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 activity is most suitable for a patient in an acute manic episode?

  1. AA competitive team game of volleyball
  2. BA complicated board game such as chess with other patients
  3. CA long group discussion in the day room
  4. DA walk with a staff member
2.精神科护理困难

On the day after hip surgery, a 58-year-old patient has a new tremor, sweating, anxiety and a fast pulse. He did not report any alcohol use on admission. What should the nurse do?

  1. AWait until the next day to see if the symptoms go away on their own once his pain is better controlled
  2. BAssume he has post-operative pain and give extra analgesia only
  3. CTell him that his symptoms are normal after hip surgery
  4. DAsk him and his family about his alcohol use and the time of his last drink, and report the findings
3.临床心理学中等

哪种人格障碍的特点是普遍地漠视他人权利？

  1. A依赖型人格障碍
  2. B反社会型人格障碍
  3. C边缘型人格障碍
  4. D回避型人格障碍
4.临床心理学困难

共病是指：

  1. A某种障碍由同时存在的躯体疾病引起
  2. B某种障碍在家族中多发
  3. C某个症状为群体中所有人共有
  4. D一个人同时符合两种或以上障碍的诊断标准
5.药理学中等

An IV site is cool, swollen and pale, and the infusion is running slowly. What should the nurse do?

  1. AIncrease the infusion rate to push through and clear the blockage
  2. BFlush the cannula forcefully with saline
  3. CApply a tight bandage over the site
  4. DStop the infusion, remove the cannula and elevate the limb
6.药理学困难

A patient has SIADH with mild hyponatraemia and no neurological symptoms. What is usually the first-line treatment?

  1. AA rapid bolus of hypertonic saline
  2. BFluid restriction
  3. CLarge volumes of IV glucose 5%
  4. DDesmopressin

3溶液

1.精神科护理

答案: D · A walk with a staff member

为什么是这个答案

Solitary, non-competitive physical activity helps release energy safely. Competitive games, large groups and tasks requiring long concentration can increase agitation and conflict.

答案

D · A walk with a staff member
2.精神科护理

答案: D · Ask him and his family about his alcohol use and the time of his last drink, and report the findings

为什么是这个答案

Unexpected alcohol withdrawal is common in surgical patients. Asking about drinking, using a withdrawal scale and reporting early allows treatment before seizures or delirium tremens develop.

答案

D · Ask him and his family about his alcohol use and the time of his last drink, and report the findings
3.临床心理学

答案: B · 反社会型人格障碍

为什么是这个答案

反社会型人格障碍包括欺骗、冲动、攻击性和缺乏悔意，并在童年有品行障碍的证据。

答案

B · 反社会型人格障碍
4.临床心理学

答案: D · 一个人同时符合两种或以上障碍的诊断标准

为什么是这个答案

共病是同一个人同时存在多种障碍，这使诊断和治疗更复杂，也引发了对分类式诊断体系的质疑。

答案

D · 一个人同时符合两种或以上障碍的诊断标准
5.药理学

答案: D · Stop the infusion, remove the cannula and elevate the limb

为什么是这个答案

These signs suggest infiltration. The infusion is stopped and the cannula removed, the limb is elevated, and a new cannula is placed elsewhere; vesicant drugs need the extravasation protocol.

答案

D · Stop the infusion, remove the cannula and elevate the limb
6.药理学

答案: B · Fluid restriction

为什么是这个答案

In SIADH, excess ADH makes the kidneys retain water. Restricting fluid intake raises sodium gradually; hypertonic saline is kept for severe symptomatic cases, and hypotonic fluids and desmopressin would worsen it.

答案

B · Fluid restriction

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