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

电休克治疗（ECT）后，哪种效应是预期的且是暂时的？

  1. A治疗前所有长期记忆的永久丧失
  2. B数月失语
  3. C治疗前后短暂的意识模糊和记忆丧失
  4. D双腿瘫痪
2.精神科护理困难

A patient who has taken haloperidol for many years now has repeated lip smacking and tongue movements. Which action is most appropriate?

  1. AGive benztropine, because it reliably reverses these movements
  2. BIncrease the haloperidol dose, because a higher dose suppresses the abnormal movements of the mouth and tongue
  3. CReport the movements, assess them with a scale such as the AIMS and ask for a medication review
  4. DReassure the patient that the movements will soon stop on their own
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治愈痴呆
  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预防复发性抑郁患者的复发
4.临床心理学困难

临床心理学中的"科学家—实践者"（博尔德）模式意味着临床工作者应当：

  1. A以研究证据指导实践，并评估自己的干预效果
  2. B以开药作为主要治疗，并严格遵循精神科指南
  3. C完全回避研究
  4. D只做实验室实验
5.药理学中等

When does oseltamivir give the most benefit in influenza?

  1. AOnly after symptoms have lasted at least one week
  2. BWhen started within 48 hours of the first symptoms
  3. CAt any time, as the timing makes no difference
  4. DOnly after a bacterial pneumonia has developed
6.药理学困难

During general anaesthesia with a volatile agent and suxamethonium (succinylcholine), a patient develops muscle rigidity, rising end-tidal CO2 and a fast-rising temperature. Which drug is the specific treatment?

  1. AParacetamol
  2. BNeostigmine
  3. CDantrolene
  4. DNaloxone

3溶液

1.精神科护理

答案: C · 治疗前后短暂的意识模糊和记忆丧失

为什么是这个答案

治疗期间前后短暂的意识模糊、头痛和记忆空白很常见。护士帮助患者重新定向，在恢复期间监测生命体征和气道，并确保安全。

答案

C · 治疗前后短暂的意识模糊和记忆丧失
2.精神科护理

答案: C · Report the movements, assess them with a scale such as the AIMS and ask for a medication review

为什么是这个答案

These are signs of tardive dyskinesia, which can be permanent. Early detection and review of the antipsychotic are key; anticholinergic drugs do not treat tardive dyskinesia and may worsen it.

答案

C · Report the movements, assess them with a scale such as the AIMS and ask for a medication review
3.临床心理学

答案: D · 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

D · 预防复发性抑郁患者的复发
4.临床心理学

答案: A · 以研究证据指导实践，并评估自己的干预效果

为什么是这个答案

博尔德模式培养临床心理学家把科学研究与临床实践结合起来，这是循证实践的基础。

答案

A · 以研究证据指导实践，并评估自己的干预效果
5.药理学

答案: B · When started within 48 hours of the first symptoms

为什么是这个答案

Neuraminidase inhibitors work best early, while the virus is multiplying. Started within 48 hours, they shorten illness; in high-risk or hospitalised patients they may still be given later.

答案

B · When started within 48 hours of the first symptoms
6.药理学

答案: C · Dantrolene

为什么是这个答案

Malignant hyperthermia is caused by uncontrolled calcium release from the sarcoplasmic reticulum. Dantrolene blocks this release, and the triggering agents are stopped at once.

答案

C · Dantrolene

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