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 patient says, "I'm going to be a famous singer, and I'll buy this whole hospital." Which response best uses the technique of voicing doubt?

  1. A"You know that isn't true at all."
  2. B"Why do you want to buy the hospital?"
  3. C"That sounds hard to believe."
  4. D"That's wonderful. When will you start?"
2.精神科护理困难

The daughter of a man with moderate dementia says she is exhausted, is not sleeping and feels guilty for getting angry with him. What is the most helpful nursing response?

  1. AAcknowledge her strain and discuss support such as respite care and carers' groups
  2. BSuggest that she stops visiting him for a few months so that she can rest and forget about her guilt
  3. CAdvise her to take on more responsibility for his care so that she feels less guilty
  4. DTell her that good daughters do not get angry with their parents
3.临床心理学中等

在艾利斯的 ABC 模型中，"B"代表什么？

  1. A应激时的身体感觉（Bodily sensations）
  2. B对诱发事件的信念（Beliefs）
  3. C来访者的背景（Background）
  4. D事件之后的行为（Behaviour）
4.临床心理学困难

共病是指：

  1. A一个人同时符合两种或以上障碍的诊断标准
  2. B某个症状为群体中所有人共有
  3. C某种障碍在家族中多发
  4. D某种障碍由同时存在的躯体疾病引起
5.药理学中等

服用老一代 MAO 抑制剂的患者被警告避免富含酪胺的食物。可能会发生什么？

  1. A突发肾衰竭
  2. B过敏性皮疹
  3. C高血压危象
  4. D严重低血糖
6.药理学困难

An older patient with coronary artery disease is starting levothyroxine for hypothyroidism. Why is a low starting dose used?

  1. AOlder patients absorb levothyroxine much better, so small doses are all they need
  2. BFast replacement raises cardiac oxygen demand and can cause angina
  3. CLevothyroxine causes severe hypoglycaemia in older patients
  4. DHigh starting doses cause permanent hypothyroidism

3溶液

1.精神科护理

答案: C · "That sounds hard to believe."

为什么是这个答案

Voicing doubt lets the patient know the nurse does not share the belief, without a confrontation. Arguing tends to make delusional beliefs firmer, while agreeing reinforces them.

答案

C · "That sounds hard to believe."
2.精神科护理

答案: A · Acknowledge her strain and discuss support such as respite care and carers' groups

为什么是这个答案

Caregiver strain is common and can affect both the carer and the patient. Recognising it, and offering respite, practical support and carers' groups, helps the carer continue safely.

答案

A · Acknowledge her strain and discuss support such as respite care and carers' groups
3.临床心理学

答案: B · 对诱发事件的信念（Beliefs）

为什么是这个答案

在 ABC 模型中，诱发事件（Activating event）通过个人的信念（Beliefs）导致情绪后果（Consequences）。改变非理性信念就能改变后果。

答案

B · 对诱发事件的信念（Beliefs）
4.临床心理学

答案: A · 一个人同时符合两种或以上障碍的诊断标准

为什么是这个答案

共病是同一个人同时存在多种障碍，这使诊断和治疗更复杂，也引发了对分类式诊断体系的质疑。

答案

A · 一个人同时符合两种或以上障碍的诊断标准
5.药理学

答案: C · 高血压危象

为什么是这个答案

肠道中的 MAO 通常会分解饮食中的酪胺。MAO 被抑制后，来自陈年奶酪等食物的酪胺进入循环并释放去甲肾上腺素，导致血压危险地升高。

答案

C · 高血压危象
6.药理学

答案: B · Fast replacement raises cardiac oxygen demand and can cause angina

为什么是这个答案

Thyroid hormone increases metabolic rate, heart rate and contractility. In older people and those with heart disease, the dose is started low and increased slowly to avoid ischaemia and arrhythmias.

答案

B · Fast replacement raises cardiac oxygen demand and can cause angina

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