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 patient says, "I'm going to be a famous singer, and I'll buy this whole hospital." Which response best uses the technique of voicing doubt?

  1. A"Why do you want to buy the hospital?"
  2. B"That sounds hard to believe."
  3. C"That's wonderful. When will you start?"
  4. D"You know that isn't true at all."
2.Kejururawatan kesihatan mentalSukar

A patient with depression answers every question with one or two words and looks at the floor. Which approach is most helpful?

  1. AAsk several open questions in quick succession to keep the conversation going
  2. BEnd the conversation quickly, because the patient clearly does not want to talk
  3. CUse simple statements, allow extra time for answers and stay with the patient even in silence
  4. DEncourage him to cheer up and think about the good things in his life
3.Psikologi klinikalSederhana

Seseorang mengelak bas, kedai, tempat letak kereta terbuka dan barisan kerana melarikan diri mungkin sukar jika dia panik. Diagnosis manakah yang paling sesuai?

  1. AKlaustrofobia sebagai fobia spesifik
  2. BGangguan kebimbangan umum
  3. CAgorafobia
  4. DGangguan kebimbangan sosial
4.Psikologi klinikalSukar

Seorang lelaki berkata seorang penyanyi terkenal diam-diam jatuh cinta kepadanya dan menghantar mesej berkod melalui lagunya. Selain itu, pemikiran dan tingkah lakunya normal, tanpa halusinasi. Diagnosis manakah yang paling sesuai?

  1. AGangguan delusi, jenis erotomanik
  2. BGangguan personaliti narsisistik
  3. CSkizofrenia, jenis paranoid
  4. DGangguan bipolar dengan mania
5.FarmakologiSederhana

A patient takes cholestyramine. How should other oral medicines be timed?

  1. AMix them into the cholestyramine drink so they are taken together
  2. BTake them 1 hour before or several hours after cholestyramine
  3. CTake them all at the same time as cholestyramine
  4. DTiming does not matter, as cholestyramine is not absorbed
6.FarmakologiSukar

A patient with severe liver cirrhosis takes oral propranolol, a drug with a high first-pass metabolism. What effect is expected?

  1. AMore drug reaches the circulation, so a lower dose may be needed
  2. BThe first-pass effect increases, so the drug becomes inactive
  3. CThe drug is excreted faster by the kidney, so it works for a shorter time
  4. DLess drug is absorbed from the gut, so a higher dose is needed

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: B · "That sounds hard to believe."

Mengapa ini jawapannya

Voicing doubt lets the patient know the nurse does not share the belief, without a confrontation. Arguing tends to make delusional beliefs firmer, while agreeing reinforces them.

Jawapan

B · "That sounds hard to believe."
2.Kejururawatan kesihatan mental

Jawapan: C · Use simple statements, allow extra time for answers and stay with the patient even in silence

Mengapa ini jawapannya

Psychomotor slowing makes answering hard. Short, simple communication, patience and a calm presence show acceptance, while pressure or forced cheerfulness can increase feelings of failure.

Jawapan

C · Use simple statements, allow extra time for answers and stay with the patient even in silence
3.Psikologi klinikal

Jawapan: C · Agorafobia

Mengapa ini jawapannya

Agorafobia melibatkan ketakutan terhadap sekurang-kurangnya dua situasi (pengangkutan awam, ruang terbuka, ruang tertutup, orang ramai atau barisan, berada di luar bersendirian) kerana melarikan diri atau mendapatkan bantuan mungkin tidak dapat dilakukan.

Jawapan

C · Agorafobia
4.Psikologi klinikal

Jawapan: A · Gangguan delusi, jenis erotomanik

Mengapa ini jawapannya

Gangguan delusi melibatkan satu atau lebih delusi sekurang-kurangnya sebulan tanpa memenuhi kriteria skizofrenia, dan fungsi tidak terjejas dengan ketara selain daripada delusi itu. Delusi erotomanik ialah tentang orang lain yang jatuh cinta kepada pesakit.

Jawapan

A · Gangguan delusi, jenis erotomanik
5.Farmakologi

Jawapan: B · Take them 1 hour before or several hours after cholestyramine

Mengapa ini jawapannya

Bile acid sequestrants bind many drugs, such as warfarin, digoxin and levothyroxine, as well as fat-soluble vitamins. Other drugs are taken about 1 hour before or 4–6 hours after it.

Jawapan

B · Take them 1 hour before or several hours after cholestyramine
6.Farmakologi

Jawapan: A · More drug reaches the circulation, so a lower dose may be needed

Mengapa ini jawapannya

In cirrhosis, less of the oral dose is removed by the liver on its first pass, partly because blood bypasses the liver through shunts. Bioavailability and plasma levels rise, so doses of such drugs often need to be reduced.

Jawapan

A · More drug reaches the circulation, so a lower dose may be needed

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