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治疗前后短暂的意识模糊和记忆丧失
  2. B治疗前所有长期记忆的永久丧失
  3. C数月失语
  4. D双腿瘫痪
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"Thank you. I'll make sure I'm always the one assigned to you from now on."
  2. B"The other nurses are not as experienced as I am, so it makes sense that you prefer talking to me."
  3. C"You shouldn't compare nurses. That's not fair to them, and it's rude."
  4. D"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.临床心理学中等

诊断的信度是指：

  1. A诊断是否使用医学检查
  2. B诊断能否准确预测疾病的病程和结局
  3. C不同临床医生对同一患者是否得出相同诊断
  4. D患者是否接受诊断
4.临床心理学困难

一名男子说在一次激烈争吵后他的左臂瘫痪了，但神经系统检查结果与任何已知神经疾病都不相符。最可能的 DSM-5 诊断是什么？

  1. A功能性神经症状障碍（转换障碍）
  2. B诈病
  3. C躯体变形障碍
  4. D疾病焦虑障碍
5.药理学中等

Why should loperamide usually be avoided in bloody diarrhoea with fever?

  1. ASlowing the gut may keep bacteria and toxins in the bowel longer
  2. BLoperamide makes the bleeding worse by blocking platelets
  3. CLoperamide is an antibiotic that causes resistance
  4. DLoperamide causes severe hypertension when there is an infection
6.药理学困难

A patient taking long-term morphine for cancer pain becomes very sedated with slow breathing. Why is naloxone given in small, diluted doses?

  1. ABecause naloxone is much more potent and toxic in patients with cancer
  2. BBecause naloxone is toxic to the liver in large doses
  3. CTo make the effect of naloxone last longer than morphine
  4. DTo restore breathing without causing severe withdrawal and pain

3溶液

1.精神科护理

答案: A · 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

A · 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 · "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

D · "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: C · 不同临床医生对同一患者是否得出相同诊断

为什么是这个答案

信度是诊断在不同临床医生之间或不同时间的一致性；效度是诊断是否反映了真实而有意义的类别。

答案

C · 不同临床医生对同一患者是否得出相同诊断
4.临床心理学

答案: A · 功能性神经症状障碍（转换障碍）

为什么是这个答案

功能性神经症状障碍包括与公认神经疾病不相符的运动或感觉症状。诊断既不要求证明存在心理原因，也不要求证明症状是伪装的。

答案

A · 功能性神经症状障碍（转换障碍）
5.药理学

答案: A · Slowing the gut may keep bacteria and toxins in the bowel longer

为什么是这个答案

In dysentery or suspected C. difficile infection, antimotility drugs may prolong illness and increase complications such as toxic megacolon. The cause is assessed and fluids are replaced first.

答案

A · Slowing the gut may keep bacteria and toxins in the bowel longer
6.药理学

答案: D · To restore breathing without causing severe withdrawal and pain

为什么是这个答案

In opioid-dependent patients, a large dose of naloxone can cause abrupt withdrawal, severe pain and agitation. Small titrated doses aim to restore adequate breathing while keeping some analgesia.

答案

D · To restore breathing without causing severe withdrawal and pain

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