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 started a high-dose corticosteroid (prednisolone or prednisone) a week ago is now euphoric, sleeping little and talking very fast. What should the nurse suspect?

  1. AAlcohol withdrawal
  2. BLithium toxicity
  3. CA normal reaction to feeling better from the treatment
  4. DMood changes caused by the corticosteroid
2.Kejururawatan kesihatan mentalSukar

An 8-year-old with separation anxiety disorder has missed two weeks of school. What is the most helpful approach?

  1. ASupport a gradual, planned return to school with a consistent goodbye routine
  2. BLet a parent stay with him in class every day for the rest of the year
  3. CTell him that he is being silly and must go
  4. DAllow him to stay at home until he wants to go back
3.Psikologi klinikalSederhana

Terapi kognitif berasaskan kesedaran penuh (MBCT) mempunyai bukti terbaik untuk:

  1. AMencegah kambuh pada orang yang mengalami kemurungan berulang
  2. BMerawat psikosis akut
  3. CMerawat masalah perhatian pada kanak-kanak kecil yang mengidap ADHD
  4. DMenyembuhkan demensia
4.Psikologi klinikalSukar

Temu duga yang mengikut set soalan tetap dalam susunan tetap untuk mencapai diagnosis dipanggil:

  1. ASesi asosiasi bebas
  2. BTemu duga tidak berstruktur
  3. CTemu duga klinikal berstruktur
  4. DUjian projektif
5.FarmakologiSederhana

A patient with Addison's disease on hydrocortisone develops a fever with flu. What is the usual advice?

  1. AHalve the hydrocortisone to reduce side effects
  2. BMake no change, as illness does not affect cortisol needs
  3. CIncrease the dose as instructed (sick-day rules) and seek help if vomiting
  4. DStop the hydrocortisone until the fever settles, to let the body recover
6.FarmakologiSukar

A patient taking long-term morphine for cancer pain becomes very sedated with slow breathing. Why is naloxone given in small, diluted doses?

  1. ATo restore breathing without causing severe withdrawal and pain
  2. BTo make the effect of naloxone last longer than morphine
  3. CBecause naloxone is much more potent and toxic in patients with cancer
  4. DBecause naloxone is toxic to the liver in large doses

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: D · Mood changes caused by the corticosteroid

Mengapa ini jawapannya

High-dose corticosteroids can cause mood changes, including mania, depression and psychosis. The nurse reports the change so the prescriber can review the dose and treatment.

Jawapan

D · Mood changes caused by the corticosteroid
2.Kejururawatan kesihatan mental

Jawapan: A · Support a gradual, planned return to school with a consistent goodbye routine

Mengapa ini jawapannya

Long-term avoidance strengthens anxiety. A gradual, planned return, short and predictable goodbyes, praise for brave behaviour and cooperation between parents and school, often with CBT, help the child cope.

Jawapan

A · Support a gradual, planned return to school with a consistent goodbye routine
3.Psikologi klinikal

Jawapan: A · Mencegah kambuh pada orang yang mengalami kemurungan berulang

Mengapa ini jawapannya

MBCT menggabungkan amalan kesedaran penuh dengan terapi kognitif. Ujian menunjukkan ia mengurangkan kambuh pada orang yang pernah mengalami tiga atau lebih episod kemurungan.

Jawapan

A · Mencegah kambuh pada orang yang mengalami kemurungan berulang
4.Psikologi klinikal

Jawapan: C · Temu duga klinikal berstruktur

Mengapa ini jawapannya

Temu duga berstruktur seperti SCID mengemukakan soalan piawai yang dikaitkan dengan kriteria diagnostik, meningkatkan kebolehpercayaan berbanding temu duga tidak berstruktur.

Jawapan

C · Temu duga klinikal berstruktur
5.Farmakologi

Jawapan: C · Increase the dose as instructed (sick-day rules) and seek help if vomiting

Mengapa ini jawapannya

During illness, the body needs more cortisol, so patients usually double their glucocorticoid dose as instructed. If they cannot keep tablets down, they need injectable hydrocortisone and urgent care.

Jawapan

C · Increase the dose as instructed (sick-day rules) and seek help if vomiting
6.Farmakologi

Jawapan: A · To restore breathing without causing severe withdrawal and pain

Mengapa ini jawapannya

In opioid-dependent patients, a large dose of naloxone can cause abrupt withdrawal, severe pain and agitation. Small titrated doses aim to restore adequate breathing while keeping some analgesia.

Jawapan

A · To restore breathing without causing severe withdrawal and pain

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