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

电休克治疗（ECT）后，哪种效应是预期的且是暂时的？

  1. A治疗前所有长期记忆的永久丧失
  2. B数月失语
  3. C治疗前后短暂的意识模糊和记忆丧失
  4. D双腿瘫痪
2.精神科护理困难

A charming patient with antisocial personality disorder tells a new nurse, "The other nurses always let me smoke in my room. You're cooler than them, right?" What is the best response?

  1. A"Well, if the others let you, I suppose it's fine this once."
  2. B"I'll let you if you promise not to tell anyone else about it."
  3. C"You're lying to me. The other nurses would never let you smoke in your room, so stop trying it on."
  4. D"Smoking is only allowed in the garden, and that rule is the same for everyone."
3.临床心理学中等

下列哪项是精神分裂症的阳性症状？

  1. A社交退缩
  2. B情感平淡
  3. C言语贫乏
  4. D妄想
4.临床心理学困难

一位临床工作者在考虑对人格障碍采用分类方法还是维度方法更好。哪一点支持维度方法？

  1. A人格特质在任何一个人身上要么完全存在，要么完全不存在
  2. B维度模型无法用问卷或访谈测量
  3. C特质是连续变化的，而各类别相互重叠，划界点武断
  4. D已证明分类诊断具有完美的评分者间信度
5.药理学中等

Which teaching about antiepileptic drugs is most important?

  1. ATake a double dose if you feel a seizure coming
  2. BStop the drug when you have had no seizures for one whole week
  3. CDo not stop the drug suddenly, as this can trigger severe seizures
  4. DAlcohol has no effect on seizure control
6.药理学困难

A patient has a serum potassium of 7.0 mmol/L (mEq/L) and peaked T waves on the ECG. Which drug is given first to protect the heart?

  1. AOral sodium polystyrene sulfonate
  2. BIntravenous calcium gluconate
  3. COral potassium chloride
  4. DIntravenous furosemide

3溶液

1.精神科护理

答案: C · 治疗前后短暂的意识模糊和记忆丧失

为什么是这个答案

治疗期间前后短暂的意识模糊、头痛和记忆空白很常见。护士帮助患者重新定向，在恢复期间监测生命体征和气道，并确保安全。

答案

C · 治疗前后短暂的意识模糊和记忆丧失
2.精神科护理

答案: D · "Smoking is only allowed in the garden, and that rule is the same for everyone."

为什么是这个答案

Patients with antisocial traits may use charm and flattery to manipulate staff. A calm, non-defensive restatement of the rule, applied consistently by all staff, avoids both being manipulated and starting a power struggle.

答案

D · "Smoking is only allowed in the garden, and that rule is the same for everyone."
3.临床心理学

答案: D · 妄想

为什么是这个答案

阳性症状是"增加"的（幻觉、妄想、言语紊乱），阴性症状是"缺失"的（情感平淡、意志减退、言语贫乏）。

答案

D · 妄想
4.临床心理学

答案: C · 特质是连续变化的，而各类别相互重叠，划界点武断

为什么是这个答案

分类诊断高度重叠，并把一个连续体当作"有/无"来处理。因此 DSM-5 第三部分和 ICD-11 提供了基于特质的人格障碍维度模型。

答案

C · 特质是连续变化的，而各类别相互重叠，划界点武断
5.药理学

答案: C · Do not stop the drug suddenly, as this can trigger severe seizures

为什么是这个答案

Abrupt withdrawal of antiepileptic drugs can cause rebound seizures and even status epilepticus. Any change is made gradually under medical supervision.

答案

C · Do not stop the drug suddenly, as this can trigger severe seizures
6.药理学

答案: B · Intravenous calcium gluconate

为什么是这个答案

IV calcium stabilises the myocardial cell membrane within minutes and reduces the risk of arrhythmia. Other treatments then shift potassium into cells (insulin with glucose) or remove it from the body.

答案

B · Intravenous calcium gluconate

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