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 who has started chlorpromazine feels dizzy when she gets out of bed. What should the nurse teach her?

  1. ADrink a cup of strong coffee before getting out of bed each morning
  2. BGet up quickly to get the blood flowing to the brain
  3. CStop the medicine if the dizziness happens more than once
  4. DSit on the edge of the bed for a moment and then stand up slowly
2.Kejururawatan kesihatan mentalSukar

A nurse teaches a family member how to use a naloxone kit. Which statement shows a need for further teaching?

  1. A"I'll check his breathing and put him in the recovery position if he is breathing but still not awake."
  2. B"If he doesn't respond, I may need to give a second dose."
  3. C"I'll stay with him, because the overdose can come back."
  4. D"Once I've given the naloxone, I don't need to call an ambulance."
3.Psikologi klinikalSederhana

Dalam penilaian risiko bunuh diri, faktor manakah yang merupakan antara peramal terkuat percubaan bunuh diri pada masa depan?

  1. ABercakap secara terbuka dengan ahli terapi
  2. BMenjadi pelajar universiti
  3. CMempunyai bulatan rakan yang besar
  4. DPercubaan bunuh diri sebelum ini
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. ATerapi penerimaan dan komitmen (ACT)
  2. BTerapi tingkah laku emotif rasional
  3. CPsikoanalisis klasik
  4. DPenyahpekaan sistematik
5.FarmakologiSederhana

How does sucralfate help a peptic ulcer heal?

  1. AIt forms a protective coating over the ulcer base
  2. BIt neutralises acid by releasing bicarbonate
  3. CIt kills Helicobacter pylori directly
  4. DIt blocks histamine H2 receptors in the stomach
6.FarmakologiSukar

A patient taking co-trimoxazole develops fever, a spreading blistering rash and painful mouth sores. What is the most likely diagnosis?

  1. AA mild rash that will settle; continue the drug and give moisturiser
  2. BStevens–Johnson syndrome; stop the drug and get urgent medical care
  3. CSunburn caused by the drug; advise sunscreen only
  4. DOral thrush; start an antifungal and continue the antibiotic

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: D · Sit on the edge of the bed for a moment and then stand up slowly

Mengapa ini jawapannya

Many antipsychotics cause orthostatic hypotension through alpha-1 blockade. Rising slowly reduces dizziness and the risk of falls; the nurse also checks lying and standing blood pressure.

Jawapan

D · Sit on the edge of the bed for a moment and then stand up slowly
2.Kejururawatan kesihatan mental

Jawapan: D · "Once I've given the naloxone, I don't need to call an ambulance."

Mengapa ini jawapannya

Naloxone is short-acting, so the opioid effect can return. Emergency services must always be called, and the person must be watched until help arrives.

Jawapan

D · "Once I've given the naloxone, I don't need to call an ambulance."
3.Psikologi klinikal

Jawapan: D · Percubaan bunuh diri sebelum ini

Mengapa ini jawapannya

Sejarah percubaan bunuh diri antara faktor risiko terkuat. Bertanya secara langsung tentang fikiran bunuh diri tidak meningkatkan risiko dan merupakan sebahagian daripada penilaian yang baik.

Jawapan

D · Percubaan bunuh diri sebelum ini
4.Psikologi klinikal

Jawapan: A · 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

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

Jawapan: A · It forms a protective coating over the ulcer base

Mengapa ini jawapannya

Sucralfate forms a gel-like barrier that sticks to the ulcer and protects it from acid and pepsin. It is taken on an empty stomach and can reduce the absorption of other drugs taken at the same time.

Jawapan

A · It forms a protective coating over the ulcer base
6.Farmakologi

Jawapan: B · Stevens–Johnson syndrome; stop the drug and get urgent medical care

Mengapa ini jawapannya

Stevens–Johnson syndrome is a severe drug reaction with skin blistering and mucosal involvement. Sulfonamides are a common cause, and the drug must be stopped immediately.

Jawapan

B · Stevens–Johnson syndrome; stop the drug and get urgent medical care

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