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 risk of suicide particularly high for patients after psychiatric inpatient care?

  1. AOnly while the patient is asleep in hospital
  2. BThere is no change in risk after discharge
  3. COnly after one year at home
  4. DIn the first weeks after discharge
2.精神科护理困难

Which patient has the highest risk of suicide?

  1. AA 45-year-old man with well-controlled hypertension who works full time
  2. BA 72-year-old widowed man with alcohol dependence who has a gun at home and a plan
  3. CA 20-year-old student with exam stress who has no thoughts of suicide and good friends
  4. DA 30-year-old woman with mild anxiety who has a supportive family
3.临床心理学中等

一个人在一次严重车祸两周后出现令人痛苦的症状，至今已持续十天。哪种诊断最恰当？

  1. A广泛性焦虑障碍
  2. B创伤后应激障碍
  3. C适应障碍
  4. D急性应激障碍
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. A来访者说他们喜欢自己的治疗师
  2. BCBT 比药物便宜
  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 已使用了五十多年
5.药理学中等

A person who has never been vaccinated against tetanus has a deep, dirty wound. What is usually given?

  1. ATetanus vaccine only, after the wound heals
  2. BTetanus vaccine and tetanus immunoglobulin
  3. CNo treatment unless symptoms appear
  4. DOral antibiotics only
6.药理学困难

A patient taking furosemide has a serum potassium of 2.9 mmol/L (mEq/L). Which ECG change is typical of this level?

  1. AFlattened T waves and prominent U waves
  2. BTall, peaked T waves
  3. CA short QT interval with high R waves
  4. DWidened QRS with a sine-wave pattern

3溶液

1.精神科护理

答案: D · In the first weeks after discharge

为什么是这个答案

The period shortly after discharge carries a high risk of suicide. Early follow-up, a safety plan and clear crisis contacts help bridge the transition.

答案

D · In the first weeks after discharge
2.精神科护理

答案: B · A 72-year-old widowed man with alcohol dependence who has a gun at home and a plan

为什么是这个答案

Older age, male sex, being widowed, substance misuse, access to lethal means and a specific plan all raise suicide risk. Having several factors together greatly increases the overall risk.

答案

B · A 72-year-old widowed man with alcohol dependence who has a gun at home and a plan
3.临床心理学

答案: D · 急性应激障碍

为什么是这个答案

急性应激障碍涵盖事件后持续三天至一个月的创伤症状。如果症状持续超过一个月，可诊断为 PTSD。

答案

D · 急性应激障碍
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 · Tetanus vaccine and tetanus immunoglobulin

为什么是这个答案

Tetanus immunoglobulin gives immediate passive protection, while the vaccine starts active immunity. Thorough wound cleaning is also essential.

答案

B · Tetanus vaccine and tetanus immunoglobulin
6.药理学

答案: A · Flattened T waves and prominent U waves

为什么是这个答案

Hypokalaemia causes flat T waves, ST depression and U waves, and it increases the risk of arrhythmias. Peaked T waves and wide QRS complexes are signs of hyperkalaemia.

答案

A · Flattened T waves and prominent U waves

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