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 tool is widely used to screen for delirium at the bedside?

  1. AThe CIWA-Ar
  2. BThe Confusion Assessment Method (CAM)
  3. CThe Abnormal Involuntary Movement Scale (AIMS)
  4. DThe CAGE questionnaire
2.精神科护理困难

A woman who takes lithium for bipolar disorder tells the nurse she would like to become pregnant. What is the best response?

  1. A"Please don't stop your lithium on your own. Let's arrange for you to plan this with your prescriber before you conceive."
  2. B"Lithium is completely safe in pregnancy, so there is no need to change anything at all."
  3. C"You'll need to choose between treating your bipolar disorder and having a baby."
  4. D"Stop the lithium today so that it is out of your body before you get pregnant."
3.临床心理学中等

行为激活治疗抑郁主要通过：

  1. A详细探讨童年冲突
  2. B让当事人循序渐进地接触所恐惧的身体感觉
  3. C安排一段时间的完全休息
  4. D增加对有奖赏性和有价值活动的投入
4.临床心理学困难

哪项证据最能支持 CBT 是焦虑障碍的有效治疗，而不只是安慰剂效应？

  1. ACBT 比药物便宜
  2. BCBT 已使用了五十多年
  3. C随机试验表明 CBT 优于可信的注意-安慰剂对照条件
  4. D来访者说他们喜欢自己的治疗师
5.药理学中等

What should the nurse teach a patient about taking levothyroxine?

  1. ATake it on an empty stomach, 30–60 minutes before breakfast
  2. BTake it together with the iron tablet to save time
  3. CTake it with milk at dinner, as calcium protects the stomach lining
  4. DTake it only on days when feeling tired
6.药理学困难

A woman has received a high-dose oxytocin infusion with large volumes of hypotonic fluid for many hours. She now has a headache, confusion and a low serum sodium. What is the most likely cause?

  1. AWater intoxication from the antidiuretic effect of oxytocin
  2. BNormal tiredness after a long labour
  3. CAn allergic reaction to oxytocin causing brain swelling
  4. DExcessive salt in the infusion fluid

3溶液

1.精神科护理

答案: B · The Confusion Assessment Method (CAM)

为什么是这个答案

The CAM checks for acute onset and fluctuating course, inattention, and either disorganised thinking or an altered level of consciousness. Other tools, such as the 4AT, are also used.

答案

B · The Confusion Assessment Method (CAM)
2.精神科护理

答案: A · "Please don't stop your lithium on your own. Let's arrange for you to plan this with your prescriber before you conceive."

为什么是这个答案

Lithium in early pregnancy is linked to cardiac malformations, but stopping it abruptly greatly raises the risk of relapse. Pre-conception planning with the prescriber balances these risks.

答案

A · "Please don't stop your lithium on your own. Let's arrange for you to plan this with your prescriber before you conceive."
3.临床心理学

答案: D · 增加对有奖赏性和有价值活动的投入

为什么是这个答案

行为激活安排能带来愉悦感或掌控感的活动，打破退缩与强化不足的循环。它是一种有循证依据的抑郁治疗方法。

答案

D · 增加对有奖赏性和有价值活动的投入
4.临床心理学

答案: C · 随机试验表明 CBT 优于可信的注意-安慰剂对照条件

为什么是这个答案

证明优于可信的安慰剂对照，就排除了非特异性因素是唯一解释的可能。许多试验和元分析都报告了 CBT 治疗焦虑障碍的这一结果。

答案

C · 随机试验表明 CBT 优于可信的注意-安慰剂对照条件
5.药理学

答案: A · Take it on an empty stomach, 30–60 minutes before breakfast

为什么是这个答案

Levothyroxine is best absorbed on an empty stomach, and calcium, iron and antacids should be taken some hours apart. It is taken every day, usually for life.

答案

A · Take it on an empty stomach, 30–60 minutes before breakfast
6.药理学

答案: A · Water intoxication from the antidiuretic effect of oxytocin

为什么是这个答案

Oxytocin has antidiuretic activity at high doses. With large volumes of fluid this can cause water retention and dilutional hyponatraemia, so fluid balance and sodium are monitored.

答案

A · Water intoxication from the antidiuretic effect of oxytocin

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