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

The wife of a man with alcohol dependence organises her life around his drinking, hides it from others and neglects her own needs. What does this pattern suggest?

  1. ALearned helplessness in the patient
  2. BEnabling by the healthcare team
  3. CCodependency
  4. DDelirium tremens
2.精神科护理困难

A depressed patient says, "I don't enjoy anything any more, so there's no point in doing anything." Which intervention best reflects behavioural activation?

  1. AEncourage him to rest in bed as much as possible until the medicine works
  2. BWait until his mood improves before suggesting activities
  3. CPlan small, scheduled activities with him and review how he felt afterwards
  4. DTell him that his thoughts are irrational and he should stop thinking that way
3.临床心理学中等

正念认知疗法（MBCT）证据最充分的用途是：

  1. A预防复发性抑郁患者的复发
  2. B治疗急性精神病
  3. C治疗患有 ADHD 的幼儿的注意问题
  4. D治愈痴呆
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安慰剂反应率相当高，因此试验需要对照组来显示药物效果
  3. C抑郁症中从不出现安慰剂效应
  4. D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
5.药理学中等

Which side effects are most common when starting gabapentin?

  1. ACough and runny nose
  2. BInsomnia and agitation
  3. CHair loss and weight loss
  4. DDrowsiness and dizziness
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尖端扭转型室性心动过速
  2. B窦性心动过速
  3. C心房颤动
  4. D一度房室传导阻滞

3溶液

1.精神科护理

答案: C · Codependency

为什么是这个答案

Codependency describes a family member whose life becomes centred on the other person's addiction, often with caretaking, covering up and neglect of self. Support groups such as Al-Anon can help.

答案

C · Codependency
2.精神科护理

答案: C · Plan small, scheduled activities with him and review how he felt afterwards

为什么是这个答案

Behavioural activation is based on the idea that activity improves mood, not the other way round. Scheduling achievable, meaningful activities and reviewing the effect breaks the cycle of withdrawal and low mood.

答案

C · Plan small, scheduled activities with him and review how he felt afterwards
3.临床心理学

答案: A · 预防复发性抑郁患者的复发

为什么是这个答案

MBCT 把正念练习与认知疗法相结合。试验表明，它能减少既往有三次或以上抑郁发作者的复发。

答案

A · 预防复发性抑郁患者的复发
4.临床心理学

答案: B · 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

B · 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: D · Drowsiness and dizziness

为什么是这个答案

Gabapentin and pregabalin commonly cause sedation, dizziness and unsteadiness, which raise the risk of falls. They also increase sedation when combined with opioids.

答案

D · Drowsiness and dizziness
6.药理学

答案: A · 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

A · 尖端扭转型室性心动过速

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