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 taking clozapine complains of drooling, especially at night. How should the nurse respond?

  1. ARecognise it as a common side effect, report it and suggest a towel on the pillow
  2. BTell him that it means the clozapine dose is too low and needs to be increased
  3. CExplain that it is a sign of an allergic reaction to the medicine
  4. DStop the clozapine immediately, because this is a sign of agranulocytosis
2.Kejururawatan kesihatan mentalSukar

During a ward community meeting, several patients complain that the ward is too noisy at night. What reflects a therapeutic milieu?

  1. ADiscuss the problem openly and involve patients in finding a solution
  2. BTell the patients that the rules cannot be changed
  3. CAsk the patients to write their complaints down and then do nothing
  4. DEnd the meeting so the complaint is not discussed further
3.Psikologi klinikalSederhana

Pakatan terapeutik (therapeutic alliance) merujuk kepada:

  1. ADiagnosis klien, seperti yang dipersetujui secara bebas oleh dua pakar psikiatri semasa penilaian awal
  2. BKumpulan ahli terapi yang berkongsi rujukan
  3. CIkatan kolaboratif dan persetujuan tentang matlamat dan tugasan antara ahli terapi dan klien
  4. DKontrak undang-undang antara klinik dan syarikat insurans
4.Psikologi klinikalSukar

Seorang pesakit skizofrenia kekal tidak bergerak dalam postur janggal selama berjam-jam dan menentang percubaan untuk menggerakkannya. Kelompok gejala manakah yang diterangkan oleh ini?

  1. AKatatonia
  2. BPenyiaran pemikiran
  3. CDiskinesia tardif
  4. DAlogia
5.FarmakologiSederhana

Which adverse effect of doxorubicin requires monitoring of heart function?

  1. ARapid rise in cholesterol
  2. BCumulative heart muscle damage leading to heart failure
  3. CPericarditis caused by infection
  4. DSevere hypertension during the infusion itself
6.FarmakologiSukar

A patient with type 2 diabetes starts a high dose of prednisolone for a flare of COPD. Which change should the nurse expect?

  1. AHigher blood glucose, so more frequent glucose checks are needed
  2. BNo change in glucose, as steroids act only in the lungs
  3. CLower potassium only, with no effect on glucose
  4. DLower blood glucose, so the diabetes medicines should be stopped

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: A · Recognise it as a common side effect, report it and suggest a towel on the pillow

Mengapa ini jawapannya

Hypersalivation is a common, unpleasant effect of clozapine, often worse at night. It can be embarrassing and affect adherence, so it is reported; treatments are available, and the nurse also watches for aspiration risk.

Jawapan

A · Recognise it as a common side effect, report it and suggest a towel on the pillow
2.Kejururawatan kesihatan mental

Jawapan: A · Discuss the problem openly and involve patients in finding a solution

Mengapa ini jawapannya

In a therapeutic milieu, the ward environment itself is used for treatment. Shared decision-making in community meetings builds responsibility, social skills and trust.

Jawapan

A · Discuss the problem openly and involve patients in finding a solution
3.Psikologi klinikal

Jawapan: C · Ikatan kolaboratif dan persetujuan tentang matlamat dan tugasan antara ahli terapi dan klien

Mengapa ini jawapannya

Pakatan terapeutik secara konsisten meramalkan hasil terapi merentasi pendekatan yang berbeza, yang menyokong kepentingan faktor sepunya dalam psikoterapi.

Jawapan

C · Ikatan kolaboratif dan persetujuan tentang matlamat dan tugasan antara ahli terapi dan klien
4.Psikologi klinikal

Jawapan: A · Katatonia

Mengapa ini jawapannya

Ciri katatonik termasuk stupor, postur, kelenturan seperti lilin, kebisuan dan negativisme. Dalam DSM-5 katatonia boleh berlaku bersama skizofrenia, gangguan mood atau keadaan perubatan.

Jawapan

A · Katatonia
5.Farmakologi

Jawapan: B · Cumulative heart muscle damage leading to heart failure

Mengapa ini jawapannya

Anthracyclines such as doxorubicin can damage heart muscle, and the risk increases with cumulative dose. Heart function is assessed before and during treatment; the drug can also turn urine red.

Jawapan

B · Cumulative heart muscle damage leading to heart failure
6.Farmakologi

Jawapan: A · Higher blood glucose, so more frequent glucose checks are needed

Mengapa ini jawapannya

Glucocorticoids raise blood glucose by increasing liver glucose production and insulin resistance. Glucose is monitored more often, and diabetes treatment may need to be increased during the course.

Jawapan

A · Higher blood glucose, so more frequent glucose checks are needed

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