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

A patient who has just been admitted says, "I don't want to talk to anyone." What is the best initial nursing approach?

  1. ATell the patient that talking is required to be discharged
  2. BSpend short, regular periods with the patient without forcing conversation
  3. CAsk a series of direct questions until he answers
  4. DLeave the patient alone until he asks to talk
2.精神科护理困难

A patient asks, "Do you think I should divorce my husband?" Which response best supports the patient's autonomy?

  1. A"What are your thoughts about the options you have?"
  2. B"No, divorce would only make things worse for you."
  3. C"Yes, I think you'd be happier without him."
  4. D"You should ask your doctor what to do about it."
3.临床心理学中等

哪种人格障碍的特点是人际关系、自我形象和情绪不稳定，并伴有明显的冲动性？

  1. A回避型人格障碍
  2. B自恋型人格障碍
  3. C分裂样人格障碍
  4. D边缘型人格障碍
4.临床心理学困难

情感表达研究促成了精神分裂症的家庭干预。这些干预最可靠地改善了哪项结果？

  1. A兄弟姐妹的遗传风险
  2. B对任何抗精神病药的需要
  3. C患者的智商分数
  4. D复发率和再住院率
5.药理学中等

During an infusion of a vesicant chemotherapy drug, the patient reports burning, and the site is swollen. What should the nurse do first?

  1. AFlush the line with a large volume of saline
  2. BRemove the cannula at once and massage the area firmly
  3. CStop the infusion, leave the cannula in and follow the protocol
  4. DIncrease the infusion rate to finish quickly
6.药理学困难

A noradrenaline infusion is running through a peripheral cannula. The skin around the site becomes pale, cold and hard. What should the nurse do?

  1. AStop the infusion at that site and follow the extravasation protocol
  2. BLeave the infusion running and recheck in 4 hours
  3. CApply heat and massage the area, then continue the infusion
  4. DIncrease the rate to improve blood flow to the area

3溶液

1.精神科护理

答案: B · Spend short, regular periods with the patient without forcing conversation

为什么是这个答案

Short, frequent, predictable contacts show acceptance and help build trust. Forcing conversation increases anxiety, while leaving the patient alone can reinforce withdrawal.

答案

B · Spend short, regular periods with the patient without forcing conversation
2.精神科护理

答案: A · "What are your thoughts about the options you have?"

为什么是这个答案

Asking the patient to explore her own options supports problem-solving and autonomy. Giving an opinion, or passing the question on, takes the decision away from her.

答案

A · "What are your thoughts about the options you have?"
3.临床心理学

答案: D · 边缘型人格障碍

为什么是这个答案

边缘型人格障碍包括人际关系和身份认同不稳定、情感不稳定、害怕被抛弃、冲动以及反复自伤。DBT 是一种证据充分的治疗方法。

答案

D · 边缘型人格障碍
4.临床心理学

答案: D · 复发率和再住院率

为什么是这个答案

教授沟通和问题解决、减少批评的家庭干预能降低复发率和再住院率，通常与药物治疗同时进行。

答案

D · 复发率和再住院率
5.药理学

答案: C · Stop the infusion, leave the cannula in and follow the protocol

为什么是这个答案

Suspected extravasation of a vesicant is an emergency. The infusion is stopped, the cannula is left in so that drug can be aspirated, and the protocol, which may include an antidote and cold or warm packs, is followed.

答案

C · Stop the infusion, leave the cannula in and follow the protocol
6.药理学

答案: A · Stop the infusion at that site and follow the extravasation protocol

为什么是这个答案

Extravasation of a vasopressor can cause tissue necrosis. The infusion is stopped and moved to another site, and phentolamine, an alpha blocker, may be injected into the area to reverse vasoconstriction.

答案

A · Stop the infusion at that site and follow the extravasation protocol

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