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 on a mental health ward insists that he is a famous inventor whose ideas were stolen by the government. Which type of delusion is the main one here?

  1. AErotomanic
  2. BSomatic
  3. CNihilistic
  4. DGrandiose
2.精神科护理困难

A patient starting clozapine is being taught about blood tests. Which statement shows a need for further teaching?

  1. A"The tests are done because clozapine can lower my white cells."
  2. B"If I get a sore throat or fever, I'll tell someone straight away."
  3. C"After a few months I can stop having blood tests."
  4. D"I'll need regular blood tests for as long as I take clozapine."
3.临床心理学中等

氯氮平通常仅用于难治性精神分裂症，因为：

  1. A它可能导致粒细胞缺乏症，因此需要定期监测血液
  2. B它不能以片剂形式服用
  3. C它只对阴性症状有效
  4. D它是现有抗精神病药中疗效最差的，因此只是最后的选择
4.临床心理学困难

一名长期大量饮酒者出现意识混乱、步态不稳和眼球运动异常。必须紧急治疗哪种缺乏？

  1. A维生素 C
  2. B维生素 D
  3. C铁
  4. D硫胺素（维生素 B1）
5.药理学中等

Why are many drugs started at lower doses in older adults?

  1. AKidney and liver clearance often decline, and sensitivity to drugs increases
  2. BOlder adults always weigh more than younger adults, so drugs last longer
  3. COlder adults absorb no drugs from the stomach
  4. DLower doses are cheaper for older patients
6.药理学困难

A patient took a doxycycline tablet with a sip of water just before lying down. Now swallowing is very painful. What is the most likely cause?

  1. AGastric ulcer caused by doxycycline
  2. BAn allergic reaction to the tablet coating
  3. COral candidiasis from the antibiotic
  4. DPill-induced oesophagitis

3溶液

1.精神科护理

答案: D · Grandiose

为什么是这个答案

Grandiose delusions are false beliefs about one's own importance, power or identity. They may combine with persecutory themes, as here, but the central belief is about being exceptional.

答案

D · Grandiose
2.精神科护理

答案: C · "After a few months I can stop having blood tests."

为什么是这个答案

Blood count monitoring is most frequent in the first months of clozapine treatment but continues throughout treatment, because agranulocytosis can occur at any time.

答案

C · "After a few months I can stop having blood tests."
3.临床心理学

答案: A · 它可能导致粒细胞缺乏症，因此需要定期监测血液

为什么是这个答案

其他抗精神病药无效时氯氮平仍然有效，但它可能导致中性粒细胞危险地减少，因此患者需要定期验血。

答案

A · 它可能导致粒细胞缺乏症，因此需要定期监测血液
4.临床心理学

答案: D · 硫胺素（维生素 B1）

为什么是这个答案

韦尼克脑病由硫胺素缺乏引起，表现为意识混乱、共济失调和眼部体征。若不治疗，可发展为伴有严重遗忘和虚构的科尔萨科夫综合征。

答案

D · 硫胺素（维生素 B1）
5.药理学

答案: A · Kidney and liver clearance often decline, and sensitivity to drugs increases

为什么是这个答案

Ageing reduces kidney function, changes body composition and often slows liver metabolism. Many drugs also have stronger effects on the ageing brain, so doses are started low and increased slowly.

答案

A · Kidney and liver clearance often decline, and sensitivity to drugs increases
6.药理学

答案: D · Pill-induced oesophagitis

为什么是这个答案

Doxycycline can cause oesophageal ulceration if it stays in the oesophagus. It is taken with a full glass of water while upright, and the patient stays upright for at least 30 minutes.

答案

D · Pill-induced oesophagitis

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