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 patient stopped paroxetine suddenly a few days ago. She now has dizziness, irritability, flu-like symptoms and brief "electric shock" feelings. What is the most likely cause?

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

下列哪项是精神分裂症的阳性症状？

  1. A情感平淡
  2. B言语贫乏
  3. C妄想
  4. D社交退缩
4.临床心理学困难

临床心理学中的"科学家—实践者"（博尔德）模式意味着临床工作者应当：

  1. A以开药作为主要治疗，并严格遵循精神科指南
  2. B只做实验室实验
  3. C完全回避研究
  4. D以研究证据指导实践，并评估自己的干预效果
5.药理学中等

A patient takes low-dose weekly methotrexate for rheumatoid arthritis. Which monitoring is needed?

  1. AWeekly INR checks and a monthly ECG to check the heart rhythm
  2. BRegular blood count, liver and kidney function tests
  3. CDaily blood glucose checks
  4. DMonthly hearing tests
6.药理学困难

Why should a dose never be written as "5.0 mg" on a medication order?

  1. AThe pharmacy cannot supply doses that contain a decimal point
  2. BThe decimal point may be missed, and the dose read as 50 mg
  3. CIt means the dose must be given five times
  4. DIt is too precise for most drugs

3溶液

1.精神科护理

答案: D · Antidepressant discontinuation syndrome

为什么是这个答案

Stopping an SSRI or SNRI suddenly, especially one with a short half-life such as paroxetine, can cause discontinuation symptoms. Antidepressants should be reduced gradually under medical guidance.

答案

D · Antidepressant discontinuation syndrome
2.精神科护理

答案: C · "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

C · "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: C · 妄想

为什么是这个答案

阳性症状是"增加"的（幻觉、妄想、言语紊乱），阴性症状是"缺失"的（情感平淡、意志减退、言语贫乏）。

答案

C · 妄想
4.临床心理学

答案: D · 以研究证据指导实践，并评估自己的干预效果

为什么是这个答案

博尔德模式培养临床心理学家把科学研究与临床实践结合起来，这是循证实践的基础。

答案

D · 以研究证据指导实践，并评估自己的干预效果
5.药理学

答案: B · Regular blood count, liver and kidney function tests

为什么是这个答案

Methotrexate can cause bone marrow suppression and liver damage, and poor kidney function raises its levels. Blood tests are regular, alcohol is limited and folic acid is usually given on another day.

答案

B · Regular blood count, liver and kidney function tests
6.药理学

答案: B · The decimal point may be missed, and the dose read as 50 mg

为什么是这个答案

Trailing zeros (5.0) and missing leading zeros (.5) are well-known causes of tenfold errors. Safe practice is to write 5 mg and 0.5 mg.

答案

B · The decimal point may be missed, and the dose read as 50 mg

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