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 physical finding is common in bulimia nervosa?

  1. AVery low body weight with lanugo hair
  2. BSwelling of the salivary glands at the angle of the jaw
  3. CA high serum potassium level
  4. DRaised blood pressure, a fast pulse and a high temperature
2.精神科护理困难

A patient with dementia repeatedly walks towards the ward exit, saying he must go to work. What is the most appropriate action?

  1. AUse a physical restraint in a chair for the rest of the day so that he stays safe and cannot reach the exit
  2. BLock him in his room so that he cannot leave
  3. CWalk with him, acknowledge his concern and gently redirect him to an activity
  4. DTell him firmly that he has been retired for 20 years
3.临床心理学中等

哪种异常标准在某种行为在人群中罕见时就判定其为异常？

  1. A统计上的罕见性
  2. B偏离社会规范
  3. C不能充分发挥功能
  4. D偏离理想的心理健康
4.临床心理学困难

哪项观察支持精神分裂症的多巴胺假说？

  1. A抗精神病药增加中脑边缘通路的多巴胺活动并减轻症状
  2. B苯丙胺等提高多巴胺的药物可诱发精神病性症状
  3. C所有患者对抗抑郁药的反应同样好
  4. D仅凭 5-羟色胺水平就能预测症状
5.药理学中等

A patient takes isoniazid. Which advice is most important?

  1. AStop the drug when the cough improves
  2. BExpect the urine to turn orange
  3. CTake it with antacids to protect the stomach from irritation
  4. DAvoid alcohol and report jaundice, dark urine or poor appetite
6.药理学困难

合用几种延长 QT 间期的药物会增加哪种危及生命的心律失常的风险？

  1. A窦性心动过速
  2. B心房颤动
  3. C尖端扭转型室性心动过速
  4. D一度房室传导阻滞

3溶液

1.精神科护理

答案: B · Swelling of the salivary glands at the angle of the jaw

为什么是这个答案

Repeated vomiting can enlarge the parotid glands and erode tooth enamel. Patients with bulimia often have a normal weight, and purging tends to lower potassium.

答案

B · Swelling of the salivary glands at the angle of the jaw
2.精神科护理

答案: C · Walk with him, acknowledge his concern and gently redirect him to an activity

为什么是这个答案

Wandering often has a reason, such as a past routine, boredom or a physical need. Redirection, meaningful activity and a safe environment are preferred over restraint, which increases agitation and the risk of injury.

答案

C · Walk with him, acknowledge his concern and gently redirect him to an activity
3.临床心理学

答案: A · 统计上的罕见性

为什么是这个答案

统计罕见性把远离平均水平的行为定义为异常。其缺点是有些罕见特质（如极高的智商）是令人向往的。

答案

A · 统计上的罕见性
4.临床心理学

答案: B · 苯丙胺等提高多巴胺的药物可诱发精神病性症状

为什么是这个答案

苯丙胺可诱发精神病，阻断 D2 的抗精神病药能减轻阳性症状。阴性症状较难解释，因此该假说已被修订。

答案

B · 苯丙胺等提高多巴胺的药物可诱发精神病性症状
5.药理学

答案: D · Avoid alcohol and report jaundice, dark urine or poor appetite

为什么是这个答案

Isoniazid can cause hepatitis, and alcohol increases the risk. Signs of liver injury are reported at once, and liver tests may be checked.

答案

D · Avoid alcohol and report jaundice, dark urine or poor appetite
6.药理学

答案: C · 尖端扭转型室性心动过速

为什么是这个答案

QT 间期延长会延迟复极，可诱发尖端扭转型室速，并可能转为心室颤动。某些大环内酯类、抗精神病药和抗心律失常药都会增加这一风险。

答案

C · 尖端扭转型室性心动过速

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