精神科护理：速成包

公式表、每个专题的关键方法步骤和 6 道练习题，完整解答附在最后。

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1公式与方法

精神科护理

方法

  1. 判断是否存在即时风险：自杀、暴力、药物急症或躯体疾病。
  2. 先保障安全：观察、移除危险物品、缓和局面、停用有害药物、寻求帮助。
  3. 选择治疗性回应：承认感受、陈述现实，避免虚假的安慰和“为什么”式提问。
  4. 尊重权利：采用限制最少的方案，知情同意，以及保密及其限度。

2练习题

1.精神科护理中等

A patient asks the nurse for her home phone number so they can keep in touch after discharge. What is the best response?

  1. A"I'll give you my number, but please only call me at weekends when I'm not working, and keep it short."
  2. B"I can't give you my number, because our relationship is a professional one. Let's talk about support you can contact after discharge."
  3. C"That would be against the rules, so please stop asking about it."
  4. D"Of course, as long as you don't tell the other patients."
2.精神科护理困难

An 81-year-old woman's memory has slowly worsened over 2 years. She repeats questions and gets lost in familiar places, but she is alert and her attention is normal. Which condition is most likely?

  1. ABrief psychotic disorder in later life
  2. BDelirium
  3. CA neurocognitive disorder such as Alzheimer's disease
  4. DNormal ageing with mild forgetfulness
3.临床心理学中等

罗森汉的研究《On being sane in insane places》引发了对什么的担忧？

  1. A抗抑郁药的安全性
  2. B精神科诊断的效度
  3. CCBT 的有效性
  4. D动物研究的伦理
4.临床心理学困难

一名 22 岁的人出现幻觉和妄想两个月，之后症状完全消失，期间没有心境发作。哪种诊断最合适？

  1. A分裂情感性障碍
  2. B精神分裂症
  3. C短暂精神病性障碍
  4. D精神分裂症样障碍
5.药理学中等

药物的清除率描述的是什么？

  1. A药物从血浆中完全消失所需的时间
  2. B单位时间内被清除药物的血浆容积
  3. C一次透析去除的药量
  4. D被吸收的剂量比例
6.药理学困难

A nurse gave a patient ten times the prescribed dose of hydromorphone. The patient is currently alert. What is the most appropriate sequence of actions?

  1. AChange the chart so that it shows the correct dose, and continue to monitor
  2. BGive another dose later to balance it out
  3. CSay nothing because the patient is alert
  4. DMonitor closely, have naloxone ready, inform the prescriber and report

3溶液

1.精神科护理

答案: B · "I can't give you my number, because our relationship is a professional one. Let's talk about support you can contact after discharge."

为什么是这个答案

Personal contact outside the therapeutic relationship crosses a professional boundary. The nurse explains the boundary kindly and redirects to appropriate after-discharge support.

答案

B · "I can't give you my number, because our relationship is a professional one. Let's talk about support you can contact after discharge."
2.精神科护理

答案: C · A neurocognitive disorder such as Alzheimer's disease

为什么是这个答案

Gradual, progressive memory loss with impaired daily functioning and normal alertness suggests dementia, most commonly Alzheimer's disease. Delirium is acute and fluctuating with impaired attention.

答案

C · A neurocognitive disorder such as Alzheimer's disease
3.临床心理学

答案: B · 精神科诊断的效度

为什么是这个答案

自称听到一个词的假病人被收治并住院数周，表明诊断受情境影响。此后该研究的方法也受到质疑。

答案

B · 精神科诊断的效度
4.临床心理学

答案: D · 精神分裂症样障碍

为什么是这个答案

精神分裂症样障碍具有精神分裂症的症状，但持续一到六个月。病程是区分它与短暂精神病性障碍和精神分裂症的主要特征。

答案

D · 精神分裂症样障碍
5.药理学

答案: B · 单位时间内被清除药物的血浆容积

为什么是这个答案

清除率是单位时间内药物被清除的血浆容积。它与给药速率共同决定稳态浓度。

答案

B · 单位时间内被清除药物的血浆容积
6.药理学

答案: D · Monitor closely, have naloxone ready, inform the prescriber and report

为什么是这个答案

The patient may become sedated and develop respiratory depression later, so close monitoring and a ready antidote are needed. The prescriber is informed, the patient is told honestly, and the error is reported to improve the system.

答案

D · Monitor closely, have naloxone ready, inform the prescriber and report

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