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 memantine work in Alzheimer's disease?

  1. AIt inhibits the breakdown of acetylcholine
  2. BIt blocks NMDA glutamate receptors
  3. CIt increases serotonin by blocking its reuptake
  4. DIt blocks dopamine D2 receptors
2.精神科护理困难

A voluntary patient asks to leave the ward now. While talking, he says he plans to jump from a bridge on the way home. What should the nurse do?

  1. ALet him leave, because voluntary patients can always go when they want
  2. BAsk him to promise that he will not jump, and then let him go home on his own
  3. CStay with him and inform the team at once, so he can be urgently assessed under mental health law
  4. DTell him to go home now and come back tomorrow morning when he feels calmer and safer
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作为特定恐惧症的幽闭恐惧症
  2. B社交焦虑障碍
  3. C广泛性焦虑障碍
  4. D广场恐惧症
4.临床心理学困难

习得性无助（塞利格曼）被提出作为哪种障碍的模型？

  1. A特定恐惧症
  2. B抑郁症
  3. C精神分裂症
  4. D孤独症谱系障碍
5.药理学中等

A nurse has a needlestick injury from a patient with HIV. When should post-exposure prophylaxis start?

  1. AAfter one week, when the risk of infection is clearer
  2. BAs soon as possible, and within 72 hours at the latest
  3. COnly if the patient's viral load is above a set level
  4. DOnly after the nurse's HIV test turns positive
6.药理学困难

How does aripiprazole differ from most other antipsychotics?

  1. AIt is a full dopamine agonist that increases dopamine activity
  2. BIt is a partial agonist at dopamine D2 receptors
  3. CIt works by blocking the reuptake of serotonin only
  4. DIt has no effect on dopamine and acts only on histamine

3溶液

1.精神科护理

答案: B · It blocks NMDA glutamate receptors

为什么是这个答案

Memantine is an NMDA receptor antagonist used in moderate to severe Alzheimer's disease. It may be combined with a cholinesterase inhibitor.

答案

B · It blocks NMDA glutamate receptors
2.精神科护理

答案: C · Stay with him and inform the team at once, so he can be urgently assessed under mental health law

为什么是这个答案

A voluntary patient who shows immediate serious risk may need urgent assessment under mental health legislation, which often includes short-term holding powers for nurses. The nurse acts quickly to keep him safe.

答案

C · Stay with him and inform the team at once, so he can be urgently assessed under mental health law
3.临床心理学

答案: D · 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

D · 广场恐惧症
4.临床心理学

答案: B · 抑郁症

为什么是这个答案

经历无法控制的厌恶事件后，动物和人即使在能够逃脱时也可能放弃尝试，这与抑郁中的被动和绝望相似。

答案

B · 抑郁症
5.药理学

答案: B · As soon as possible, and within 72 hours at the latest

为什么是这个答案

Post-exposure prophylaxis aims to stop infection becoming established. It works best when started within hours, is not started after 72 hours, and is usually taken for 28 days.

答案

B · As soon as possible, and within 72 hours at the latest
6.药理学

答案: B · It is a partial agonist at dopamine D2 receptors

为什么是这个答案

Aripiprazole is a D2 partial agonist, reducing dopamine activity where it is high and providing some where it is low. It causes less weight gain and prolactin rise than many antipsychotics, but akathisia is common.

答案

B · It is a partial agonist at dopamine D2 receptors

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