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

What is the key difference between factitious disorder and malingering?

  1. AIn factitious disorder, the aim is to be seen as ill; in malingering, the aim is an external reward
  2. BThere is no real difference between them, and both terms mean exactly the same thing
  3. CMalingering is a severe mental disorder, while factitious disorder is not classed as a mental disorder at all
  4. DIn factitious disorder, the symptoms are not produced on purpose at all
2.精神科护理困难

An 80-year-old patient taking a benzodiazepine for sleep fell at night on the way to the toilet. After checking her for injury, what is the most appropriate next step?

  1. AReport the fall, put falls precautions in place and ask for a review of her sleep medicine
  2. BGive an extra dose so that she sleeps through the night without getting up
  3. CDo nothing more, because falls are normal in older people
  4. DUse bed rails and a restraint every night to keep her safely in bed until the morning
3.临床心理学中等

哪种人格障碍的特点是人际关系、自我形象和情绪不稳定，并伴有明显的冲动性？

  1. A回避型人格障碍
  2. B分裂样人格障碍
  3. C自恋型人格障碍
  4. D边缘型人格障碍
4.临床心理学困难

情感表达研究促成了精神分裂症的家庭干预。这些干预最可靠地改善了哪项结果？

  1. A复发率和再住院率
  2. B患者的智商分数
  3. C对任何抗精神病药的需要
  4. D兄弟姐妹的遗传风险
5.药理学中等

Which adverse effects are typical of donepezil?

  1. AHair loss and skin pigmentation
  2. BNausea, diarrhoea and a slow heart rate
  3. CWeight gain and high blood glucose
  4. DDry mouth, constipation and a fast heart rate
6.药理学困难

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

3溶液

1.精神科护理

答案: A · In factitious disorder, the aim is to be seen as ill; in malingering, the aim is an external reward

为什么是这个答案

In both, symptoms are produced or exaggerated on purpose. In factitious disorder the motivation is internal, the sick role; in malingering it is external, such as money, drugs or avoiding duties.

答案

A · In factitious disorder, the aim is to be seen as ill; in malingering, the aim is an external reward
2.精神科护理

答案: A · Report the fall, put falls precautions in place and ask for a review of her sleep medicine

为什么是这个答案

Benzodiazepines increase the risk of falls in older adults. After a fall, the nurse reports it, reduces risks such as poor lighting and the distance to the toilet, and asks for a medication review.

答案

A · Report the fall, put falls precautions in place and ask for a review of her sleep medicine
3.临床心理学

答案: D · 边缘型人格障碍

为什么是这个答案

边缘型人格障碍包括人际关系和身份认同不稳定、情感不稳定、害怕被抛弃、冲动以及反复自伤。DBT 是一种证据充分的治疗方法。

答案

D · 边缘型人格障碍
4.临床心理学

答案: A · 复发率和再住院率

为什么是这个答案

教授沟通和问题解决、减少批评的家庭干预能降低复发率和再住院率，通常与药物治疗同时进行。

答案

A · 复发率和再住院率
5.药理学

答案: B · Nausea, diarrhoea and a slow heart rate

为什么是这个答案

Cholinesterase inhibitors cause cholinergic effects such as nausea, vomiting, diarrhoea and bradycardia. Patients are watched for dizziness and fainting from a slow pulse.

答案

B · Nausea, diarrhoea and a slow heart rate
6.药理学

答案: B · To restore breathing without causing severe withdrawal and pain

为什么是这个答案

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.

答案

B · To restore breathing without causing severe withdrawal and pain

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