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

Which physical finding is common in bulimia nervosa?

  1. ASwelling of the salivary glands at the angle of the jaw
  2. BVery low body weight with lanugo hair
  3. CRaised blood pressure, a fast pulse and a high temperature
  4. DA high serum potassium level
2.精神科护理困难

A patient with OCD asks the nurse many times an hour, "Are you sure the door is locked?" What is the most helpful approach in his care plan?

  1. AReassure him every time he asks, as often as he needs
  2. BAnswer once, then follow the agreed plan to limit repeated reassurance
  3. CLock and unlock the door in front of him each time he asks
  4. DTell him firmly that if he asks about the door again, he will lose his privileges on the ward for the day
3.临床心理学中等

一个人回避公交车、商店、空旷的停车场和排队，因为一旦惊恐发作可能难以逃离。哪种诊断最合适？

  1. A广场恐惧症
  2. B广泛性焦虑障碍
  3. C社交焦虑障碍
  4. D作为特定恐惧症的幽闭恐惧症
4.临床心理学困难

共病是指：

  1. A一个人同时符合两种或以上障碍的诊断标准
  2. B某种障碍在家族中多发
  3. C某种障碍由同时存在的躯体疾病引起
  4. D某个症状为群体中所有人共有
5.药理学中等

Which teaching about zolpidem is correct?

  1. ADrive soon after waking, as the drug has no next-day effect
  2. BTake it in the morning so that it is out of the system by night
  3. CTake it right before bed, only if you can sleep a full night
  4. DTake it with alcohol to make it act faster
6.药理学困难

A breastfeeding mother needs a mild analgesic. Which drug is generally considered compatible with breastfeeding?

  1. ACodeine (as co-codamol)
  2. BParacetamol (acetaminophen)
  3. CAspirin
  4. DPethidine (meperidine)

3溶液

1.精神科护理

答案: A · Swelling of the salivary glands at the angle of the jaw

为什么是这个答案

Repeated vomiting can enlarge the parotid glands and erode tooth enamel. Patients with bulimia often have a normal weight, and purging tends to lower potassium.

答案

A · Swelling of the salivary glands at the angle of the jaw
2.精神科护理

答案: B · Answer once, then follow the agreed plan to limit repeated reassurance

为什么是这个答案

Seeking reassurance relieves anxiety only briefly and keeps the OCD cycle going. In line with exposure and response prevention, the team agrees to limit reassurance and support the patient to tolerate the anxiety.

答案

B · Answer once, then follow the agreed plan to limit repeated reassurance
3.临床心理学

答案: A · 广场恐惧症

为什么是这个答案

广场恐惧症是对至少两类情境（公共交通、开放空间、封闭空间、人群或排队、独自外出）的恐惧，因为在这些情境中可能无法逃离或得不到帮助。

答案

A · 广场恐惧症
4.临床心理学

答案: A · 一个人同时符合两种或以上障碍的诊断标准

为什么是这个答案

共病是同一个人同时存在多种障碍，这使诊断和治疗更复杂，也引发了对分类式诊断体系的质疑。

答案

A · 一个人同时符合两种或以上障碍的诊断标准
5.药理学

答案: C · Take it right before bed, only if you can sleep a full night

为什么是这个答案

Zolpidem can cause next-day impairment and complex sleep behaviours such as sleep-walking or sleep-driving. Alcohol and other sedatives increase these risks.

答案

C · Take it right before bed, only if you can sleep a full night
6.药理学

答案: B · Paracetamol (acetaminophen)

为什么是这个答案

Paracetamol passes into milk in small amounts and is widely regarded as safe. Codeine can cause dangerous opioid levels in babies of ultra-rapid metaboliser mothers, aspirin carries a Reye's risk and pethidine's metabolite accumulates in infants.

答案

B · Paracetamol (acetaminophen)

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