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

In a therapy group, one member talks constantly and interrupts others. What should the group leader do?

  1. ACriticise the member in front of the whole group so that she learns to stay quiet
  2. BAsk the member to leave the group permanently so that others can speak
  3. CAcknowledge the member's contribution and invite others to share their views
  4. DLet the member continue, because she has a lot to say
2.精神科护理困难

一名服用 MAOI 的患者从聚会回来，出现后脑勺剧烈头痛、颈部僵硬和心悸。护士应首先做什么？

  1. A提前给她下一剂 MAOI
  2. B给她一杯浓咖啡缓解头痛
  3. C测量血压并紧急通知开医嘱者
  4. D建议她躺下睡一觉就好
3.临床心理学中等

服用单胺氧化酶抑制剂（MAOI）的患者必须避免富含酪胺的食物，因为：

  1. A两者合用会导致迟发性运动障碍
  2. B酪胺会导致严重的体重下降
  3. C两者合用可导致血压危险地升高
  4. D酪胺会完全阻断 MAOI 的抗抑郁效果
4.临床心理学困难

一位强迫症来访者出门前要检查炉子二十次。根据认知行为模型，为什么检查会维持这种障碍？

  1. A检查后的解脱感强化了检查，并阻碍其认识到恐惧没有根据
  2. B检查带来强烈的快感，使来访者上瘾
  3. C每次检查都使焦虑升高，从而惩罚并逐渐削弱检查的冲动
  4. D检查主要由智力低和工作记忆差引起
5.药理学中等

Why should a patient rinse the mouth after using an inhaled corticosteroid?

  1. ATo prevent a fall in blood glucose
  2. BTo make the drug work faster in the lungs
  3. CTo stop the drug being absorbed too quickly into the blood
  4. DTo reduce the risk of oral thrush (candidiasis) and hoarseness
6.药理学困难

A patient is switched from oral to intravenous morphine. Why is the IV dose lower than the oral dose?

  1. AIV morphine is a stronger chemical form of the drug
  2. BIV morphine is excreted much more slowly by the kidney than oral morphine
  3. CThe oral route causes tolerance faster than the IV route
  4. DOral morphine has a large first-pass effect, so less reaches the blood

3溶液

1.精神科护理

答案: C · Acknowledge the member's contribution and invite others to share their views

为什么是这个答案

The leader manages a monopolising member by acknowledging her and redirecting to others, and may discuss it privately. This keeps the group safe and gives everyone a chance to take part.

答案

C · Acknowledge the member's contribution and invite others to share their views
2.精神科护理

答案: C · 测量血压并紧急通知开医嘱者

为什么是这个答案

这些是高血压危象的征象。应测量血压，对她进行观察，并紧急寻求医疗帮助。咖啡因会使情况更糟。

答案

C · 测量血压并紧急通知开医嘱者
3.临床心理学

答案: C · 两者合用可导致血压危险地升高

为什么是这个答案

MAO 正常时分解食物中的酪胺。它被抑制后，酪胺可引发高血压危象，因此使用 MAOI 需要饮食限制。

答案

C · 两者合用可导致血压危险地升高
4.临床心理学

答案: A · 检查后的解脱感强化了检查，并阻碍其认识到恐惧没有根据

为什么是这个答案

强迫行为因短期的解脱而得到负强化，并使当事人无法认识到焦虑会自行下降。这就是 ERP 要阻止仪式行为的原因。

答案

A · 检查后的解脱感强化了检查，并阻碍其认识到恐惧没有根据
5.药理学

答案: D · To reduce the risk of oral thrush (candidiasis) and hoarseness

为什么是这个答案

Steroid left in the mouth and throat suppresses local immunity and can cause candidiasis and a hoarse voice. Rinsing and spitting, and using a spacer, reduce this risk.

答案

D · To reduce the risk of oral thrush (candidiasis) and hoarseness
6.药理学

答案: D · Oral morphine has a large first-pass effect, so less reaches the blood

为什么是这个答案

Much of an oral morphine dose is metabolised by the liver before reaching the systemic circulation. Equianalgesic tables are used, so the IV dose is a fraction of the oral dose.

答案

D · Oral morphine has a large first-pass effect, so less reaches the blood

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