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

What must a patient be told for consent to a new psychotropic medicine to be valid?

  1. AThe expected benefits, the main risks and the alternatives, including no treatment
  2. BNothing at all, because psychiatric patients cannot give consent
  3. COnly the benefits, so that the patient is not frightened by the side effects
  4. DOnly the name of the medicine and the time of day it will be given
2.精神科护理困难

For 8 months, a woman has worried about her job, money and family's health nearly every day. She has muscle tension, tiredness and poor sleep, but no sudden attacks of fear. Which diagnosis fits best?

  1. AAcute stress disorder after a recent trauma
  2. BSpecific phobia
  3. CPanic disorder
  4. DGeneralised anxiety disorder
3.临床心理学中等

一名女性三年来大部分日子里一天中的大部分时间都情绪低落，但程度未达到重性抑郁。哪种 DSM-5 诊断最合适？

  1. A环性心境障碍
  2. B双相 II 型障碍
  3. C伴抑郁心境的适应障碍
  4. D持续性抑郁障碍（心境恶劣）
4.临床心理学困难

一位精神分裂症患者以别扭的姿势一动不动地保持数小时，并抗拒别人移动他。这描述的是哪一组症状？

  1. A言语贫乏
  2. B思维被广播
  3. C紧张症
  4. D迟发性运动障碍
5.药理学中等

克拉霉素等大环内酯类的作用机制是：

  1. A与核糖体 50S 亚基结合，抑制蛋白质合成
  2. B阻断叶酸合成
  3. C抑制细胞壁合成
  4. D抑制 DNA 旋转酶
6.药理学困难

A baby born to a mother on methadone becomes irritable on day 2, with a high-pitched cry, tremors, sneezing and poor feeding. What is the most likely cause?

  1. ANeonatal opioid withdrawal syndrome
  2. BNeonatal hypoglycaemia from maternal diabetes
  3. CNormal newborn behaviour
  4. DVitamin K deficiency bleeding

3溶液

1.精神科护理

答案: A · The expected benefits, the main risks and the alternatives, including no treatment

为什么是这个答案

Valid consent requires that the patient has capacity, has enough information about benefits, risks and alternatives, and decides voluntarily. A mental illness does not automatically remove capacity.

答案

A · The expected benefits, the main risks and the alternatives, including no treatment
2.精神科护理

答案: D · Generalised anxiety disorder

为什么是这个答案

Generalised anxiety disorder is ongoing, excessive worry about many things for at least 6 months. Panic disorder involves recurrent, unexpected panic attacks and worry about having more.

答案

D · Generalised anxiety disorder
3.临床心理学

答案: D · 持续性抑郁障碍（心境恶劣）

为什么是这个答案

成人持续性抑郁障碍要求抑郁心境至少持续两年，并伴有食欲差、精力不足或绝望感等其他症状。

答案

D · 持续性抑郁障碍（心境恶劣）
4.临床心理学

答案: C · 紧张症

为什么是这个答案

紧张症的特征包括木僵、作态、蜡样屈曲、缄默和违拗。在 DSM-5 中，紧张症可以伴随精神分裂症、心境障碍或躯体疾病出现。

答案

C · 紧张症
5.药理学

答案: A · 与核糖体 50S 亚基结合，抑制蛋白质合成

为什么是这个答案

大环内酯类与细菌核糖体 50S 亚基结合，阻断蛋白质合成。氟喹诺酮类抑制 DNA 旋转酶，β-内酰胺类作用于细胞壁。

答案

A · 与核糖体 50S 亚基结合，抑制蛋白质合成
6.药理学

答案: A · Neonatal opioid withdrawal syndrome

为什么是这个答案

After birth the baby no longer receives opioid from the mother and develops withdrawal. Assessment uses a scoring tool, with non-drug care first and opioid treatment if signs are severe.

答案

A · Neonatal opioid withdrawal syndrome

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