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 student avoids eating in the canteen and speaking in seminars because she fears others will judge her or see her blush. Which disorder does this suggest?

  1. AGeneralised anxiety disorder
  2. BSocial anxiety disorder
  3. CObsessive-compulsive disorder
  4. DAgoraphobia
2.Kejururawatan kesihatan mentalSukar

A depressed patient says, "I don't enjoy anything any more, so there's no point in doing anything." Which intervention best reflects behavioural activation?

  1. ATell him that his thoughts are irrational and he should stop thinking that way
  2. BWait until his mood improves before suggesting activities
  3. CPlan small, scheduled activities with him and review how he felt afterwards
  4. DEncourage him to rest in bed as much as possible until the medicine works
3.Psikologi klinikalSederhana

Dalam model dua faktor fobia (Mowrer), bagaimanakah fobia dikekalkan?

  1. APenghindaran mengurangkan kebimbangan, yang mengukuhkan penghindaran secara negatif
  2. BPeneguhan positif ketakutan melalui ganjaran
  3. CHukuman terhadap tingkah laku menghampiri oleh orang lain, yang mengukuhkan ketakutan itu sendiri
  4. DKetakutan dipelajari dengan memerhati orang lain sahaja
4.Psikologi klinikalSukar

Seorang lelaki melaporkan lengan kirinya lumpuh selepas pertengkaran teruk, tetapi pemeriksaan neurologi menunjukkan penemuan yang tidak selaras dengan sebarang penyakit neurologi yang diketahui. Diagnosis DSM-5 manakah yang paling berkemungkinan?

  1. AGangguan kebimbangan penyakit
  2. BGangguan dismorfik badan
  3. CGangguan gejala neurologi fungsian (gangguan konversi)
  4. DMalingering
5.FarmakologiSederhana

A patient refuses a prescribed oral medicine. What should the nurse do?

  1. AExplore the reason, respect the decision, document and inform the prescriber
  2. BHide the tablet in the patient's food
  3. CLeave the tablet on the bedside table for later
  4. DRecord the medicine as given, so that the chart stays complete for the next shift
6.FarmakologiSukar

A patient taking a GLP-1 receptor agonist such as semaglutide has severe, constant upper abdominal pain spreading to the back, with vomiting. What should the nurse suspect?

  1. AHypoglycaemia; the patient should eat sweets and continue as usual
  2. BAcute pancreatitis; the drug is stopped and urgent assessment arranged
  3. CConstipation; a laxative will solve the problem
  4. DExpected nausea; the patient should take the next dose with food

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: B · Social anxiety disorder

Mengapa ini jawapannya

Social anxiety disorder is a marked fear of social situations in which the person may be scrutinised, with fear of embarrassment or negative judgement, leading to avoidance or intense distress.

Jawapan

B · Social anxiety disorder
2.Kejururawatan kesihatan mental

Jawapan: C · Plan small, scheduled activities with him and review how he felt afterwards

Mengapa ini jawapannya

Behavioural activation is based on the idea that activity improves mood, not the other way round. Scheduling achievable, meaningful activities and reviewing the effect breaks the cycle of withdrawal and low mood.

Jawapan

C · Plan small, scheduled activities with him and review how he felt afterwards
3.Psikologi klinikal

Jawapan: A · Penghindaran mengurangkan kebimbangan, yang mengukuhkan penghindaran secara negatif

Mengapa ini jawapannya

Ketakutan diperoleh melalui pelaziman klasik dan dikekalkan kerana mengelak objek yang ditakuti mengurangkan kebimbangan, lalu mengukuhkan penghindaran secara negatif.

Jawapan

A · Penghindaran mengurangkan kebimbangan, yang mengukuhkan penghindaran secara negatif
4.Psikologi klinikal

Jawapan: C · Gangguan gejala neurologi fungsian (gangguan konversi)

Mengapa ini jawapannya

Gangguan gejala neurologi fungsian melibatkan gejala motor atau deria yang tidak serasi dengan keadaan neurologi yang diiktiraf. Ia tidak memerlukan bukti punca psikologi atau bahawa gejala itu dipalsukan.

Jawapan

C · Gangguan gejala neurologi fungsian (gangguan konversi)
5.Farmakologi

Jawapan: A · Explore the reason, respect the decision, document and inform the prescriber

Mengapa ini jawapannya

Competent patients may refuse treatment. The nurse explores concerns, explains the purpose and risks, documents the refusal and informs the prescriber; covert administration needs formal legal and clinical procedures.

Jawapan

A · Explore the reason, respect the decision, document and inform the prescriber
6.Farmakologi

Jawapan: B · Acute pancreatitis; the drug is stopped and urgent assessment arranged

Mengapa ini jawapannya

Mild nausea is common with GLP-1 agonists, but severe persistent abdominal pain radiating to the back suggests pancreatitis. The drug is stopped and the patient needs urgent assessment, including serum lipase or amylase.

Jawapan

B · Acute pancreatitis; the drug is stopped and urgent assessment arranged

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