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 is the Abnormal Involuntary Movement Scale (AIMS) used for?

  1. ATo rate the severity of depression
  2. BTo screen for and monitor tardive dyskinesia
  3. CTo assess the risk of a patient becoming violent
  4. DTo measure the severity of alcohol withdrawal
2.精神科护理困难

A patient's mood changes several times a day, usually after conflicts with others. She has chronic feelings of emptiness and a strong fear of being abandoned. Which diagnosis is most likely?

  1. ASchizoid personality disorder with low mood
  2. BPersistent depressive disorder
  3. CBipolar I disorder
  4. DBorderline personality disorder
3.临床心理学中等

诊断的信度是指：

  1. A患者是否接受诊断
  2. B诊断是否使用医学检查
  3. C诊断能否准确预测疾病的病程和结局
  4. D不同临床医生对同一患者是否得出相同诊断
4.临床心理学困难

关于抗抑郁药试验中的安慰剂效应，哪项说法最准确？

  1. A安慰剂只对躯体疾病有效
  2. B安慰剂反应非常强，以致试验中抗抑郁药从未显示出优于安慰剂的任何益处
  3. C安慰剂反应率相当高，因此试验需要对照组来显示药物效果
  4. D抑郁症中从不出现安慰剂效应
5.药理学中等

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

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

An older patient on amlodipine develops ankle swelling and is prescribed furosemide. She then becomes dizzy and falls. What does this sequence illustrate?

  1. ADrug tolerance
  2. BEnzyme induction
  3. CA prescribing cascade
  4. DA type B allergic reaction

3溶液

1.精神科护理

答案: B · To screen for and monitor tardive dyskinesia

为什么是这个答案

The AIMS is a structured examination of involuntary movements of the face, limbs and trunk. It is done at baseline and regularly during long-term antipsychotic treatment so tardive dyskinesia is detected early.

答案

B · To screen for and monitor tardive dyskinesia
2.精神科护理

答案: D · Borderline personality disorder

为什么是这个答案

In borderline personality disorder, mood shifts are short-lived, often hours, and are usually triggered by interpersonal events. Bipolar episodes last days to weeks and are not mainly reactive to relationships.

答案

D · Borderline personality disorder
3.临床心理学

答案: D · 不同临床医生对同一患者是否得出相同诊断

为什么是这个答案

信度是诊断在不同临床医生之间或不同时间的一致性；效度是诊断是否反映了真实而有意义的类别。

答案

D · 不同临床医生对同一患者是否得出相同诊断
4.临床心理学

答案: C · 安慰剂反应率相当高，因此试验需要对照组来显示药物效果

为什么是这个答案

抑郁症试验中的安慰剂反应率常达 30–40%，因此需要随机安慰剂对照设计来显示药物的特异性效果。

答案

C · 安慰剂反应率相当高，因此试验需要对照组来显示药物效果
5.药理学

答案: C · 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

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

答案: C · A prescribing cascade

为什么是这个答案

In a prescribing cascade, an adverse effect of one drug is mistaken for a new condition and treated with another drug, which brings new risks. Amlodipine oedema does not respond well to diuretics; reviewing the original drug is better.

答案

C · A prescribing cascade

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