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 woman was assaulted 10 days ago. She has nightmares, avoids the area and feels detached. According to DSM-5, which diagnosis fits the timing best?

  1. AGeneralised anxiety disorder
  2. BAcute stress disorder
  3. CAdjustment disorder with anxiety
  4. DPost-traumatic stress disorder
2.精神科护理困难

一名营养不良的酒精依赖患者需要静脉输注葡萄糖。护士应首先预期哪项医嘱？

  1. A利尿剂
  2. B只给葡萄糖，不补充维生素
  3. C先给葡萄糖，一周后再给硫胺素
  4. D在葡萄糖之前或同时给予硫胺素
3.临床心理学中等

关于抑郁的单胺假说，哪项说法最准确？

  1. A它已通过直接测量活体患者大脑中的 5-羟色胺水平得到完全证实
  2. B它预测抗抑郁药服药后几小时内就能改善情绪
  3. C它把抑郁与单胺活性低联系起来，但难以解释药物起效的延迟
  4. D它证明抑郁仅由额叶多巴胺水平低引起
4.临床心理学困难

情感表达研究促成了精神分裂症的家庭干预。这些干预最可靠地改善了哪项结果？

  1. A对任何抗精神病药的需要
  2. B患者的智商分数
  3. C复发率和再住院率
  4. D兄弟姐妹的遗传风险
5.药理学中等

After naloxone reverses an opioid overdose, why must the patient be watched closely?

  1. ANaloxone itself causes respiratory depression at high doses
  2. BNaloxone makes the opioid stay longer in the body
  3. CNaloxone may wear off before the opioid does, so breathing can slow again
  4. DNaloxone often causes severe low blood glucose a few hours after the dose
6.药理学困难

A patient on heparin for 7 days has a platelet count that has fallen by more than half, and a new leg vein thrombosis. What is the most likely cause and the key action?

  1. AVitamin K deficiency; give vitamin K and continue heparin
  2. BWarfarin skin necrosis; switch from heparin to warfarin at once
  3. CHeparin-induced thrombocytopenia; stop all heparin
  4. DNormal dilution of platelets; continue and recheck in a week

3溶液

1.精神科护理

答案: B · Acute stress disorder

为什么是这个答案

Acute stress disorder lasts from 3 days to 1 month after a trauma. If symptoms last longer than 1 month, PTSD is diagnosed. ICD-11 does not have this diagnosis and describes an acute stress reaction as a normal response rather than a disorder.

答案

B · Acute stress disorder
2.精神科护理

答案: D · 在葡萄糖之前或同时给予硫胺素

为什么是这个答案

给缺乏硫胺素的患者输葡萄糖可诱发或加重 Wernicke 脑病。硫胺素应在葡萄糖之前或同时给予，但低血糖的治疗不得延误。

答案

D · 在葡萄糖之前或同时给予硫胺素
3.临床心理学

答案: C · 它把抑郁与单胺活性低联系起来，但难以解释药物起效的延迟

为什么是这个答案

该假说源于药物对单胺的作用。起效前数周的延迟提示，受体适应等下游变化也起作用。

答案

C · 它把抑郁与单胺活性低联系起来，但难以解释药物起效的延迟
4.临床心理学

答案: C · 复发率和再住院率

为什么是这个答案

教授沟通和问题解决、减少批评的家庭干预能降低复发率和再住院率，通常与药物治疗同时进行。

答案

C · 复发率和再住院率
5.药理学

答案: C · Naloxone may wear off before the opioid does, so breathing can slow again

为什么是这个答案

Naloxone acts for a shorter time than many opioids, especially long-acting and slow-release ones. Repeated doses or an infusion may be needed.

答案

C · Naloxone may wear off before the opioid does, so breathing can slow again
6.药理学

答案: C · Heparin-induced thrombocytopenia; stop all heparin

为什么是这个答案

Heparin-induced thrombocytopenia (HIT) is caused by antibodies against heparin–platelet factor 4 complexes. It usually starts 5–10 days after heparin begins and causes thrombosis, so all heparin is stopped and a non-heparin anticoagulant is used.

答案

C · Heparin-induced thrombocytopenia; stop all heparin

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