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 man taking risperidone reports breast enlargement and his partner says he has lost interest in sex. Which effect is the most likely cause?

  1. ARaised blood calcium
  2. BLow blood sodium
  3. CLow thyroid hormone
  4. DRaised prolactin
2.精神科护理困难

During a panic attack, a patient breathes very fast and complains of light-headedness and tingling in her fingers and around her mouth. What should the nurse do?

  1. AStay with her and coach her to breathe slowly and steadily
  2. BAsk her to breathe into a paper bag for at least 10 minutes
  3. CLeave her alone so that she can calm down without anyone watching
  4. DGive her oxygen at a high flow rate through a mask
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边缘型人格障碍
  2. B反社会型人格障碍
  3. C依赖型人格障碍
  4. D回避型人格障碍
4.临床心理学困难

同卵双生子的精神分裂症同病率高于异卵双生子。这说明什么？

  1. A双胞胎比其他兄弟姐妹更容易被临床医生误诊
  2. B环境不起任何作用
  3. C精神分裂症完全由基因引起
  4. D基因会增加风险，但环境也很重要
5.药理学中等

An adult patient is due to receive digoxin. The apical pulse, counted for a full minute, is 52 beats per minute. What should the nurse do?

  1. AWithhold the dose and notify the prescriber
  2. BGive the dose and recheck the pulse in one hour
  3. CGive half the dose and document the pulse
  4. DGive the dose with food to slow absorption
6.药理学困难

Why is glibenclamide (glyburide) generally avoided in older adults?

  1. AIt causes high blood glucose in older adults
  2. BIt causes severe weight loss and muscle wasting in older people
  3. CIt is long-acting and can cause prolonged, severe hypoglycaemia
  4. DIt is not absorbed in people over 65

3溶液

1.精神科护理

答案: D · Raised prolactin

为什么是这个答案

Blocking dopamine in the tuberoinfundibular pathway raises prolactin. This can cause gynaecomastia, galactorrhoea, menstrual problems and sexual dysfunction; risperidone and first-generation antipsychotics commonly cause it.

答案

D · Raised prolactin
2.精神科护理

答案: A · Stay with her and coach her to breathe slowly and steadily

为什么是这个答案

Hyperventilation causes respiratory alkalosis, which leads to tingling and dizziness. Calm coaching of slow breathing restores carbon dioxide levels. Breathing into a paper bag is not recommended, because it can cause hypoxia and mask a medical cause.

答案

A · Stay with her and coach her to breathe slowly and steadily
3.临床心理学

答案: B · 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

B · 反社会型人格障碍
4.临床心理学

答案: D · 基因会增加风险，但环境也很重要

为什么是这个答案

同卵高于异卵的同病率表明存在遗传作用，而远低于 100% 的同病率说明环境因素同样重要。

答案

D · 基因会增加风险，但环境也很重要
5.药理学

答案: A · Withhold the dose and notify the prescriber

为什么是这个答案

Digoxin is usually withheld in adults if the apical pulse is below 60 per minute, and the prescriber is informed. Bradycardia may be an early sign of toxicity.

答案

A · Withhold the dose and notify the prescriber
6.药理学

答案: C · It is long-acting and can cause prolonged, severe hypoglycaemia

为什么是这个答案

Glibenclamide has a long action and active metabolites that accumulate when kidney function declines. Older adults are at high risk of prolonged hypoglycaemia, so shorter-acting agents or other drug classes are preferred.

答案

C · It is long-acting and can cause prolonged, severe hypoglycaemia

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