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 taking clozapine complains of drooling, especially at night. How should the nurse respond?

  1. ARecognise it as a common side effect, report it and suggest a towel on the pillow
  2. BStop the clozapine immediately, because this is a sign of agranulocytosis
  3. CTell him that it means the clozapine dose is too low and needs to be increased
  4. DExplain that it is a sign of an allergic reaction to the medicine
2.精神科护理困难

An 8-year-old taking methylphenidate for 6 months has dropped from the 50th to the 25th centile for weight. What is the most appropriate nursing action?

  1. AIgnore it, because weight changes in children are always normal
  2. BAdvise giving a double dose at night instead, so that the medicine does not affect his appetite during the day
  3. CStop the medicine immediately without telling the prescriber
  4. DReport the finding, review his eating pattern and suggest giving the medicine after breakfast
3.临床心理学中等

一个人每天花几个小时担心鼻子上的一个小斑点很丑，不停地照镜子，而别人看不出有任何问题。哪种诊断合适？

  1. A社交焦虑障碍
  2. B躯体变形障碍
  3. C神经性厌食症
  4. D疾病焦虑障碍
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孤独症谱系障碍
  2. B特定恐惧症
  3. C抑郁症
  4. D精神分裂症
5.药理学中等

Why is a progestogen added to oestrogen in hormone replacement therapy for a woman who still has her uterus?

  1. ATo lower the risk of blood clots to zero
  2. BTo reduce hot flushes much more than oestrogen alone can
  3. CTo protect against endometrial hyperplasia and cancer
  4. DTo prevent breast cancer completely
6.药理学困难

A patient on simvastatin is prescribed gemfibrozil. What is the main concern?

  1. ASevere hypoglycaemia
  2. BA sharp rise in LDL cholesterol and triglycerides
  3. CA much higher risk of myopathy and rhabdomyolysis
  4. DLoss of all lipid-lowering effect

3溶液

1.精神科护理

答案: A · Recognise it as a common side effect, report it and suggest a towel on the pillow

为什么是这个答案

Hypersalivation is a common, unpleasant effect of clozapine, often worse at night. It can be embarrassing and affect adherence, so it is reported; treatments are available, and the nurse also watches for aspiration risk.

答案

A · Recognise it as a common side effect, report it and suggest a towel on the pillow
2.精神科护理

答案: D · Report the finding, review his eating pattern and suggest giving the medicine after breakfast

为什么是这个答案

Appetite suppression is a common stimulant effect and can affect growth. The prescriber needs to know, and strategies such as giving the dose after breakfast and offering a good evening meal can help.

答案

D · Report the finding, review his eating pattern and suggest giving the medicine after breakfast
3.临床心理学

答案: B · 躯体变形障碍

为什么是这个答案

躯体变形障碍是对外貌上轻微或无法观察到的"缺陷"的过度关注，伴有照镜子或寻求安慰等重复行为。

答案

B · 躯体变形障碍
4.临床心理学

答案: C · 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

C · 抑郁症
5.药理学

答案: C · To protect against endometrial hyperplasia and cancer

为什么是这个答案

Oestrogen alone causes endometrial proliferation and increases the risk of endometrial cancer. A progestogen protects the endometrium; women without a uterus can take oestrogen alone.

答案

C · To protect against endometrial hyperplasia and cancer
6.药理学

答案: C · A much higher risk of myopathy and rhabdomyolysis

为什么是这个答案

Gemfibrozil reduces statin clearance and adds its own muscle toxicity. The combination greatly increases the risk of rhabdomyolysis and is generally avoided.

答案

C · A much higher risk of myopathy and rhabdomyolysis

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