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 24-year-old woman with bipolar disorder is starting valproate. What is the most important teaching point?

  1. AIt can seriously harm an unborn baby, so effective contraception and specialist advice are essential
  2. BIt is safe in pregnancy and needs no special precautions
  3. CIt must be taken with grapefruit juice to be absorbed
  4. DIt will cause her to lose weight quickly, so she should eat extra meals and snacks every day
2.精神科护理困难

The parent of a child recently diagnosed with autism asks, "Did his vaccines cause this?" What is the most accurate response?

  1. A"We don't know, so it is best to stop all of his other vaccines."
  2. B"Autism is caused by cold and distant parenting styles in early childhood."
  3. C"Yes, the MMR vaccine is a proven cause of autism."
  4. D"Large studies have found no link between vaccines and autism."
3.临床心理学中等

一位患者躯体症状很少或没有，多次检查结果正常，却对患有严重疾病感到强烈焦虑。哪种诊断最合适？

  1. A躯体症状障碍
  2. B做作性障碍
  3. C疾病焦虑障碍
  4. D功能性神经症状障碍
4.临床心理学困难

一位强迫症来访者出门前要检查炉子二十次。根据认知行为模型，为什么检查会维持这种障碍？

  1. A检查带来强烈的快感，使来访者上瘾
  2. B检查后的解脱感强化了检查，并阻碍其认识到恐惧没有根据
  3. C检查主要由智力低和工作记忆差引起
  4. D每次检查都使焦虑升高，从而惩罚并逐渐削弱检查的冲动
5.药理学中等

A patient with suspected sepsis has blood cultures ordered and a first antibiotic dose due. What should the nurse do?

  1. AGive the antibiotic only if the temperature is above 40 °C (104 °F)
  2. BWait for the culture results before giving any antibiotic
  3. CGive the antibiotic first, then take blood cultures the next day
  4. DTake the blood cultures first, then give the antibiotic at once
6.药理学困难

A patient on valproate becomes lethargic, starts vomiting and develops jaundice. Which adverse effect should be suspected first?

  1. ALiver toxicity
  2. BHypothyroidism
  3. CNormal start-up side effects
  4. DKidney stones

3溶液

1.精神科护理

答案: A · It can seriously harm an unborn baby, so effective contraception and specialist advice are essential

为什么是这个答案

Valproate is highly teratogenic, causing neural tube defects and developmental problems. Women who could become pregnant need clear information, effective contraception and specialist review.

答案

A · It can seriously harm an unborn baby, so effective contraception and specialist advice are essential
2.精神科护理

答案: D · "Large studies have found no link between vaccines and autism."

为什么是这个答案

Large, well-conducted studies have found no link between vaccines and autism, and the paper that first claimed a link was retracted. Autism is a neurodevelopmental condition with strong genetic contributions.

答案

D · "Large studies have found no link between vaccines and autism."
3.临床心理学

答案: C · 疾病焦虑障碍

为什么是这个答案

疾病焦虑障碍是在躯体症状轻微的情况下，过度关注自己患有或将患上严重疾病。躯体症状障碍的核心则是令人痛苦的症状以及对症状的过度思虑。

答案

C · 疾病焦虑障碍
4.临床心理学

答案: B · 检查后的解脱感强化了检查，并阻碍其认识到恐惧没有根据

为什么是这个答案

强迫行为因短期的解脱而得到负强化，并使当事人无法认识到焦虑会自行下降。这就是 ERP 要阻止仪式行为的原因。

答案

B · 检查后的解脱感强化了检查，并阻碍其认识到恐惧没有根据
5.药理学

答案: D · Take the blood cultures first, then give the antibiotic at once

为什么是这个答案

Cultures are taken before antibiotics so the organism can be identified, but antibiotics must not be delayed in sepsis. Taking cultures quickly and then giving the antibiotic meets both aims.

答案

D · Take the blood cultures first, then give the antibiotic at once
6.药理学

答案: A · Liver toxicity

为什么是这个答案

Valproate can cause serious hepatotoxicity, especially in young children and early in treatment. Liver function tests are checked, and the drug may need to be stopped; pancreatitis is another serious risk.

答案

A · Liver toxicity

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