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

A young person who took LSD at a festival is frightened by what he is seeing. What is the most helpful nursing approach?

  1. AShine a bright light in his eyes every few minutes to check his pupils and keep him alert until it wears off
  2. BArgue with him that what he sees is not real until he accepts it
  3. CLeave him alone in a dark room so that he can sleep it off
  4. DStay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass
2.精神科护理困难

A child has been admitted several times with unexplained fevers that only happen when her mother is present. Staff see the mother tampering with the child's IV line. What is the priority action?

  1. ADiscuss the matter with the mother alone and ask her to stop
  2. BDocument the event carefully in the notes and wait to see whether it happens again before telling anyone else
  3. CEnsure the child's safety and follow child protection procedures
  4. DDischarge the child home with the mother as soon as possible
3.临床心理学中等

暴露与反应预防是哪种障碍的主要心理治疗方法？

  1. A双相障碍
  2. B强迫症
  3. C注意缺陷多动障碍
  4. D失眠
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 已使用了五十多年
  2. B来访者说他们喜欢自己的治疗师
  3. C随机试验表明 CBT 优于可信的注意-安慰剂对照条件
  4. DCBT 比药物便宜
5.药理学中等

Which advice helps reduce the most common side effect of varenicline?

  1. ATake it with alcohol to reduce nausea
  2. BTake it after food with a full glass of water
  3. CTake double doses in the first week
  4. DTake it on an empty stomach at bedtime with a little milk
6.药理学困难

药物 X 的最大反应为 100%，EC50 为 1 mg。药物 Y 的最大反应为 100%，EC50 为 10 mg。哪种说法正确？

  1. AY 的效价强度高于 X，两者效能相同
  2. BY 的效能高于 X
  3. CX 的效价强度高于 Y，两者效能相同
  4. DX 的效能高于 Y

3溶液

1.精神科护理

答案: D · Stay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass

为什么是这个答案

For a frightening hallucinogen experience, a calm setting, a supportive person and simple reassurance usually help. The nurse also monitors vital signs and watches for injury or other substances.

答案

D · Stay with him in a calm, quiet place and reassure him that the effects are from the drug and will pass
2.精神科护理

答案: C · Ensure the child's safety and follow child protection procedures

为什么是这个答案

This suggests factitious disorder imposed on another, which is a form of child abuse. The nurse protects the child and reports through safeguarding procedures. Confronting the parent alone can increase the risk to the child.

答案

C · Ensure the child's safety and follow child protection procedures
3.临床心理学

答案: B · 强迫症

为什么是这个答案

ERP 让患者接触强迫的诱发因素，同时阻止强迫行为，使焦虑在不执行仪式的情况下下降。

答案

B · 强迫症
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: B · Take it after food with a full glass of water

为什么是这个答案

Nausea is the most common adverse effect of varenicline and is reduced by taking it after food with water. Patients should also report changes in mood or behaviour.

答案

B · Take it after food with a full glass of water
6.药理学

答案: C · X 的效价强度高于 Y，两者效能相同

为什么是这个答案

EC50 越低，产生一半效应所需的药量越少，因此 X 的效价强度更高。两者达到相同的最大反应，所以效能相等。

答案

C · X 的效价强度高于 Y，两者效能相同

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