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

An agitated patient has not responded to verbal de-escalation. A PRN medicine is prescribed. What is the most appropriate step?

  1. AOffer the oral medicine first, before considering an injection
  2. BPlace him in seclusion and then decide about medicine later
  3. CHide the medicine in his drink without telling him
  4. DGive an intramuscular injection at once without offering any choice
2.精神科护理困难

A new nurse asks why the therapeutic relationship is different from a social relationship. Which statement is correct?

  1. ABoth people share their needs equally, as in any friendship
  2. BIt is goal-directed and focused on the patient's needs, with the nurse responsible for keeping boundaries
  3. CThe patient is responsible for setting the boundaries of the relationship
  4. DIt has no fixed end, and it can continue as a friendship after discharge if both the nurse and the patient want it to
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不能充分发挥功能
  3. C偏离理想的心理健康
  4. D偏离社会规范
4.临床心理学困难

治疗师说："与其和'我是个失败者'这个想法作斗争，不如把它仅仅当作一个想法来觉察，然后去做对你重要的事。"这最能代表哪种疗法？

  1. A系统脱敏
  2. B理性情绪行为疗法
  3. C经典精神分析
  4. D接纳承诺疗法（ACT）
5.药理学中等

A patient takes theophylline for COPD. Which advice is most important?

  1. ATake extra doses when short of breath
  2. BLimit coffee, tea and cola, because caffeine adds to the side effects
  3. CDrink plenty of grapefruit juice each morning to improve absorption
  4. DAvoid potassium-rich foods such as bananas
6.药理学困难

A patient with epilepsy needs pain relief. Why is tramadol used with caution?

  1. AIt causes a sharp rise in blood glucose
  2. BIt speeds up the metabolism of all antiepileptic drugs
  3. CIt always causes respiratory arrest in epilepsy
  4. DIt lowers the seizure threshold

3溶液

1.精神科护理

答案: A · Offer the oral medicine first, before considering an injection

为什么是这个答案

Offering oral medication respects choice and is less restrictive than an injection. Covert administration is only lawful in specific, documented circumstances, not as a routine approach.

答案

A · Offer the oral medicine first, before considering an injection
2.精神科护理

答案: B · It is goal-directed and focused on the patient's needs, with the nurse responsible for keeping boundaries

为什么是这个答案

A therapeutic relationship has a clear purpose, focuses on the patient's needs and has a planned end. The nurse, not the patient, is responsible for keeping professional boundaries.

答案

B · It is goal-directed and focused on the patient's needs, with the nurse responsible for keeping boundaries
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: D · 接纳承诺疗法（ACT）

为什么是这个答案

ACT（海斯）运用接纳、认知解离和基于价值的行动。与传统认知疗法不同，它不试图驳斥想法的内容。

答案

D · 接纳承诺疗法（ACT）
5.药理学

答案: B · Limit coffee, tea and cola, because caffeine adds to the side effects

为什么是这个答案

Theophylline has a narrow therapeutic range, and caffeine adds stimulant effects such as tachycardia, restlessness and insomnia. Toxicity can cause arrhythmias and seizures, so blood levels may be monitored.

答案

B · Limit coffee, tea and cola, because caffeine adds to the side effects
6.药理学

答案: D · It lowers the seizure threshold

为什么是这个答案

Tramadol can cause seizures, especially at high doses or with other drugs that lower the seizure threshold. Its serotonergic action also raises the risk of serotonin syndrome.

答案

D · It lowers the seizure threshold

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