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

Which setting is best for an initial assessment interview with a new patient?

  1. AThe busy day room, so that the patient feels part of the ward
  2. BA small office with the nurse sitting behind a high desk between herself and the door
  3. CA quiet, private room with chairs at the same level and easy access to the door
  4. DThe corridor, so that the interview can be done quickly
2.精神科护理困难

A charming patient with antisocial personality disorder tells a new nurse, "The other nurses always let me smoke in my room. You're cooler than them, right?" What is the best response?

  1. A"I'll let you if you promise not to tell anyone else about it."
  2. B"Smoking is only allowed in the garden, and that rule is the same for everyone."
  3. C"You're lying to me. The other nurses would never let you smoke in your room, so stop trying it on."
  4. D"Well, if the others let you, I suppose it's fine this once."
3.临床心理学中等

对于成人慢性失眠，推荐的一线治疗是什么？

  1. A失眠的认知行为疗法（CBT-I）
  2. B精神分析
  3. C长期每日服用苯二氮䓬类药物或其他催眠药物
  4. D电休克疗法
4.临床心理学困难

治疗师说："与其和'我是个失败者'这个想法作斗争，不如把它仅仅当作一个想法来觉察，然后去做对你重要的事。"这最能代表哪种疗法？

  1. A接纳承诺疗法（ACT）
  2. B系统脱敏
  3. C经典精神分析
  4. D理性情绪行为疗法
5.药理学中等

Why is testing for HLA-B*15:02 recommended before carbamazepine in people of some Asian ancestries?

  1. AThis gene variant causes carbamazepine to raise blood glucose
  2. BThis gene variant speeds up the kidney excretion of carbamazepine
  3. CIt greatly raises the risk of Stevens–Johnson syndrome
  4. DThis gene variant makes carbamazepine ineffective
6.药理学困难

A patient with heart failure starts taking naproxen regularly for back pain. Why is this a concern?

  1. ANSAIDs block the absorption of furosemide completely
  2. BNSAIDs lower potassium, which makes digoxin and diuretics fail
  3. CNSAIDs cause salt and water retention and can worsen heart failure
  4. DNSAIDs increase heart contractility too much

3溶液

1.精神科护理

答案: C · A quiet, private room with chairs at the same level and easy access to the door

为什么是这个答案

A private, quiet space protects confidentiality and helps the patient talk. Seating at the same level is less intimidating, and keeping access to the door supports safety for both people.

答案

C · A quiet, private room with chairs at the same level and easy access to the door
2.精神科护理

答案: B · "Smoking is only allowed in the garden, and that rule is the same for everyone."

为什么是这个答案

Patients with antisocial traits may use charm and flattery to manipulate staff. A calm, non-defensive restatement of the rule, applied consistently by all staff, avoids both being manipulated and starting a power struggle.

答案

B · "Smoking is only allowed in the garden, and that rule is the same for everyone."
3.临床心理学

答案: A · 失眠的认知行为疗法（CBT-I）

为什么是这个答案

CBT-I 结合了睡眠限制、刺激控制、睡眠卫生和认知技术。其效果持久，推荐在使用催眠药物之前采用。

答案

A · 失眠的认知行为疗法（CBT-I）
4.临床心理学

答案: A · 接纳承诺疗法（ACT）

为什么是这个答案

ACT（海斯）运用接纳、认知解离和基于价值的行动。与传统认知疗法不同，它不试图驳斥想法的内容。

答案

A · 接纳承诺疗法（ACT）
5.药理学

答案: C · It greatly raises the risk of Stevens–Johnson syndrome

为什么是这个答案

The HLA-B*15:02 allele, common in parts of South-East Asia, is strongly linked to carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis. Carriers are given a different drug.

答案

C · It greatly raises the risk of Stevens–Johnson syndrome
6.药理学

答案: C · NSAIDs cause salt and water retention and can worsen heart failure

为什么是这个答案

NSAIDs inhibit renal prostaglandins, causing sodium and water retention and reducing the effect of diuretics. They can trigger decompensation of heart failure and are usually avoided.

答案

C · NSAIDs cause salt and water retention and can worsen heart failure

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