Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.
2Soalan latihan
1.Kejururawatan kesihatan mentalSederhana
A patient who has taken lithium for 3 years reports tiredness, weight gain, feeling cold and constipation. Which problem should be checked?
AHyperthyroidism
BHypothyroidism
CSerotonin syndrome
DAgranulocytosis
2.Kejururawatan kesihatan mentalSukar
A colleague suggests putting a loud but non-violent patient in seclusion "because he's annoying everyone". What is the correct response?
AIt would be inappropriate, because seclusion is only a last resort for serious risk of harm
BIt is acceptable as long as the seclusion lasts for less than an hour
CIt is acceptable, because it will make the ward quieter and safer for the other patients
DIt is acceptable as long as the patient agrees afterwards
3.Psikologi klinikalSederhana
Pengaktifan tingkah laku merawat kemurungan terutamanya dengan:
AMenetapkan tempoh rehat sepenuhnya
BMeneroka konflik zaman kanak-kanak secara terperinci
CMeningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
DMendedahkan seseorang kepada sensasi badan yang ditakuti secara berperingkat
4.Psikologi klinikalSukar
Seorang ahli terapi membantu klien dengan gangguan panik sengaja mencetuskan pening dengan berpusing di atas kerusi, tanpa menggunakan tingkah laku keselamatan. Apakah nama teknik ini dan mengapa ia digunakan?
APendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya
BTerapi aversi, supaya klien belajar mengaitkan panik dengan ketidakselesaan fizikal
CAsosiasi bebas, supaya ketakutan tidak sedar terdedah
DFlooding, supaya klien melupakan traumanya
5.FarmakologiSederhana
A patient with heart failure starts furosemide. Which self-monitoring instruction is most useful?
ACheck the blood glucose before every meal
BWeigh daily at the same time on the same scales
CCount the respiratory rate each evening
DMeasure the temperature twice a day and record it in a diary
6.FarmakologiSukar
Why must several weeks pass before starting an MAO inhibitor after stopping fluoxetine?
AFluoxetine permanently and irreversibly blocks MAO enzymes
BFluoxetine and its active metabolite have very long half-lives
CMAO inhibitors are absorbed only after fluoxetine is gone
DFluoxetine must first be converted into an MAO inhibitor
3Larutan
1.Kejururawatan kesihatan mental
Jawapan: B · Hypothyroidism
Mengapa ini jawapannya
Lithium can reduce thyroid hormone production, causing hypothyroidism. Thyroid function is checked regularly, and treatment with levothyroxine allows lithium to be continued if needed.
Jawapan
B · Hypothyroidism
2.Kejururawatan kesihatan mental
Jawapan: A · It would be inappropriate, because seclusion is only a last resort for serious risk of harm
Mengapa ini jawapannya
Seclusion is a restrictive intervention used only to contain severe behaviour likely to cause harm to others, as a last resort, for the shortest time. Using it for convenience or punishment breaches patients' rights.
Jawapan
A · It would be inappropriate, because seclusion is only a last resort for serious risk of harm
3.Psikologi klinikal
Jawapan: C · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
Mengapa ini jawapannya
Pengaktifan tingkah laku menjadualkan aktiviti yang mendatangkan keseronokan atau penguasaan, memutuskan kitaran penarikan diri dan peneguhan rendah. Ia rawatan berasaskan bukti untuk kemurungan.
Jawapan
C · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
4.Psikologi klinikal
Jawapan: A · Pendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya
Mengapa ini jawapannya
Pendedahan interoseptif mencetuskan sensasi badan yang ditakuti supaya klien dapat menguji ramalan bencana dan menjadi terbiasa. Ia bahagian teras CBT untuk gangguan panik.
Jawapan
A · Pendedahan interoseptif, supaya klien belajar bahawa sensasi badan tidak berbahaya
5.Farmakologi
Jawapan: B · Weigh daily at the same time on the same scales
Mengapa ini jawapannya
Daily weight is the best home measure of fluid balance. A rapid gain suggests fluid retention, and a rapid loss suggests overdiuresis and dehydration, both of which should be reported.
Jawapan
B · Weigh daily at the same time on the same scales
6.Farmakologi
Jawapan: B · Fluoxetine and its active metabolite have very long half-lives
Mengapa ini jawapannya
Norfluoxetine, the active metabolite of fluoxetine, stays in the body for weeks. A long washout is needed before an MAOI to avoid serotonin syndrome.
Jawapan
B · Fluoxetine and its active metabolite have very long half-lives