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

A child repeatedly eats paint flakes, soil and paper for more than a month. What is this called, and what is a key risk?

  1. AARFID; the risk of choking on food
  2. BAnorexia; dangerously low body weight and bradycardia
  3. CBulimia; severe hypokalaemia from vomiting
  4. DPica; poisoning such as lead toxicity, or bowel obstruction
2.精神科护理困难

On a mental health ward, which task is most appropriate for the nurse to delegate to a healthcare assistant?

  1. AEvaluating whether a PRN medicine given an hour ago has worked
  2. BAccompanying a stable patient to the dining room and recording his food intake
  3. CCarrying out the full admission suicide risk assessment of a newly admitted patient
  4. DTeaching a patient about the side effects of lithium
3.临床心理学中等

下列哪项是精神分裂症的阳性症状？

  1. A言语贫乏
  2. B情感平淡
  3. C妄想
  4. D社交退缩
4.临床心理学困难

一名男子说在一次激烈争吵后他的左臂瘫痪了，但神经系统检查结果与任何已知神经疾病都不相符。最可能的 DSM-5 诊断是什么？

  1. A功能性神经症状障碍（转换障碍）
  2. B疾病焦虑障碍
  3. C躯体变形障碍
  4. D诈病
5.药理学中等

A patient with suspected sepsis has blood cultures ordered and a first antibiotic dose due. What should the nurse do?

  1. AGive the antibiotic only if the temperature is above 40 °C (104 °F)
  2. BTake the blood cultures first, then give the antibiotic at once
  3. CGive the antibiotic first, then take blood cultures the next day
  4. DWait for the culture results before giving any antibiotic
6.药理学困难

非竞争性（不可逆）拮抗剂如何改变量效曲线？

  1. A使曲线左移
  2. B降低最大效应
  3. C使曲线变陡，没有其他变化
  4. D使曲线右移，最大效应不变

3溶液

1.精神科护理

答案: D · Pica; poisoning such as lead toxicity, or bowel obstruction

为什么是这个答案

Pica is persistent eating of non-food substances, inappropriate for the person's developmental level. Risks include lead poisoning, infections, dental damage and intestinal obstruction.

答案

D · Pica; poisoning such as lead toxicity, or bowel obstruction
2.精神科护理

答案: B · Accompanying a stable patient to the dining room and recording his food intake

为什么是这个答案

Routine, predictable tasks with stable patients, such as escorting and recording intake, can be delegated. Assessment, care planning, teaching and evaluation require the nurse's judgement.

答案

B · Accompanying a stable patient to the dining room and recording his food intake
3.临床心理学

答案: C · 妄想

为什么是这个答案

阳性症状是"增加"的（幻觉、妄想、言语紊乱），阴性症状是"缺失"的（情感平淡、意志减退、言语贫乏）。

答案

C · 妄想
4.临床心理学

答案: A · 功能性神经症状障碍（转换障碍）

为什么是这个答案

功能性神经症状障碍包括与公认神经疾病不相符的运动或感觉症状。诊断既不要求证明存在心理原因，也不要求证明症状是伪装的。

答案

A · 功能性神经症状障碍（转换障碍）
5.药理学

答案: B · Take the blood cultures first, then give the antibiotic at once

为什么是这个答案

Cultures are taken before antibiotics so the organism can be identified, but antibiotics must not be delayed in sepsis. Taking cultures quickly and then giving the antibiotic meets both aims.

答案

B · Take the blood cultures first, then give the antibiotic at once
6.药理学

答案: B · 降低最大效应

为什么是这个答案

竞争性拮抗剂使曲线右移，但更大剂量的激动剂仍可达到相同的最大效应。非竞争性拮抗剂会降低最大效应。

答案

B · 降低最大效应

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