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

A patient who started lithium 2 weeks ago has a fine tremor of the hands and is passing more urine than usual. Her level is within the therapeutic range. How should the nurse interpret this?

  1. AThese are signs of an allergic reaction, so she should never take lithium again
  2. BThese are definite signs of severe lithium toxicity, so emergency dialysis is needed straight away
  3. CThese are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
  4. DThese symptoms mean that the lithium is not working, so the dose should be stopped and a new drug chosen
2.精神科护理困难

A patient in a mental health unit asks to read his own health records. What is the correct general principle?

  1. APsychiatric patients are never allowed to see their records
  2. BOnly his family can request access to his records on his behalf
  3. CThe nurse should give him the records immediately without following any procedure
  4. DPatients generally have a right of access, with limited exceptions to prevent serious harm
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电休克疗法
  3. C精神分析
  4. D长期每日服用苯二氮䓬类药物或其他催眠药物
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系统脱敏
  2. B理性情绪行为疗法
  3. C接纳承诺疗法（ACT）
  4. D经典精神分析
5.药理学中等

A woman taking the combined pill should seek care urgently for which symptom?

  1. AA painful, swollen calf or sudden chest pain
  2. BMild breast tenderness in the first month
  3. CLight spotting between periods early on
  4. DSlight nausea in the first few weeks
6.药理学困难

一名患者在首剂阿莫西林后发生过敏性休克。按常用的 A/B 分类系统，这种不良反应如何分类？

  1. AA 型，因为剂量太高
  2. BA 型，因为它与剂量相关，可以根据药物的药理学作用预测
  3. CB 型，因为它只在长期使用后发生
  4. DB 型，因为它不可预测，且与药物的正常作用无关

3溶液

1.精神科护理

答案: C · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored

为什么是这个答案

Fine tremor, thirst, polyuria and mild nausea are common early effects of lithium. A coarse tremor, vomiting, diarrhoea, confusion or unsteadiness suggest toxicity.

答案

C · These are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
2.精神科护理

答案: D · Patients generally have a right of access, with limited exceptions to prevent serious harm

为什么是这个答案

Data protection and health records laws in many countries give patients a right to access their records. Requests follow a formal procedure, and information may be withheld only in limited cases, for example if it could cause serious harm.

答案

D · Patients generally have a right of access, with limited exceptions to prevent serious harm
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: C · 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

C · 接纳承诺疗法（ACT）
5.药理学

答案: A · A painful, swollen calf or sudden chest pain

为什么是这个答案

Combined hormonal contraception increases the risk of venous thromboembolism and, rarely, stroke. Leg pain or swelling, chest pain, breathlessness, severe headache or vision changes need urgent assessment.

答案

A · A painful, swollen calf or sudden chest pain
6.药理学

答案: D · B 型，因为它不可预测，且与药物的正常作用无关

为什么是这个答案

A 型（增强型）反应可根据药物的药理作用预测，并与剂量相关。B 型（异常型）反应，如免疫介导的过敏，与剂量无关且难以预测。

答案

D · B 型，因为它不可预测，且与药物的正常作用无关

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