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

An 86-year-old nursing home resident becomes acutely confused over two days. Which cause should be considered first?

  1. AA sudden onset of Alzheimer's disease
  2. BThe normal ageing process
  3. CA first episode of schizophrenia caused by moving into the home
  4. DAn infection such as a urinary tract infection, or a medicine side effect
2.精神科护理困难

A patient with depression answers every question with one or two words and looks at the floor. Which approach is most helpful?

  1. AAsk several open questions in quick succession to keep the conversation going
  2. BUse simple statements, allow extra time for answers and stay with the patient even in silence
  3. CEncourage him to cheer up and think about the good things in his life
  4. DEnd the conversation quickly, because the patient clearly does not want to talk
3.临床心理学中等

一个人在一次严重车祸两周后出现令人痛苦的症状，至今已持续十天。哪种诊断最恰当？

  1. A急性应激障碍
  2. B创伤后应激障碍
  3. C广泛性焦虑障碍
  4. D适应障碍
4.临床心理学困难

研究者发现，生母患精神分裂症的被收养者比生母未患病的被收养者更常患病，尽管他们都由未患病的家庭抚养。这种设计有助于区分什么？

  1. A按 DSM 诊断与按 ICD 诊断
  2. B阳性症状与阴性症状
  3. C抗精神病药物的效果与心理治疗的效果
  4. D遗传影响与抚养环境的影响
5.药理学中等

A patient starting niacin (nicotinic acid) complains of flushing and warmth after doses. Which advice may reduce this?

  1. ATake it on an empty stomach in a hot bath
  2. BDouble the dose to build tolerance faster
  3. CTake the niacin with a hot drink so that it dissolves and acts faster
  4. DTake aspirin 30 minutes before the niacin, if the prescriber agrees
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. ANeostigmine
  2. BDantrolene
  3. CNaloxone
  4. DParacetamol

3溶液

1.精神科护理

答案: D · An infection such as a urinary tract infection, or a medicine side effect

为什么是这个答案

Acute confusion in an older adult suggests delirium, which has an underlying cause. Common causes include infections, medicines (especially anticholinergics and sedatives), dehydration, hypoxia, pain and urinary retention.

答案

D · An infection such as a urinary tract infection, or a medicine side effect
2.精神科护理

答案: B · Use simple statements, allow extra time for answers and stay with the patient even in silence

为什么是这个答案

Psychomotor slowing makes answering hard. Short, simple communication, patience and a calm presence show acceptance, while pressure or forced cheerfulness can increase feelings of failure.

答案

B · Use simple statements, allow extra time for answers and stay with the patient even in silence
3.临床心理学

答案: A · 急性应激障碍

为什么是这个答案

急性应激障碍涵盖事件后持续三天至一个月的创伤症状。如果症状持续超过一个月，可诊断为 PTSD。

答案

A · 急性应激障碍
4.临床心理学

答案: D · 遗传影响与抚养环境的影响

为什么是这个答案

收养研究（如赫斯顿的研究和丹麦的研究）能把遗传风险与家庭环境分开，因为孩子是在远离亲生父母的环境中长大的。

答案

D · 遗传影响与抚养环境的影响
5.药理学

答案: D · Take aspirin 30 minutes before the niacin, if the prescriber agrees

为什么是这个答案

Niacin causes prostaglandin-mediated vasodilation and flushing. Aspirin beforehand, taking it with food and avoiding hot drinks and alcohol reduce this effect.

答案

D · Take aspirin 30 minutes before the niacin, if the prescriber agrees
6.药理学

答案: B · 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

B · Dantrolene

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