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 lies awake in bed for hours worrying about not sleeping. Which stimulus control advice is correct?

  1. ADo vigorous exercise in the bedroom until tired enough to fall asleep straight away
  2. BLook at the clock often to check how much sleep is being lost
  3. CStay in bed and watch television or use a phone until sleep finally comes
  4. DIf still awake after about 20 minutes, get up, do something calm and return when sleepy
2.精神科护理困难

A nurse notices that a colleague smells of alcohol, has slurred speech and is about to give medicines. What should the nurse do?

  1. AReport the concern immediately to the nurse in charge, following policy, to protect patients
  2. BSay nothing, because it is not her responsibility
  3. CGive the colleague some strong coffee and let her continue with the medicine round if she says she feels fine
  4. DWait until the end of the shift, then talk privately with the colleague
3.临床心理学中等

来访者说："我有一次考试不及格，所以我什么都会失败。"这是哪种认知歪曲？

  1. A读心术
  2. B个人化
  3. C情绪化推理
  4. D过度概括
4.临床心理学困难

心理治疗研究中的"渡渡鸟裁决"是指以下哪项发现？

  1. A只有精神分析对抑郁有效
  2. B药物总是优于心理治疗
  3. C各种真正的心理疗法往往产生大致相似的效果
  4. D等待名单上未经治疗的来访者比接受治疗的来访者好转得更快
5.药理学中等

When does oseltamivir give the most benefit in influenza?

  1. AOnly after a bacterial pneumonia has developed
  2. BOnly after symptoms have lasted at least one week
  3. CAt any time, as the timing makes no difference
  4. DWhen started within 48 hours of the first symptoms
6.药理学困难

为什么庆大霉素的给药需要监测血药浓度？

  1. A它会引起严重低血糖
  2. B它完全由肝脏代谢，因此由肝功能决定剂量
  3. C它只在极高浓度下有效
  4. D它有肾毒性和耳毒性，且治疗指数窄

3溶液

1.精神科护理

答案: D · If still awake after about 20 minutes, get up, do something calm and return when sleepy

为什么是这个答案

Stimulus control strengthens the bed as a cue for sleep. Getting up when unable to sleep, using the bed only for sleep and intimacy, and keeping a regular wake time are key parts.

答案

D · If still awake after about 20 minutes, get up, do something calm and return when sleepy
2.精神科护理

答案: A · Report the concern immediately to the nurse in charge, following policy, to protect patients

为什么是这个答案

An impaired nurse is a risk to patients. The concern is reported at once through the proper channel so the colleague can be removed from patient care and offered support through the organisation's procedures.

答案

A · Report the concern immediately to the nurse in charge, following policy, to protect patients
3.临床心理学

答案: D · 过度概括

为什么是这个答案

过度概括是从单一事件得出笼统的结论。贝克的认知疗法教来访者觉察并检验这类歪曲。

答案

D · 过度概括
4.临床心理学

答案: C · 各种真正的心理疗法往往产生大致相似的效果

为什么是这个答案

元分析常发现成熟疗法之间的差异很小，这被视为支持治疗联盟等共同因素的证据。但强迫症和恐惧症等障碍显示，暴露等特定疗法具有明显优势。

答案

C · 各种真正的心理疗法往往产生大致相似的效果
5.药理学

答案: D · When started within 48 hours of the first symptoms

为什么是这个答案

Neuraminidase inhibitors work best early, while the virus is multiplying. Started within 48 hours, they shorten illness; in high-risk or hospitalised patients they may still be given later.

答案

D · When started within 48 hours of the first symptoms
6.药理学

答案: D · 它有肾毒性和耳毒性，且治疗指数窄

为什么是这个答案

庆大霉素等氨基糖苷类可损伤肾脏和内耳。它们经肾清除，肾功能受损时浓度升高，因此需要监测。

答案

D · 它有肾毒性和耳毒性，且治疗指数窄

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