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

A newly admitted patient asks, "Do you think I'm crazy?" Which response is most therapeutic?

  1. A"Yes, but you're in the right place now."
  2. B"You seem worried about what being here means. Can you tell me more?"
  3. C"Everyone here is a bit crazy in some way, so there's really nothing for you to worry about."
  4. D"Of course not. Only crazy people would ask that."
2.精神科护理困难

The parents of a 15-year-old with anorexia nervosa ask what treatment is usually recommended first. Which answer is most accurate?

  1. ALong-term treatment in an inpatient unit far away from her family, so that the parents cannot interfere
  2. BFamily-based treatment, in which the parents take an active role in restoring the child's eating
  3. CMedicine alone, because therapy is not effective in adolescents
  4. DLeaving the young person to decide on her own when to start eating more
3.临床心理学中等

罗森汉的研究《On being sane in insane places》引发了对什么的担忧？

  1. ACBT 的有效性
  2. B抗抑郁药的安全性
  3. C动物研究的伦理
  4. D精神科诊断的效度
4.临床心理学困难

为什么心理学取向的支持者批评精神疾病的医学模式？

  1. A它可能忽视心理和社会原因，并削弱人们的能动感
  2. B它只以梦的解析为基础
  3. C它完全拒绝使用药物
  4. D它否认大脑和生物学因素对行为或情绪有任何作用
5.药理学中等

A patient with heart failure starts furosemide. Which self-monitoring instruction is most useful?

  1. ACount the respiratory rate each evening
  2. BCheck the blood glucose before every meal
  3. CWeigh daily at the same time on the same scales
  4. DMeasure the temperature twice a day and record it in a diary
6.药理学困难

A heparin infusion contains 25,000 units in 500 mL. The order is 1,000 units per hour. What rate should be set on the pump?

  1. A10 mL/h
  2. B25 mL/h
  3. C50 mL/h
  4. D20 mL/h

3溶液

1.精神科护理

答案: B · "You seem worried about what being here means. Can you tell me more?"

为什么是这个答案

The question often hides fear or shame about being in a mental health setting. Exploring the concern shows acceptance, while labelling or false reassurance does not help.

答案

B · "You seem worried about what being here means. Can you tell me more?"
2.精神科护理

答案: B · Family-based treatment, in which the parents take an active role in restoring the child's eating

为什么是这个答案

Family-based treatment, which developed from the Maudsley approach, is a first-line treatment for adolescents with anorexia nervosa. Parents are supported to take charge of meals at first, before control is gradually handed back.

答案

B · Family-based treatment, in which the parents take an active role in restoring the child's eating
3.临床心理学

答案: D · 精神科诊断的效度

为什么是这个答案

自称听到一个词的假病人被收治并住院数周，表明诊断受情境影响。此后该研究的方法也受到质疑。

答案

D · 精神科诊断的效度
4.临床心理学

答案: A · 它可能忽视心理和社会原因，并削弱人们的能动感

为什么是这个答案

医学模式把障碍视为有生物学原因的疾病，这减少了指责，但可能忽视生活事件、意义和情境，并可能助长对药物的被动依赖。

答案

A · 它可能忽视心理和社会原因，并削弱人们的能动感
5.药理学

答案: C · Weigh daily at the same time on the same scales

为什么是这个答案

Daily weight is the best home measure of fluid balance. A rapid gain suggests fluid retention, and a rapid loss suggests overdiuresis and dehydration, both of which should be reported.

答案

C · Weigh daily at the same time on the same scales
6.药理学

答案: D · 20 mL/h

为什么是这个答案

25,000 units ÷ 500 mL = 50 units/mL, and 1,000 units/h ÷ 50 units/mL = 20 mL/h. Heparin is a high-alert drug, so the calculation and pump settings are independently double-checked.

答案

D · 20 mL/h

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