
4.Psikologi klinikalSukar

Seorang ahli terapi berkata: "Daripada melawan pemikiran 'Saya seorang yang gagal', perhatikannya sebagai sekadar pemikiran, dan bertindaklah mengikut apa yang penting bagi anda." Terapi manakah yang paling mewakili perkara ini?

  1. APenyahpekaan sistematik
  2. BTerapi tingkah laku emotif rasional
  3. CTerapi penerimaan dan komitmen (ACT)
  4. DPsikoanalisis klasik
5.FarmakologiSederhana

Bethanechol may be used for non-obstructive urinary retention. How does it work?

  1. AIt shrinks the prostate gland
  2. BIt stimulates muscarinic receptors and contracts the bladder muscle
  3. CIt increases urine production in the kidney
  4. DIt blocks muscarinic receptors and relaxes the bladder wall muscle
6.FarmakologiSukar

A postoperative patient using morphine PCA is very drowsy, hard to rouse and has a respiratory rate of 7 per minute. What should the nurse do first?

  1. AEncourage the patient to press the button only when awake and in pain
  2. BStop the PCA, try to rouse the patient and give naloxone as per protocol
  3. CReduce the PCA dose and leave the pump running
  4. DLet the patient sleep and recheck in one hour

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: C · It can seriously harm an unborn baby, so effective contraception and specialist advice are essential

Mengapa ini jawapannya

Valproate is highly teratogenic, causing neural tube defects and developmental problems. Women who could become pregnant need clear information, effective contraception and specialist review.

Jawapan

C · It can seriously harm an unborn baby, so effective contraception and specialist advice are essential
2.Kejururawatan kesihatan mental

Jawapan: D · Delusional disorder

Mengapa ini jawapannya

Delusional disorder involves one or more delusions for at least 1 month, without other prominent symptoms of schizophrenia, and functioning is not markedly impaired apart from the effects of the delusion. Jealous delusions are one recognised type.

Jawapan

D · Delusional disorder
3.Psikologi klinikal

Jawapan: B · Ia mengaitkan kemurungan dengan aktiviti monoamina yang rendah tetapi sukar menerangkan tindak balas ubat yang tertangguh

Mengapa ini jawapannya

Hipotesis ini tercetus daripada kesan ubat pada monoamina. Kelewatan beberapa minggu sebelum manfaat menunjukkan bahawa perubahan hiliran, seperti penyesuaian reseptor, juga penting.

Jawapan

B · Ia mengaitkan kemurungan dengan aktiviti monoamina yang rendah tetapi sukar menerangkan tindak balas ubat yang tertangguh
4.Psikologi klinikal

Jawapan: C · Terapi penerimaan dan komitmen (ACT)

Mengapa ini jawapannya

ACT (Hayes) menggunakan penerimaan, penyahgabungan kognitif dan tindakan berasaskan nilai. Tidak seperti terapi kognitif tradisional, ia tidak cuba mempertikaikan kandungan pemikiran.

Jawapan

C · Terapi penerimaan dan komitmen (ACT)
5.Farmakologi

Jawapan: B · It stimulates muscarinic receptors and contracts the bladder muscle

Mengapa ini jawapannya

Bethanechol mimics acetylcholine at muscarinic receptors, contracting the detrusor muscle. It must not be used if there is mechanical obstruction to outflow.

Jawapan

B · It stimulates muscarinic receptors and contracts the bladder muscle
6.Farmakologi

Jawapan: B · Stop the PCA, try to rouse the patient and give naloxone as per protocol

Mengapa ini jawapannya

Excessive sedation and a low respiratory rate signal opioid-induced respiratory depression. The opioid is stopped, the patient is stimulated and supported with oxygen, naloxone is given as per protocol and help is called.

Jawapan

B · Stop the PCA, try to rouse the patient and give naloxone as per protocol

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