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

Which action reflects trauma-informed care?

  1. AAsking the patient to repeat the full trauma story to each new staff member
  2. BMaking all decisions for the patient so that she does not feel burdened
  3. CExplaining each procedure in advance and offering choices wherever possible
  4. DUsing physical restraint early to prevent any loss of control
2.精神科护理困难

A man with gambling disorder has lost his savings and has large debts. He tells the nurse, "My family would be better off without me." What should the nurse do?

  1. AAsk directly about suicidal thoughts and plans, and assess his risk
  2. BFocus only on helping him create a budget
  3. CReassure him that his family will forgive him
  4. DChange the subject to his gambling triggers and how to avoid the betting shop
3.临床心理学中等

选择性 5-羟色胺再摄取抑制剂（SSRI）通过什么方式增加突触中的 5-羟色胺？

  1. A阻断 5-羟色胺被再摄取回突触前神经元
  2. B破坏 5-羟色胺受体
  3. C阻断多巴胺释放
  4. D加快单胺氧化酶对 5-羟色胺的分解
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特质是连续变化的，而各类别相互重叠，划界点武断
  2. B维度模型无法用问卷或访谈测量
  3. C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
  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

A woman taking tamoxifen should report which symptom promptly?

  1. AMild hot flushes, especially at night, in the first months
  2. BMild tiredness in the afternoon
  3. CUnusual vaginal bleeding or a painful swollen leg
  4. DSlightly dry skin
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. ATall, peaked T waves
  2. BFlattened T waves and prominent U 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: C · Explaining each procedure in advance and offering choices wherever possible

为什么是这个答案

Trauma-informed care assumes that many patients have trauma histories. It focuses on safety, trust, choice and collaboration, and on avoiding practices that can re-traumatise, such as unnecessary restraint.

答案

C · Explaining each procedure in advance and offering choices wherever possible
2.精神科护理

答案: A · Ask directly about suicidal thoughts and plans, and assess his risk

为什么是这个答案

Gambling disorder is associated with a raised risk of suicide, especially with debt, shame and hopelessness. The statement is a warning sign that needs direct questions and risk assessment.

答案

A · Ask directly about suicidal thoughts and plans, and assess his risk
3.临床心理学

答案: A · 阻断 5-羟色胺被再摄取回突触前神经元

为什么是这个答案

SSRI 阻断 5-羟色胺转运体，使 5-羟色胺在突触间隙停留更久。临床效果通常需要数周才出现。

答案

A · 阻断 5-羟色胺被再摄取回突触前神经元
4.临床心理学

答案: A · 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

A · 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 · Unusual vaginal bleeding or a painful swollen leg

为什么是这个答案

Tamoxifen has oestrogen-like effects on the uterus and clotting, increasing the risk of endometrial cancer and venous thromboembolism. Hot flushes are common and expected.

答案

C · Unusual vaginal bleeding or a painful swollen leg
6.药理学

答案: B · 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

B · Flattened T waves and prominent U waves

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