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 findings suggest recent cannabis use?

  1. ASlow heart rate, constricted pupils, drooling and watery eyes
  2. BPinpoint pupils, slow breathing and drowsiness
  3. CRed eyes, increased appetite, dry mouth and a fast heart rate
  4. DDilated pupils, high fever and severe muscle rigidity
2.精神科护理困难

A patient says, "I'm such a failure. My wife left me and I lost my job." The nurse answers, "Don't worry, things will get better soon." What is wrong with this response?

  1. AIt is too direct and confronting
  2. BIt uses the technique of presenting reality wrongly
  3. CIt is false reassurance that dismisses the patient's feelings
  4. DIt explores the problem too deeply too early
3.临床心理学中等

暴露与反应预防是哪种障碍的主要心理治疗方法？

  1. A强迫症
  2. B双相障碍
  3. C注意缺陷多动障碍
  4. D失眠
4.临床心理学困难

一位老年患者在开始服用一种新药后两天内出现意识混乱，注意力一天中时好时坏。她的女儿说上周她的记忆还很正常。最恰当的解释是什么？

  1. A早期阿尔茨海默病，需要转诊到记忆门诊
  2. B正常老化
  3. C晚发性精神分裂症
  4. D谵妄，需要查找躯体原因或药物原因
5.药理学中等

A patient takes low-dose weekly methotrexate for rheumatoid arthritis. Which monitoring is needed?

  1. ADaily blood glucose checks
  2. BMonthly hearing tests
  3. CWeekly INR checks and a monthly ECG to check the heart rhythm
  4. DRegular blood count, liver and kidney function tests
6.药理学困难

Which finding most favours serotonin syndrome over neuroleptic malignant syndrome?

  1. ARecent start of an antipsychotic drug
  2. BA very high creatine kinase
  3. CSlow onset over days with lead-pipe rigidity
  4. DRapid onset with hyperreflexia and clonus

3溶液

1.精神科护理

答案: C · Red eyes, increased appetite, dry mouth and a fast heart rate

为什么是这个答案

Cannabis intoxication typically causes conjunctival injection, increased appetite, dry mouth, tachycardia, impaired coordination and altered perception of time. High doses can cause anxiety or psychosis.

答案

C · Red eyes, increased appetite, dry mouth and a fast heart rate
2.精神科护理

答案: C · It is false reassurance that dismisses the patient's feelings

为什么是这个答案

False reassurance minimises the patient's concerns and discourages further talk. A therapeutic response would acknowledge the losses and invite the patient to share more.

答案

C · It is false reassurance that dismisses the patient's feelings
3.临床心理学

答案: A · 强迫症

为什么是这个答案

ERP 让患者接触强迫的诱发因素，同时阻止强迫行为，使焦虑在不执行仪式的情况下下降。

答案

A · 强迫症
4.临床心理学

答案: D · 谵妄，需要查找躯体原因或药物原因

为什么是这个答案

急性起病伴注意力波动提示谵妄，这是一种医疗急症，原因可能是药物、感染或脱水。痴呆则在数月至数年间逐渐发展。

答案

D · 谵妄，需要查找躯体原因或药物原因
5.药理学

答案: D · Regular blood count, liver and kidney function tests

为什么是这个答案

Methotrexate can cause bone marrow suppression and liver damage, and poor kidney function raises its levels. Blood tests are regular, alcohol is limited and folic acid is usually given on another day.

答案

D · Regular blood count, liver and kidney function tests
6.药理学

答案: D · Rapid onset with hyperreflexia and clonus

为什么是这个答案

Serotonin syndrome develops within hours of a serotonergic drug and causes clonus, hyperreflexia, agitation, dilated pupils and diarrhoea. NMS develops over days after a dopamine antagonist, with lead-pipe rigidity and slow reflexes.

答案

D · Rapid onset with hyperreflexia and clonus

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