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

When is the best time to teach a patient with an anxiety disorder a relaxation technique?

  1. ADuring a panic attack, when the patient needs it most
  2. BWhen the patient's anxiety is at a mild level
  3. CWhen the patient's anxiety is severe, so that the effect can be seen clearly
  4. DOnly after the patient has been discharged from hospital
2.精神科护理困难

A patient with schizophrenia has marked negative symptoms. He stays in bed most of the day and neglects his hygiene. Which nursing approach is most helpful?

  1. AAgree a simple daily routine with small, achievable activities and give positive feedback
  2. BTell him firmly that he will lose his ward privileges unless he gets up and showers at once
  3. CWait until he asks to join activities before involving him
  4. DLet him stay in bed, because negative symptoms cannot change
3.临床心理学中等

一名女性三年来大部分日子里一天中的大部分时间都情绪低落，但程度未达到重性抑郁。哪种 DSM-5 诊断最合适？

  1. A伴抑郁心境的适应障碍
  2. B持续性抑郁障碍（心境恶劣）
  3. C双相 II 型障碍
  4. D环性心境障碍
4.临床心理学困难

艾伦和阿兹林在精神科病房引入了代币制。其主要发现和局限是什么？

  1. A该方法在几周内治愈了精神分裂症
  2. B目标行为增加，但效果往往不能泛化到病房之外
  3. C患者的幻觉永久消失，且出院后疗效仍然持续
  4. D代币对行为没有影响
5.药理学中等

During an oxytocin infusion, contractions become very frequent and the fetal heart rate shows late decelerations. What is the nurse's first action?

  1. AStop the oxytocin infusion
  2. BPosition the woman flat on her back
  3. CGive a second oxytocin bolus
  4. DIncrease the infusion to finish labour quickly
6.药理学困难

Before starting long-term bisphosphonate treatment, a patient is advised to have a dental check-up. Why?

  1. ABisphosphonates cause severe gum overgrowth
  2. BBisphosphonates stain the teeth black if taken for many years
  3. CBisphosphonates dissolve tooth enamel within weeks
  4. DThey are linked to osteonecrosis of the jaw after dental surgery

3溶液

1.精神科护理

答案: B · When the patient's anxiety is at a mild level

为什么是这个答案

Patients with severe anxiety or panic cannot take in new information. New coping skills are taught when anxiety is low, so they can be used later when anxiety rises.

答案

B · When the patient's anxiety is at a mild level
2.精神科护理

答案: A · Agree a simple daily routine with small, achievable activities and give positive feedback

为什么是这个答案

Negative symptoms such as avolition and anhedonia improve with structure, step-by-step goals and encouragement. Punishment or waiting for the patient to start on his own usually makes withdrawal worse.

答案

A · Agree a simple daily routine with small, achievable activities and give positive feedback
3.临床心理学

答案: B · 持续性抑郁障碍（心境恶劣）

为什么是这个答案

成人持续性抑郁障碍要求抑郁心境至少持续两年，并伴有食欲差、精力不足或绝望感等其他症状。

答案

B · 持续性抑郁障碍（心境恶劣）
4.临床心理学

答案: B · 目标行为增加，但效果往往不能泛化到病房之外

为什么是这个答案

代币制增加了长期住院患者的自理和劳动行为，但没有强化时这些改变往往会消退，而且这种方法引发了关于控制的伦理担忧。

答案

B · 目标行为增加，但效果往往不能泛化到病房之外
5.药理学

答案: A · Stop the oxytocin infusion

为什么是这个答案

Excessive contractions reduce placental blood flow and cause fetal distress. The oxytocin is stopped first, then the woman is turned on her side, IV fluids and oxygen are given as per protocol and the provider is informed.

答案

A · Stop the oxytocin infusion
6.药理学

答案: D · They are linked to osteonecrosis of the jaw after dental surgery

为什么是这个答案

Osteonecrosis of the jaw is a rare but serious adverse effect, mostly after invasive dental work. Dental problems are treated before starting, and good oral hygiene is maintained.

答案

D · They are linked to osteonecrosis of the jaw after dental surgery

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