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

How does repetitive transcranial magnetic stimulation (rTMS) differ from ECT?

  1. AIt involves surgically implanting electrodes deep in the brain under anaesthetic
  2. BIt needs a general anaesthetic and causes a seizure, like ECT
  3. CIt is given as a daily tablet that contains tiny magnetic particles
  4. DIt uses magnetic pulses on the scalp while the patient is awake, without causing a seizure
2.精神科护理困难

A patient on suicide precautions asks for his razor to shave. What is the most appropriate response?

  1. AFollow policy, for example by supervising the shave or offering an electric razor
  2. BLet another patient lend him a razor so that staff do not need to be involved and he can keep his privacy
  3. CRefuse, and tell him he cannot shave at all while in hospital
  4. DGive him the razor, because he has the right to his own belongings
3.临床心理学中等

治疗联盟是指：

  1. A治疗师与来访者之间的合作关系以及在目标和任务上的一致
  2. B来访者的诊断，由两位精神科医生在初次评估时独立确认
  3. C一群相互转介来访者的治疗师
  4. D诊所与保险公司之间的法律合同
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患者的智商分数
  2. B复发率和再住院率
  3. C兄弟姐妹的遗传风险
  4. D对任何抗精神病药的需要
5.药理学中等

How should the nurse straighten the ear canal to give ear drops to a 2-year-old child?

  1. ALeave the ear untouched and drop into the canal
  2. BPush the pinna forward and up
  3. CPull the pinna down and back
  4. DPull the pinna up and back
6.药理学困难

Why may omeprazole be avoided in a patient taking clopidogrel?

  1. AIt speeds up kidney excretion of clopidogrel
  2. BIt inhibits CYP2C19, so less clopidogrel is converted to its active form
  3. CIt binds clopidogrel in the stomach and makes it insoluble
  4. DIt increases clopidogrel absorption from the gut and causes bleeding

3溶液

1.精神科护理

答案: D · It uses magnetic pulses on the scalp while the patient is awake, without causing a seizure

为什么是这个答案

rTMS stimulates specific brain areas with a magnetic coil held on the head. It does not need anaesthesia or cause a seizure and is used for depression that has not responded to medicines.

答案

D · It uses magnetic pulses on the scalp while the patient is awake, without causing a seizure
2.精神科护理

答案: A · Follow policy, for example by supervising the shave or offering an electric razor

为什么是这个答案

Patients at risk still need hygiene and dignity. Policies usually allow supervised use of sharps or safer alternatives, which balance safety with respect.

答案

A · Follow policy, for example by supervising the shave or offering an electric razor
3.临床心理学

答案: A · 治疗师与来访者之间的合作关系以及在目标和任务上的一致

为什么是这个答案

在不同治疗取向中，治疗联盟都能稳定地预测治疗效果，这支持了共同因素在心理治疗中的重要性。

答案

A · 治疗师与来访者之间的合作关系以及在目标和任务上的一致
4.临床心理学

答案: B · 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

B · 复发率和再住院率
5.药理学

答案: C · Pull the pinna down and back

为什么是这个答案

In children under about 3 years, the pinna is pulled down and back; in adults it is pulled up and back. The child then lies with the treated ear up for a few minutes.

答案

C · Pull the pinna down and back
6.药理学

答案: B · It inhibits CYP2C19, so less clopidogrel is converted to its active form

为什么是这个答案

Clopidogrel must be activated by liver enzymes, mainly CYP2C19. Omeprazole inhibits this enzyme and can reduce its antiplatelet effect, so another acid suppressant may be chosen.

答案

B · It inhibits CYP2C19, so less clopidogrel is converted to its active form

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