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 a patient with anorexia nervosa be weighed in hospital?

  1. AOnly when she asks to be weighed, to respect her wishes
  2. BIn her own clothes and shoes after breakfast, so that she feels more comfortable
  3. CAt a different time each day so that she cannot prepare for it
  4. DAt the same time, on the same scale, in a gown, after emptying the bladder
2.精神科护理困难

A nurse feels strong irritation every time she cares for a patient who reminds her of her abusive father. What is the most appropriate action?

  1. ARecognise this as countertransference and discuss it in clinical supervision
  2. BIgnore the feeling, because feelings do not affect nursing care
  3. CAvoid the patient and let other staff do all of his care
  4. DTell the patient that he reminds her of her father
3.临床心理学中等

在自杀风险评估中，哪个因素是未来自杀未遂最强的预测因素之一？

  1. A朋友圈很大
  2. B既往有自杀未遂
  3. C是大学生
  4. D与治疗师坦诚交谈
4.临床心理学困难

为什么心理学取向的支持者批评精神疾病的医学模式？

  1. A它否认大脑和生物学因素对行为或情绪有任何作用
  2. B它只以梦的解析为基础
  3. C它完全拒绝使用药物
  4. D它可能忽视心理和社会原因，并削弱人们的能动感
5.药理学中等

How does sucralfate help a peptic ulcer heal?

  1. AIt neutralises acid by releasing bicarbonate
  2. BIt blocks histamine H2 receptors in the stomach
  3. CIt forms a protective coating over the ulcer base
  4. DIt kills Helicobacter pylori directly
6.药理学困难

A man taking spironolactone for heart failure develops painful breast enlargement. Which change may be considered?

  1. ASwitching to potassium chloride tablets
  2. BDoubling the spironolactone dose to overcome the side effect
  3. CSwitching to eplerenone, which has fewer anti-androgen effects
  4. DAdding testosterone injections

3溶液

1.精神科护理

答案: D · At the same time, on the same scale, in a gown, after emptying the bladder

为什么是这个答案

Standardised weighing gives reliable trends. Patients may drink large amounts of water or hide objects to increase their weight, so consistent conditions and a gown are used.

答案

D · At the same time, on the same scale, in a gown, after emptying the bladder
2.精神科护理

答案: A · Recognise this as countertransference and discuss it in clinical supervision

为什么是这个答案

Countertransference is common and is not a failure, but it can affect care if not recognised. Supervision helps the nurse understand the reaction and keep the relationship therapeutic.

答案

A · Recognise this as countertransference and discuss it in clinical supervision
3.临床心理学

答案: B · 既往有自杀未遂

为什么是这个答案

自杀未遂史是最强的风险因素之一。直接询问自杀想法并不会增加风险，而是良好评估的一部分。

答案

B · 既往有自杀未遂
4.临床心理学

答案: D · 它可能忽视心理和社会原因，并削弱人们的能动感

为什么是这个答案

医学模式把障碍视为有生物学原因的疾病，这减少了指责，但可能忽视生活事件、意义和情境，并可能助长对药物的被动依赖。

答案

D · 它可能忽视心理和社会原因，并削弱人们的能动感
5.药理学

答案: C · It forms a protective coating over the ulcer base

为什么是这个答案

Sucralfate forms a gel-like barrier that sticks to the ulcer and protects it from acid and pepsin. It is taken on an empty stomach and can reduce the absorption of other drugs taken at the same time.

答案

C · It forms a protective coating over the ulcer base
6.药理学

答案: C · Switching to eplerenone, which has fewer anti-androgen effects

为什么是这个答案

Spironolactone has anti-androgenic and progestogenic effects that can cause gynaecomastia. Eplerenone is a more selective mineralocorticoid antagonist with a much lower risk of this effect.

答案

C · Switching to eplerenone, which has fewer anti-androgen effects

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