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 treatment is recommended first-line for chronic insomnia in adults?

  1. ALong-term daily benzodiazepines
  2. BStaying in bed for longer each morning
  3. CCognitive behavioural therapy for insomnia (CBT-I)
  4. DDrinking alcohol in the evening to fall asleep
2.精神科护理困难

On the fourth day after giving birth, a mother is tearful and moody but is caring for her baby, eating and sleeping when she can. What is the most appropriate nursing response?

  1. AExplain that these "baby blues" are common, offer support and advise her to seek help if they last more than about 2 weeks
  2. BTell her that antidepressants must be started at once
  3. CAdvise her to stop breastfeeding and let others feed the baby at night so that she can rest and recover
  4. DArrange an emergency psychiatric admission today
3.临床心理学中等

在莫勒的恐惧症二因素模型中，恐惧症是如何维持的？

  1. A他人对接近行为的惩罚，反而强化了恐惧本身
  2. B恐惧只通过观察他人习得
  3. C回避降低了焦虑，从而负强化了回避
  4. D通过奖励对恐惧进行正强化
4.临床心理学困难

哪项观察支持精神分裂症的多巴胺假说？

  1. A仅凭 5-羟色胺水平就能预测症状
  2. B苯丙胺等提高多巴胺的药物可诱发精神病性症状
  3. C抗精神病药增加中脑边缘通路的多巴胺活动并减轻症状
  4. D所有患者对抗抑郁药的反应同样好
5.药理学中等

How should a patient store sublingual glyceryl trinitrate (nitroglycerin) tablets?

  1. ALoose in a shirt pocket close to the body for quick access
  2. BIn a plastic weekly pill box with other tablets
  3. CIn the original dark glass bottle, away from heat, light and moisture
  4. DIn the fridge in a damp, open container to keep them fresh and cool
6.药理学困难

使用氯霉素的新生儿可能发生"灰婴综合征"。主要原因是什么？

  1. A肝脏葡萄糖醛酸化功能不成熟，使药物蓄积
  2. B新生儿产生针对该药的抗体
  3. C新生儿肾脏排泄该药太快，因此要给予更高剂量
  4. D氯霉素在新生儿体内转化为维生素 K

3溶液

1.精神科护理

答案: C · Cognitive behavioural therapy for insomnia (CBT-I)

为什么是这个答案

CBT-I combines sleep education, stimulus control, sleep restriction and work on unhelpful beliefs about sleep. It has lasting effects and fewer risks than long-term sleeping tablets.

答案

C · Cognitive behavioural therapy for insomnia (CBT-I)
2.精神科护理

答案: A · Explain that these "baby blues" are common, offer support and advise her to seek help if they last more than about 2 weeks

为什么是这个答案

Baby blues are common in the first days after birth and usually resolve within 2 weeks. Symptoms that last longer or are severe may indicate postpartum depression and need assessment.

答案

A · Explain that these "baby blues" are common, offer support and advise her to seek help if they last more than about 2 weeks
3.临床心理学

答案: C · 回避降低了焦虑，从而负强化了回避

为什么是这个答案

恐惧通过经典条件作用习得，并因回避可怕对象能降低焦虑而得以维持，回避因此受到负强化。

答案

C · 回避降低了焦虑，从而负强化了回避
4.临床心理学

答案: B · 苯丙胺等提高多巴胺的药物可诱发精神病性症状

为什么是这个答案

苯丙胺可诱发精神病，阻断 D2 的抗精神病药能减轻阳性症状。阴性症状较难解释，因此该假说已被修订。

答案

B · 苯丙胺等提高多巴胺的药物可诱发精神病性症状
5.药理学

答案: C · In the original dark glass bottle, away from heat, light and moisture

为什么是这个答案

Nitroglycerin tablets lose potency when exposed to light, heat, air and moisture. They are kept in their original tightly closed dark container, and expired tablets are replaced.

答案

C · In the original dark glass bottle, away from heat, light and moisture
6.药理学

答案: A · 肝脏葡萄糖醛酸化功能不成熟，使药物蓄积

为什么是这个答案

新生儿的葡萄糖醛酸转移酶活性低，因此氯霉素不能被结合而蓄积。高浓度会引起循环衰竭并使皮肤呈灰色。这说明器官发育不成熟会改变药代动力学。

答案

A · 肝脏葡萄糖醛酸化功能不成熟，使药物蓄积

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