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

Wernicke 脑病的经典三联征是什么？

  1. A仅有头痛、呕吐和视物模糊
  2. B震颤、强直和动作缓慢
  3. C意识模糊、共济失调和眼球运动异常
  4. D发热、皮疹和颈部僵硬
2.精神科护理困难

A patient tells the nurse, "You're the only one I can talk to. You're much better than the other nurses." What is the most appropriate response?

  1. A"I'm glad our talks help. All the staff here are working with you, and it's important that you can talk to them too."
  2. B"You shouldn't compare nurses. That's not fair to them, and it's rude."
  3. C"The other nurses are not as experienced as I am, so it makes sense that you prefer talking to me."
  4. D"Thank you. I'll make sure I'm always the one assigned to you from now on."
3.临床心理学中等

哪种人格障碍的特点是人际关系、自我形象和情绪不稳定，并伴有明显的冲动性？

  1. A自恋型人格障碍
  2. B边缘型人格障碍
  3. C回避型人格障碍
  4. D分裂样人格障碍
4.临床心理学困难

治疗师让来访者评估支持和反对"我总是失败"这一想法的证据。这是什么技术？

  1. A自由联想
  2. B系统脱敏
  3. C认知重构
  4. D代币制
5.药理学中等

When does oseltamivir give the most benefit in influenza?

  1. AOnly after symptoms have lasted at least one week
  2. BOnly after a bacterial pneumonia has developed
  3. CWhen started within 48 hours of the first symptoms
  4. DAt any time, as the timing makes no difference
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. AIntravenous calcium gluconate
  2. BIntravenous furosemide
  3. COral potassium chloride
  4. DOral sodium polystyrene sulfonate

3溶液

1.精神科护理

答案: C · 意识模糊、共济失调和眼球运动异常

为什么是这个答案

只有部分患者表现出完整的三联征，因此对任何有风险的人都应给予硫胺素。如不治疗，可发展为 Korsakoff 综合征。

答案

C · 意识模糊、共济失调和眼球运动异常
2.精神科护理

答案: A · "I'm glad our talks help. All the staff here are working with you, and it's important that you can talk to them too."

为什么是这个答案

Accepting the role of the "only" helper encourages dependence and splitting. The nurse acknowledges the patient's feeling and encourages trust in the whole team, which keeps care consistent.

答案

A · "I'm glad our talks help. All the staff here are working with you, and it's important that you can talk to them too."
3.临床心理学

答案: B · 边缘型人格障碍

为什么是这个答案

边缘型人格障碍包括人际关系和身份认同不稳定、情感不稳定、害怕被抛弃、冲动以及反复自伤。DBT 是一种证据充分的治疗方法。

答案

B · 边缘型人格障碍
4.临床心理学

答案: C · 认知重构

为什么是这个答案

认知重构识别自动思维、检验证据，并用平衡的想法取代过度概括等认知歪曲。

答案

C · 认知重构
5.药理学

答案: C · 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

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

答案: A · 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

A · Intravenous calcium gluconate

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