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 communication approach is best with a patient who has paranoid personality disorder?

  1. ABe clear, honest and business-like, and explain the reasons for actions
  2. BBe very warm and joke often to put the patient at ease
  3. CAvoid explaining anything so that the patient does not become suspicious
  4. DTalk about the patient with colleagues in whispers within his sight
2.精神科护理困难

A colleague suggests putting a loud but non-violent patient in seclusion "because he's annoying everyone". What is the correct response?

  1. AIt is acceptable as long as the seclusion lasts for less than an hour
  2. BIt is acceptable, because it will make the ward quieter and safer for the other patients
  3. CIt is acceptable as long as the patient agrees afterwards
  4. DIt would be inappropriate, because seclusion is only a last resort for serious risk of harm
3.临床心理学中等

哪种人格障碍的特点是普遍地漠视他人权利？

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

一名患者有严重肾功能损害。某药物主要以原形经尿排泄。通常如何调整？

  1. A无须调整，因为肝脏会接管
  2. B增加剂量以弥补吸收不良
  3. C改静脉给药为口服给药
  4. D减少剂量或延长给药间隔
6.药理学困难

Why should a dose never be written as "5.0 mg" on a medication order?

  1. AThe decimal point may be missed, and the dose read as 50 mg
  2. BThe pharmacy cannot supply doses that contain a decimal point
  3. CIt means the dose must be given five times
  4. DIt is too precise for most drugs

3溶液

1.精神科护理

答案: A · Be clear, honest and business-like, and explain the reasons for actions

为什么是这个答案

People with paranoid personality disorder are distrustful and may misread friendliness or jokes as hostility. Honesty, consistency and clear explanations reduce suspicion.

答案

A · Be clear, honest and business-like, and explain the reasons for actions
2.精神科护理

答案: D · It would be inappropriate, because seclusion is only a last resort for serious risk of harm

为什么是这个答案

Seclusion is a restrictive intervention used only to contain severe behaviour likely to cause harm to others, as a last resort, for the shortest time. Using it for convenience or punishment breaches patients' rights.

答案

D · It would be inappropriate, because seclusion is only a last resort for serious risk of harm
3.临床心理学

答案: A · 反社会型人格障碍

为什么是这个答案

反社会型人格障碍包括欺骗、冲动、攻击性和缺乏悔意，并在童年有品行障碍的证据。

答案

A · 反社会型人格障碍
4.临床心理学

答案: C · 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

C · 妄想障碍，钟情型
5.药理学

答案: D · 减少剂量或延长给药间隔

为什么是这个答案

肾清除率下降时，经肾排泄的药物会蓄积。应根据肾功能并尽可能根据血药浓度降低剂量或减少给药频次。

答案

D · 减少剂量或延长给药间隔
6.药理学

答案: A · The decimal point may be missed, and the dose read as 50 mg

为什么是这个答案

Trailing zeros (5.0) and missing leading zeros (.5) are well-known causes of tenfold errors. Safe practice is to write 5 mg and 0.5 mg.

答案

A · The decimal point may be missed, and the dose read as 50 mg

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