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 treatment is recommended first-line for chronic insomnia in adults?

  1. ALong-term daily benzodiazepines
  2. BCognitive behavioural therapy for insomnia (CBT-I)
  3. CStaying in bed for longer each morning
  4. DDrinking alcohol in the evening to fall asleep
2.精神科护理困难

A patient with somatic symptom disorder calls the nurse many times each shift to report different aches. Which approach is most helpful?

  1. ATell her that her symptoms are all in her mind, so there is no need to assess them or treat them in any way
  2. BAsk the doctor to order new tests every time she reports a symptom
  3. CStop answering her calls, because the symptoms are imaginary
  4. DArrange regular, planned contacts, assess any new symptoms and focus conversations on feelings and coping
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是大学生
  3. C与治疗师坦诚交谈
  4. D既往有自杀未遂
4.临床心理学困难

一名自称听到"砰"（thud）一词的男子被收入医院，之后表现正常。工作人员把他记笔记的行为记录为"从事书写行为"。在罗森汉的研究中，这说明了什么？

  1. A记笔记是公认的精神分裂症症状，因此工作人员将其如此记录是对的
  2. B工作人员故意伪造记录
  3. C一旦贴上标签，正常行为往往会被解释为障碍的表现
  4. D假病人在医院里出现了真实的症状
5.药理学中等

哪种副作用是钙通道阻滞剂氨氯地平的典型副作用？

  1. A支气管痉挛
  2. B干咳
  3. C踝部水肿
  4. D高钾血症
6.药理学困难

A patient with diabetic ketoacidosis is about to start an IV insulin infusion. Serum potassium is 3.1 mmol/L (mEq/L). Why is this a concern?

  1. APotassium has no link with insulin, so the infusion is started as planned
  2. BInsulin raises potassium further and can cause cardiac arrest, so the infusion is given faster
  3. CInsulin moves potassium into cells, so the level can fall dangerously low
  4. DLow potassium makes insulin ineffective, so a higher dose is needed

3溶液

1.精神科护理

答案: B · Cognitive behavioural therapy for insomnia (CBT-I)

为什么是这个答案

CBT-I combines sleep education, stimulus control, sleep restriction and work on unhelpful beliefs about sleep. It has lasting effects and fewer risks than long-term sleeping tablets.

答案

B · Cognitive behavioural therapy for insomnia (CBT-I)
2.精神科护理

答案: D · Arrange regular, planned contacts, assess any new symptoms and focus conversations on feelings and coping

为什么是这个答案

Scheduled contact reduces the need to report symptoms to get attention. New symptoms must still be assessed, because physical illness can occur, but the focus shifts towards stress, feelings and coping skills.

答案

D · Arrange regular, planned contacts, assess any new symptoms and focus conversations on feelings and coping
3.临床心理学

答案: D · 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

D · 既往有自杀未遂
4.临床心理学

答案: C · 一旦贴上标签，正常行为往往会被解释为障碍的表现

为什么是这个答案

罗森汉认为，"精神分裂症患者"这个标签使工作人员把普通行为看成病态。斯皮策等批评者认为，这项研究并未证明诊断是无效的。

答案

C · 一旦贴上标签，正常行为往往会被解释为障碍的表现
5.药理学

答案: C · 踝部水肿

为什么是这个答案

二氢吡啶类钙通道阻滞剂扩张小动脉，使下肢毛细血管压力升高，引起踝部水肿。干咳是 ACE 抑制剂的典型副作用。

答案

C · 踝部水肿
6.药理学

答案: C · Insulin moves potassium into cells, so the level can fall dangerously low

为什么是这个答案

Insulin drives potassium into cells, so a low starting level can become life-threatening hypokalaemia with arrhythmias. Potassium is replaced and monitored closely; the 2024 international consensus (ADA and others) delays insulin until potassium is above 3.5 mmol/L, while UK JBDS guidance adds potassium to the fluids and asks for senior review.

答案

C · Insulin moves potassium into cells, so the level can fall dangerously low

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