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

How should a patient take sublingual buprenorphine-naloxone tablets?

  1. ALet the tablet dissolve completely under the tongue without chewing or swallowing it
  2. BSwallow the tablet whole with a large glass of water
  3. CCrush the tablet and mix it with a spoonful of soft food such as yoghurt
  4. DChew the tablet quickly and then swallow it with juice so that it reaches the stomach faster
2.精神科护理困难

A patient with depression and a family history of bipolar disorder started an antidepressant 2 weeks ago. He now sleeps 3 hours a night, talks rapidly and is spending large amounts of money. What should the nurse suspect?

  1. ASerotonin syndrome caused by a high dose
  2. BNormal relief and extra energy now that his depression has finally lifted after the treatment
  3. CThe expected improvement in mood from the antidepressant
  4. DA switch into mania or hypomania triggered by the antidepressant
3.临床心理学中等

一个人每天花几个小时担心鼻子上的一个小斑点很丑，不停地照镜子，而别人看不出有任何问题。哪种诊断合适？

  1. A神经性厌食症
  2. B躯体变形障碍
  3. C社交焦虑障碍
  4. D疾病焦虑障碍
4.临床心理学困难

一名男子说一位著名歌手暗恋他，并通过她的歌曲向他发送暗语。除此之外，他的思维和行为都正常，也没有幻觉。哪种诊断最合适？

  1. A妄想障碍，钟情型
  2. B精神分裂症，偏执型
  3. C伴躁狂的双相障碍
  4. D自恋型人格障碍
5.药理学中等

During a rapid infusion of vancomycin, a patient develops flushing and a red rash on the face, neck and upper body. What is the most likely cause and action?

  1. AAcute kidney failure; stop all IV fluids and antibiotics at once
  2. BA sign that the infection is spreading; give a second dose
  3. CA normal effect; increase the infusion rate to finish sooner
  4. DAn infusion reaction; stop or slow the infusion and inform the prescriber
6.药理学困难

A nurse calculates a child's dose and finds it is ten times higher than the usual range in the drug reference. What should the nurse do?

  1. AGive half the dose as a compromise
  2. BGive the dose, because the prescriber is responsible for the order
  3. CWithhold it, recheck the calculation and clarify with the prescriber
  4. DGive one tenth of the dose without telling anyone

3溶液

1.精神科护理

答案: A · Let the tablet dissolve completely under the tongue without chewing or swallowing it

为什么是这个答案

Buprenorphine is poorly absorbed if swallowed, so it is dissolved under the tongue. Naloxone is added to discourage injection, because it is poorly absorbed sublingually but active if injected.

答案

A · Let the tablet dissolve completely under the tongue without chewing or swallowing it
2.精神科护理

答案: D · A switch into mania or hypomania triggered by the antidepressant

为什么是这个答案

Antidepressants can trigger mania or hypomania in people with bipolar disorder, particularly without a mood stabiliser. The nurse reports this so the prescriber can reassess the diagnosis and treatment.

答案

D · A switch into mania or hypomania triggered by the antidepressant
3.临床心理学

答案: B · 躯体变形障碍

为什么是这个答案

躯体变形障碍是对外貌上轻微或无法观察到的"缺陷"的过度关注，伴有照镜子或寻求安慰等重复行为。

答案

B · 躯体变形障碍
4.临床心理学

答案: A · 妄想障碍，钟情型

为什么是这个答案

妄想障碍是存在一种或多种妄想至少一个月，但不符合精神分裂症的标准，且除妄想外功能没有明显受损。钟情妄想是认为另一个人爱上了自己。

答案

A · 妄想障碍，钟情型
5.药理学

答案: D · An infusion reaction; stop or slow the infusion and inform the prescriber

为什么是这个答案

Rapid vancomycin infusion releases histamine, causing flushing and itching of the upper body (formerly called "red man syndrome"). It is managed by stopping or slowing the infusion, and sometimes with an antihistamine.

答案

D · An infusion reaction; stop or slow the infusion and inform the prescriber
6.药理学

答案: C · Withhold it, recheck the calculation and clarify with the prescriber

为什么是这个答案

Doses outside the safe range must be questioned before administration. The nurse holds the dose, rechecks the weight and calculation and contacts the prescriber or pharmacist.

答案

C · Withhold it, recheck the calculation and clarify with the prescriber

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