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 findings suggest recent cannabis use?

  1. APinpoint pupils, slow breathing and drowsiness
  2. BRed eyes, increased appetite, dry mouth and a fast heart rate
  3. CDilated pupils, high fever and severe muscle rigidity
  4. DSlow heart rate, constricted pupils, drooling and watery eyes
2.精神科护理困难

Which patient should the nurse check first?

  1. AA patient with schizophrenia who wants a cigarette break in the garden
  2. BA patient with OCD who is late for breakfast because of a long washing ritual in the bathroom
  3. CA patient given IM haloperidol and lorazepam 30 minutes ago who is hard to rouse, breathing 8/min
  4. DA patient with depression who is asking for help to phone his mother
3.临床心理学中等

在自杀风险评估中，哪个因素是未来自杀未遂最强的预测因素之一？

  1. A既往有自杀未遂
  2. B朋友圈很大
  3. C是大学生
  4. D与治疗师坦诚交谈
4.临床心理学困难

一位使用暴露疗法的治疗师发现，来访者在会谈中默念"我是安全的"，进展甚微。最好的解释是什么？

  1. A来访者需要更多放松训练，然后才能尝试任何进一步的暴露
  2. B这句话是精神病的阳性症状
  3. C这句话起到了安全行为的作用，妨碍了从暴露中充分学习
  4. D暴露疗法对焦虑从来无效
5.药理学中等

A patient takes low-dose weekly methotrexate for rheumatoid arthritis. Which monitoring is needed?

  1. AMonthly hearing tests
  2. BRegular blood count, liver and kidney function tests
  3. CDaily blood glucose checks
  4. DWeekly INR checks and a monthly ECG to check the heart rhythm
6.药理学困难

A toddler swallowed many of his mother's iron tablets. He has vomiting and bloody diarrhoea. Which drug may be used to bind iron?

  1. ADeferoxamine (desferrioxamine)
  2. BAcetylcysteine
  3. CNaloxone
  4. DActivated charcoal given by mouth

3溶液

1.精神科护理

答案: B · Red eyes, increased appetite, dry mouth and a fast heart rate

为什么是这个答案

Cannabis intoxication typically causes conjunctival injection, increased appetite, dry mouth, tachycardia, impaired coordination and altered perception of time. High doses can cause anxiety or psychosis.

答案

B · Red eyes, increased appetite, dry mouth and a fast heart rate
2.精神科护理

答案: C · A patient given IM haloperidol and lorazepam 30 minutes ago who is hard to rouse, breathing 8/min

为什么是这个答案

Over-sedation with respiratory depression after rapid tranquillisation is a medical emergency. Airway, breathing and vital signs are checked immediately, and help is called.

答案

C · A patient given IM haloperidol and lorazepam 30 minutes ago who is hard to rouse, breathing 8/min
3.临床心理学

答案: A · 既往有自杀未遂

为什么是这个答案

自杀未遂史是最强的风险因素之一。直接询问自杀想法并不会增加风险，而是良好评估的一部分。

答案

A · 既往有自杀未遂
4.临床心理学

答案: C · 这句话起到了安全行为的作用，妨碍了从暴露中充分学习

为什么是这个答案

心理仪式等隐蔽的安全行为使来访者把自己的安全归功于这些行为，而不是认识到情境本身是安全的。治疗师的目标是识别并放弃这些行为。

答案

C · 这句话起到了安全行为的作用，妨碍了从暴露中充分学习
5.药理学

答案: B · Regular blood count, liver and kidney function tests

为什么是这个答案

Methotrexate can cause bone marrow suppression and liver damage, and poor kidney function raises its levels. Blood tests are regular, alcohol is limited and folic acid is usually given on another day.

答案

B · Regular blood count, liver and kidney function tests
6.药理学

答案: A · Deferoxamine (desferrioxamine)

为什么是这个答案

Iron poisoning can cause GI bleeding, shock, metabolic acidosis and liver failure. Deferoxamine chelates iron and is used in serious poisoning; activated charcoal does not bind iron.

答案

A · Deferoxamine (desferrioxamine)

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