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

Under the Mental Capacity Act 2005 (England and Wales), a person lacks capacity for a decision if they cannot do which of the following?

  1. AAgree with the decision that the doctor and the rest of the healthcare team recommend for them
  2. BRemember the decision for more than a year afterwards
  3. CUnderstand, retain and weigh the information, or communicate their decision
  4. DRead and write in the language used by the staff
2.精神科护理困难

A nurse suspects that a patient is hiding his tablets in his cheek and later spitting them out. What is the best approach?

  1. AStop giving him his medicine at all, because he is not taking it anyway, and record that he refused
  2. BCheck his mouth after each dose, as policy allows, and explore why he does not want it
  3. CAccuse him in front of other patients so that he is embarrassed and stops
  4. DCrush all his tablets into his food without telling him
3.临床心理学中等

在艾利斯的 ABC 模型中，"B"代表什么？

  1. A对诱发事件的信念（Beliefs）
  2. B来访者的背景（Background）
  3. C事件之后的行为（Behaviour）
  4. D应激时的身体感觉（Bodily sensations）
4.临床心理学困难

情感表达研究表明，当家庭表现出什么时，精神分裂症更容易复发？

  1. A温暖、平静的支持
  2. B经常谈论天气
  3. C大量批评、敌意和情感过度卷入
  4. D接触很少
5.药理学中等

Why is IV promethazine given with great caution?

  1. AIt is a strong opioid that causes addiction
  2. BIt causes immediate kidney failure
  3. CIt causes a severe rise in blood pressure when it is given intravenously
  4. DIt can cause severe tissue injury if it leaks or enters an artery
6.药理学困难

A postoperative patient using morphine PCA is very drowsy, hard to rouse and has a respiratory rate of 7 per minute. What should the nurse do first?

  1. AEncourage the patient to press the button only when awake and in pain
  2. BLet the patient sleep and recheck in one hour
  3. CReduce the PCA dose and leave the pump running
  4. DStop the PCA, try to rouse the patient and give naloxone as per protocol

3溶液

1.精神科护理

答案: C · Understand, retain and weigh the information, or communicate their decision

为什么是这个答案

The Act's functional test asks whether the person can understand, retain, use or weigh the information, and communicate a decision. Making an unwise decision does not by itself mean a person lacks capacity.

答案

C · Understand, retain and weigh the information, or communicate their decision
2.精神科护理

答案: B · Check his mouth after each dose, as policy allows, and explore why he does not want it

为什么是这个答案

Mouth checks or liquid forms, as permitted, can confirm that medicine is taken. Understanding the reasons, such as side effects or beliefs about the drug, helps the team address the problem with the patient.

答案

B · Check his mouth after each dose, as policy allows, and explore why he does not want it
3.临床心理学

答案: A · 对诱发事件的信念（Beliefs）

为什么是这个答案

在 ABC 模型中，诱发事件（Activating event）通过个人的信念（Beliefs）导致情绪后果（Consequences）。改变非理性信念就能改变后果。

答案

A · 对诱发事件的信念（Beliefs）
4.临床心理学

答案: C · 大量批评、敌意和情感过度卷入

为什么是这个答案

高情感表达预示着更高的复发率；降低情感表达的家庭干预可减少复发。

答案

C · 大量批评、敌意和情感过度卷入
5.药理学

答案: D · It can cause severe tissue injury if it leaks or enters an artery

为什么是这个答案

Promethazine is a vesicant. Deep intramuscular injection is the preferred parenteral route, and if given IV it is diluted, given slowly into a well-running large vein, and stopped at once if the patient reports burning or pain.

答案

D · It can cause severe tissue injury if it leaks or enters an artery
6.药理学

答案: D · Stop the PCA, try to rouse the patient and give naloxone as per protocol

为什么是这个答案

Excessive sedation and a low respiratory rate signal opioid-induced respiratory depression. The opioid is stopped, the patient is stimulated and supported with oxygen, naloxone is given as per protocol and help is called.

答案

D · Stop the PCA, try to rouse the patient and give naloxone as per protocol

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