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

How should the nurse position herself when talking to an agitated patient?

  1. ABehind the patient and close to him, so that the patient does not feel threatened by eye contact
  2. BDirectly face to face, as close as possible, to show confidence
  3. CAt a safe distance, slightly to the side, with a clear exit available
  4. DBetween the patient and the wall, so the patient can leave easily
2.精神科护理困难

一名严重抑郁数周的患者突然变得快乐而平静，并把自己的手表送给另一名患者。最恰当的措施是什么？

  1. A计划明天让他出院
  2. B直接询问他的自杀想法和计划，并告知团队
  3. C记录他的情绪明显好转，并降低对他的观察级别
  4. D赞扬他的慷慨，不做其他事
3.临床心理学中等

一名男子在社交中拘谨，感到自己能力不足，因害怕批评而回避需要与人接触的工作，尽管他渴望亲密关系。哪种障碍最合适？

  1. A回避型人格障碍
  2. B分裂样人格障碍
  3. C表演型人格障碍
  4. D反社会型人格障碍
4.临床心理学困难

治疗师让来访者评估支持和反对"我总是失败"这一想法的证据。这是什么技术？

  1. A认知重构
  2. B代币制
  3. C系统脱敏
  4. D自由联想
5.药理学中等

How should a patient store sublingual glyceryl trinitrate (nitroglycerin) tablets?

  1. AIn the original dark glass bottle, away from heat, light and moisture
  2. BLoose in a shirt pocket close to the body for quick access
  3. CIn a plastic weekly pill box with other tablets
  4. DIn the fridge in a damp, open container to keep them fresh and cool
6.药理学困难

A patient with myasthenia gravis took extra pyridostigmine doses. She now has increasing weakness, heavy salivation, sweating, small pupils and diarrhoea. What is the most likely cause?

  1. AA stroke unrelated to the medication
  2. BAn allergic reaction to pyridostigmine
  3. CMyasthenic crisis from too little anticholinesterase drug
  4. DCholinergic crisis from too much anticholinesterase drug

3溶液

1.精神科护理

答案: C · At a safe distance, slightly to the side, with a clear exit available

为什么是这个答案

Standing at an angle and outside arm's reach is less confrontational and safer. The nurse makes sure neither she nor the patient is trapped, so both have an exit.

答案

C · At a safe distance, slightly to the side, with a clear exit available
2.精神科护理

答案: B · 直接询问他的自杀想法和计划，并告知团队

为什么是这个答案

突然平静和赠送财物可能意味着患者已决定结束自己的生命。护士应直接询问自杀意图、计划和手段，维护安全，并告知团队。

答案

B · 直接询问他的自杀想法和计划，并告知团队
3.临床心理学

答案: A · 回避型人格障碍

为什么是这个答案

回避型人格障碍（C 类）表现为对负面评价过度敏感和社交抑制。在分裂样人格障碍中，当事人几乎没有建立亲密关系的愿望。

答案

A · 回避型人格障碍
4.临床心理学

答案: A · 认知重构

为什么是这个答案

认知重构识别自动思维、检验证据，并用平衡的想法取代过度概括等认知歪曲。

答案

A · 认知重构
5.药理学

答案: A · In the original dark glass bottle, away from heat, light and moisture

为什么是这个答案

Nitroglycerin tablets lose potency when exposed to light, heat, air and moisture. They are kept in their original tightly closed dark container, and expired tablets are replaced.

答案

A · In the original dark glass bottle, away from heat, light and moisture
6.药理学

答案: D · Cholinergic crisis from too much anticholinesterase drug

为什么是这个答案

Excess acetylcholine causes muscarinic signs (salivation, sweating, miosis, diarrhoea) and depolarising weakness. In myasthenic crisis, weakness occurs without these cholinergic signs; both can cause respiratory failure.

答案

D · Cholinergic crisis from too much anticholinesterase drug

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