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 woman calls the emergency department after a sexual assault an hour ago. What advice helps to preserve forensic evidence?

  1. AShower and wash her clothes before coming in, so she feels cleaner
  2. BAvoid showering or changing clothes, and bring any clothing already removed in a paper bag
  3. CPut all clothing in a sealed plastic bag
  4. DWait a few days at home until she feels ready to talk before seeking any medical care or forensic examination
2.精神科护理困难

一名精神分裂症患者拒绝服用抗精神病药,说它让他觉得迟钝。最佳的初始回应是什么?

  1. A记录“拒绝”,以后再也不讨论
  2. B把药藏在他的食物里
  3. C告诉他,如果他不口服药片,就会被约束并注射
  4. D了解他的原因和副作用,并告知团队,以便复核治疗
3.临床心理学中等

哪种人格障碍的特点是普遍地漠视他人权利?

  1. A反社会型人格障碍
  2. B回避型人格障碍
  3. C边缘型人格障碍
  4. D依赖型人格障碍
4.临床心理学困难

为什么 DSM-5 用单一的"物质使用障碍"取代了"物质滥用"和"物质依赖"?

  1. A研究发现这两个类别反映的是同一维度,用严重程度分级描述更好
  2. B滥用被重新归类为人格障碍,而依赖则成了纯粹的医学状况
  3. C研究发现依赖并不存在
  4. D世界卫生组织禁止使用这些术语
5.药理学中等

When does oseltamivir give the most benefit in influenza?

  1. AWhen started within 48 hours of the first symptoms
  2. BAt any time, as the timing makes no difference
  3. COnly after symptoms have lasted at least one week
  4. DOnly after a bacterial pneumonia has developed
6.药理学困难

Why is the TPMT enzyme often tested before azathioprine is started?

  1. ATPMT is needed to absorb azathioprine from the gut
  2. BHigh TPMT activity causes an allergic reaction to azathioprine
  3. CLow TPMT activity causes toxic levels and marrow suppression
  4. DTPMT testing shows whether the patient has tuberculosis

3溶液

1.精神科护理

答案: B · Avoid showering or changing clothes, and bring any clothing already removed in a paper bag

为什么是这个答案

Not washing, changing or eating where possible helps keep evidence. Paper bags are used because plastic traps moisture and can degrade biological evidence. Her medical needs and choices remain the priority.

答案

B · Avoid showering or changing clothes, and bring any clothing already removed in a paper bag
2.精神科护理

答案: D · 了解他的原因和副作用,并告知团队,以便复核治疗

为什么是这个答案

患者有权被倾听,并且在大多数情况下有权拒绝治疗。了解原因和副作用有助于团队复核治疗。只有在特定的法律和政策条件下才允许隐蔽给药。

答案

D · 了解他的原因和副作用,并告知团队,以便复核治疗
3.临床心理学

答案: A · 反社会型人格障碍

为什么是这个答案

反社会型人格障碍包括欺骗、冲动、攻击性和缺乏悔意,并在童年有品行障碍的证据。

答案

A · 反社会型人格障碍
4.临床心理学

答案: A · 研究发现这两个类别反映的是同一维度,用严重程度分级描述更好

为什么是这个答案

研究表明,滥用和依赖的标准构成一个连续体。DSM-5 把它们合并为一种障碍,并按符合的标准数量评定严重程度。

答案

A · 研究发现这两个类别反映的是同一维度,用严重程度分级描述更好
5.药理学

答案: A · When started within 48 hours of the first symptoms

为什么是这个答案

Neuraminidase inhibitors work best early, while the virus is multiplying. Started within 48 hours, they shorten illness; in high-risk or hospitalised patients they may still be given later.

答案

A · When started within 48 hours of the first symptoms
6.药理学

答案: C · Low TPMT activity causes toxic levels and marrow suppression

为什么是这个答案

Thiopurine methyltransferase helps inactivate azathioprine and mercaptopurine. People with low or absent TPMT activity need much lower doses or another drug to avoid life-threatening myelosuppression.

答案

C · Low TPMT activity causes toxic levels and marrow suppression

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