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 effects of methadone should the nurse monitor for?

  1. AHypertensive crisis after eating aged cheese
  2. BRespiratory depression, sedation and a prolonged QT interval
  3. CAgranulocytosis and a sore throat
  4. DHair loss, weight loss and a painful red rash on the face
2.精神科护理困难

A resident with dementia accuses staff of stealing her purse, which she has misplaced. What is the most appropriate response?

  1. AStay calm, acknowledge her worry and offer to help her look for it
  2. BInsist that nobody would steal from her
  3. CTell her that her memory is the problem and that the purse is not stolen
  4. DIgnore the accusation and walk away until she forgets about it
3.临床心理学中等

一名女性三年来大部分日子里一天中的大部分时间都情绪低落，但程度未达到重性抑郁。哪种 DSM-5 诊断最合适？

  1. A持续性抑郁障碍（心境恶劣）
  2. B环性心境障碍
  3. C伴抑郁心境的适应障碍
  4. D双相 II 型障碍
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对任何抗精神病药的需要
  2. B兄弟姐妹的遗传风险
  3. C复发率和再住院率
  4. D患者的智商分数
5.药理学中等

Sumatriptan is contraindicated in which patient?

  1. AA patient with a recent ankle sprain
  2. BA patient with mild asthma
  3. CA patient with coronary artery disease
  4. DA patient with iron deficiency anaemia
6.药理学困难

An older patient on amlodipine develops ankle swelling and is prescribed furosemide. She then becomes dizzy and falls. What does this sequence illustrate?

  1. AA prescribing cascade
  2. BEnzyme induction
  3. CA type B allergic reaction
  4. DDrug tolerance

3溶液

1.精神科护理

答案: B · Respiratory depression, sedation and a prolonged QT interval

为什么是这个答案

Methadone can cause respiratory depression, especially when starting or with other sedatives, and it can prolong the QT interval. It has a long half-life, so toxicity can build up over several days.

答案

B · Respiratory depression, sedation and a prolonged QT interval
2.精神科护理

答案: A · Stay calm, acknowledge her worry and offer to help her look for it

为什么是这个答案

False accusations of theft are common in dementia when items are misplaced. Acknowledging the feeling, helping to search and keeping items in regular places reduce distress.

答案

A · Stay calm, acknowledge her worry and offer to help her look for it
3.临床心理学

答案: A · 持续性抑郁障碍（心境恶劣）

为什么是这个答案

成人持续性抑郁障碍要求抑郁心境至少持续两年，并伴有食欲差、精力不足或绝望感等其他症状。

答案

A · 持续性抑郁障碍（心境恶劣）
4.临床心理学

答案: C · 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

C · 复发率和再住院率
5.药理学

答案: C · A patient with coronary artery disease

为什么是这个答案

Triptans can constrict coronary arteries and cause angina or myocardial infarction. They are avoided in coronary disease, uncontrolled hypertension and previous stroke.

答案

C · A patient with coronary artery disease
6.药理学

答案: A · A prescribing cascade

为什么是这个答案

In a prescribing cascade, an adverse effect of one drug is mistaken for a new condition and treated with another drug, which brings new risks. Amlodipine oedema does not respond well to diuretics; reviewing the original drug is better.

答案

A · A prescribing cascade

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