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

How does aripiprazole differ from most other antipsychotics?

  1. AIt needs weekly white blood cell counts for safety
  2. BIt has no effect on dopamine at all
  3. CIt is a partial agonist at dopamine D2 receptors
  4. DIt is a benzodiazepine with antipsychotic effects
2.精神科护理困难

Which patient has the highest risk of suicide?

  1. AA 45-year-old man with well-controlled hypertension who works full time
  2. BA 30-year-old woman with mild anxiety who has a supportive family
  3. CA 20-year-old student with exam stress who has no thoughts of suicide and good friends
  4. DA 72-year-old widowed man with alcohol dependence who has a gun at home and a plan
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朋友圈很大
  2. B与治疗师坦诚交谈
  3. C既往有自杀未遂
  4. D是大学生
4.临床心理学困难

治疗师帮助一位惊恐障碍来访者坐在椅子上旋转，故意引发头晕，且不使用安全行为。这种技术叫什么？为什么使用它？

  1. A自由联想，使潜意识中的恐惧显露出来
  2. B冲击疗法，使来访者忘记创伤
  3. C内感性暴露，使来访者认识到身体感觉并不危险
  4. D厌恶疗法，使来访者把惊恐与身体不适联系起来
5.药理学中等

How can the absorption of oral iron be improved?

  1. ATake it at the same time as an antacid to protect the stomach
  2. BTake it with a cup of strong tea
  3. CTake it with a glass of milk
  4. DTake it with vitamin C, such as orange juice, on an empty stomach
6.药理学困难

A patient who uses insulin is taught sick-day rules. Which statement shows a need for further teaching?

  1. A"I will seek help if I keep vomiting or have ketones."
  2. B"I will check my blood glucose and ketones more often while I am ill."
  3. C"I will keep drinking fluids, even if I cannot eat much."
  4. D"If I am ill and not eating, I will stop my insulin completely."

3溶液

1.精神科护理

答案: C · It is a partial agonist at dopamine D2 receptors

为什么是这个答案

As a partial agonist, aripiprazole lowers dopamine activity where it is high and supports it where it is low. It is less likely to raise prolactin or cause sedation, but akathisia is a common side effect.

答案

C · It is a partial agonist at dopamine D2 receptors
2.精神科护理

答案: D · A 72-year-old widowed man with alcohol dependence who has a gun at home and a plan

为什么是这个答案

Older age, male sex, being widowed, substance misuse, access to lethal means and a specific plan all raise suicide risk. Having several factors together greatly increases the overall risk.

答案

D · A 72-year-old widowed man with alcohol dependence who has a gun at home and a plan
3.临床心理学

答案: C · 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

C · 既往有自杀未遂
4.临床心理学

答案: C · 内感性暴露，使来访者认识到身体感觉并不危险

为什么是这个答案

内感性暴露引发所恐惧的身体感觉，使来访者能够检验灾难化预测并产生习惯化。它是惊恐障碍 CBT 的核心组成部分。

答案

C · 内感性暴露，使来访者认识到身体感觉并不危险
5.药理学

答案: D · Take it with vitamin C, such as orange juice, on an empty stomach

为什么是这个答案

Vitamin C keeps iron in its more absorbable ferrous form. Milk, antacids, tea and some antibiotics reduce iron absorption. If the stomach becomes upset, it may be taken with food, accepting lower absorption.

答案

D · Take it with vitamin C, such as orange juice, on an empty stomach
6.药理学

答案: D · "If I am ill and not eating, I will stop my insulin completely."

为什么是这个答案

Stress hormones during illness often raise glucose, so basal insulin is usually continued and doses may need adjusting. Stopping insulin in type 1 diabetes can lead to ketoacidosis.

答案

D · "If I am ill and not eating, I will stop my insulin completely."

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