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 communication approach is best with a patient who has paranoid personality disorder?

  1. AAvoid explaining anything so that the patient does not become suspicious
  2. BTalk about the patient with colleagues in whispers within his sight
  3. CBe clear, honest and business-like, and explain the reasons for actions
  4. DBe very warm and joke often to put the patient at ease
2.精神科护理困难

一名神经性贪食患者的血清钾为 2.8 mmol/L。主要担忧是什么？

  1. A食欲增加
  2. B有发生危及生命的心律失常的风险
  3. C有体重增加的风险
  4. D肌力改善
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疾病焦虑障碍
  2. B功能性神经症状障碍
  3. C做作性障碍
  4. D躯体症状障碍
4.临床心理学困难

一名士兵患上了 PTSD，而经历同一场战斗的大多数战友却没有。哪种模型最能解释这种差异？

  1. A素质—应激模型
  2. B统计罕见性模型
  3. C感染的医学模型
  4. D代币制模型
5.药理学中等

A patient with a fentanyl patch is given home-care advice. Which instruction is correct?

  1. ACut the patch in half if the pain is mild
  2. BAvoid heating pads, hot baths and saunas over or near the patch
  3. CThrow used patches loose into the household bin with the packaging
  4. DApply each new patch over the same skin area
6.药理学困难

Which heart failure drug improves symptoms and reduces hospital admissions but has not been shown to reduce mortality?

  1. ADigoxin
  2. BAn ACE inhibitor
  3. CA beta blocker such as bisoprolol
  4. DA mineralocorticoid receptor antagonist such as spironolactone

3溶液

1.精神科护理

答案: C · Be clear, honest and business-like, and explain the reasons for actions

为什么是这个答案

People with paranoid personality disorder are distrustful and may misread friendliness or jokes as hostility. Honesty, consistency and clear explanations reduce suspicion.

答案

C · Be clear, honest and business-like, and explain the reasons for actions
2.精神科护理

答案: B · 有发生危及生命的心律失常的风险

为什么是这个答案

反复呕吐会导致低钾血症和代谢性碱中毒。钾 2.8 mmol/L 低得危险，可引起心律失常。患者需要心电监护，并按处方补钾。

答案

B · 有发生危及生命的心律失常的风险
3.临床心理学

答案: A · 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

A · 疾病焦虑障碍
4.临床心理学

答案: A · 素质—应激模型

为什么是这个答案

素质—应激模型认为，应激源主要在原本就有易感性的人身上引发障碍，例如遗传风险、既往创伤或社会支持不足。

答案

A · 素质—应激模型
5.药理学

答案: B · Avoid heating pads, hot baths and saunas over or near the patch

为什么是这个答案

Heat increases fentanyl absorption and can cause overdose. Sites are rotated, patches are never cut, and used patches are folded sticky sides together and disposed of safely, away from children and pets.

答案

B · Avoid heating pads, hot baths and saunas over or near the patch
6.药理学

答案: A · Digoxin

为什么是这个答案

ACE inhibitors (or ARBs/ARNI), beta blockers, mineralocorticoid antagonists and SGLT2 inhibitors reduce mortality in heart failure with reduced ejection fraction. Digoxin improves symptoms and reduces admissions without reducing mortality.

答案

A · Digoxin

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