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 on a mental health ward insists that he is a famous inventor whose ideas were stolen by the government. Which type of delusion is the main one here?

  1. AErotomanic
  2. BNihilistic
  3. CGrandiose
  4. DSomatic
2.Kejururawatan kesihatan mentalSukar

A man whose wife died a month ago is rude and angry with the nurses about small things. What is the best understanding of his behaviour?

  1. AHe has antisocial personality disorder that was not noticed before
  2. BHis anger may be part of grief, displaced onto staff, so she should not take it personally
  3. CHe should be told that his behaviour is unacceptable and that visits will be stopped
  4. DHe does not care about his wife's death and is using it as an excuse to be rude
3.Psikologi klinikalSederhana

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

  1. APeneguhan positif ketakutan melalui ganjaran
  2. BKetakutan dipelajari dengan memerhati orang lain sahaja
  3. CPenghindaran mengurangkan kebimbangan, yang mengukuhkan penghindaran secara negatif
  4. DHukuman terhadap tingkah laku menghampiri oleh orang lain, yang mengukuhkan ketakutan itu sendiri
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 dismorfik badan
  2. BGangguan gejala neurologi fungsian (gangguan konversi)
  3. CMalingering
  4. DGangguan kebimbangan penyakit
5.FarmakologiSederhana

A patient with diabetes is sweaty and shaky. Blood glucose is 3.0 mmol/L (54 mg/dL). The patient is awake and can swallow. What should the nurse do first?

  1. AGive 15–20 g of fast-acting carbohydrate, such as juice
  2. BGive a large meal high in fat and protein to keep glucose up for longer
  3. CGive the next scheduled dose of insulin
  4. DGive intramuscular glucagon at once
6.FarmakologiSukar

A patient on adalimumab for rheumatoid arthritis has a fever and cough on the day of her next injection. What should the nurse advise?

  1. AStop the drug permanently without telling the prescriber
  2. BWithhold the injection and get the infection assessed first
  3. CDouble the next dose to make up for the infection
  4. DGive the injection, as it will help the fever

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: C · Grandiose

Mengapa ini jawapannya

Grandiose delusions are false beliefs about one's own importance, power or identity. They may combine with persecutory themes, as here, but the central belief is about being exceptional.

Jawapan

C · Grandiose
2.Kejururawatan kesihatan mental

Jawapan: B · His anger may be part of grief, displaced onto staff, so she should not take it personally

Mengapa ini jawapannya

Anger is a common part of grief and may be directed at staff who are safer targets. The nurse responds calmly, sets limits if needed and invites him to talk about his loss.

Jawapan

B · His anger may be part of grief, displaced onto staff, so she should not take it personally
3.Psikologi klinikal

Jawapan: C · 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

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

Jawapan: B · 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

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

Jawapan: A · Give 15–20 g of fast-acting carbohydrate, such as juice

Mengapa ini jawapannya

Conscious hypoglycaemia is treated with 15–20 g of fast-acting carbohydrate, with glucose rechecked after about 15 minutes. Fat slows absorption, and glucagon is kept for patients who cannot swallow.

Jawapan

A · Give 15–20 g of fast-acting carbohydrate, such as juice
6.Farmakologi

Jawapan: B · Withhold the injection and get the infection assessed first

Mengapa ini jawapannya

TNF inhibitors increase the risk of serious infections and can mask their signs. Doses are usually withheld during an active infection until it has been assessed and treated.

Jawapan

B · Withhold the injection and get the infection assessed first

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