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 nurse statement is most consistent with motivational interviewing?

  1. A"I've decided that you need to stop drinking completely."
  2. B"If you don't stop drinking now, you'll die."
  3. C"What would be different for you if you drank less?"
  4. D"You're an alcoholic, and you need to admit it."
2.精神科护理困难

The parent of a 16-year-old taking a stimulant for ADHD says her son's friends keep asking him for his tablets. What should the nurse teach?

  1. AStore it securely and never share it, because stimulants are controlled drugs
  2. BSharing is fine as long as the friends are the same age
  3. CStop the medicine so that there is no risk of sharing
  4. DGive the friends a smaller dose if they ask, so that they do not have side effects
3.临床心理学中等

在贝克的抑郁认知模型中，"认知三联征"是指对什么的负面看法？

  1. A父母、朋友和老师
  2. B身体、心灵和精神
  3. C只有一个人的过去、现在和未来
  4. D自己、世界和未来
4.临床心理学困难

为什么 DSM-5 用单一的"物质使用障碍"取代了"物质滥用"和"物质依赖"？

  1. A研究发现依赖并不存在
  2. B世界卫生组织禁止使用这些术语
  3. C滥用被重新归类为人格障碍，而依赖则成了纯粹的医学状况
  4. D研究发现这两个类别反映的是同一维度，用严重程度分级描述更好
5.药理学中等

Sumatriptan is contraindicated in which patient?

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

A patient receiving frequent salbutamol (albuterol) nebulisers develops a fine tremor and a heart rate of 120 per minute. What is the best explanation?

  1. ASalbutamol blocks muscarinic receptors in the heart
  2. BAt high doses it also stimulates beta receptors in skeletal muscle and the heart
  3. CThe patient is allergic to salbutamol and needs adrenaline
  4. DSalbutamol causes high potassium, which speeds the heart and causes muscle twitching

3溶液

1.精神科护理

答案: C · "What would be different for you if you drank less?"

为什么是这个答案

Motivational interviewing uses open questions that invite the person to explore their own reasons for change. Labelling, threats and directives tend to increase resistance.

答案

C · "What would be different for you if you drank less?"
2.精神科护理

答案: A · Store it securely and never share it, because stimulants are controlled drugs

为什么是这个答案

Stimulants can be diverted and misused for studying or recreation. They are controlled drugs, so secure storage, monitoring the number of tablets and not sharing them are important.

答案

A · Store it securely and never share it, because stimulants are controlled drugs
3.临床心理学

答案: D · 自己、世界和未来

为什么是这个答案

贝克提出，抑郁者对自己、世界（或自身经历）和未来持负面看法，并由认知歪曲加以维持。

答案

D · 自己、世界和未来
4.临床心理学

答案: D · 研究发现这两个类别反映的是同一维度，用严重程度分级描述更好

为什么是这个答案

研究表明，滥用和依赖的标准构成一个连续体。DSM-5 把它们合并为一种障碍，并按符合的标准数量评定严重程度。

答案

D · 研究发现这两个类别反映的是同一维度，用严重程度分级描述更好
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: B · At high doses it also stimulates beta receptors in skeletal muscle and the heart

为什么是这个答案

Tremor comes from beta-2 stimulation of skeletal muscle. Tachycardia comes from some beta-1 (and cardiac beta-2) stimulation and a reflex response to vasodilation. High doses also shift potassium into cells and can cause hypokalaemia.

答案

B · At high doses it also stimulates beta receptors in skeletal muscle and the heart

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