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

In family systems theory, what is meant by the "identified patient"?

  1. AThe member whose symptoms are seen as the family's problem
  2. BThe family member who pays for the treatment
  3. CThe family member who has the most serious physical illness
  4. DThe patient whose identity has been checked against a wristband before treatment
2.精神科护理困难

A patient who stopped drinking 24 hours ago has a generalised tonic-clonic seizure in bed. What is the nurse's first action?

  1. ARestrain his arms and legs to stop the movements
  2. BProtect the airway and keep him safe from injury
  3. CGive oral thiamine with a glass of water
  4. DPut something in his mouth to stop him biting his tongue
3.临床心理学中等

一个人对同事怀有强烈的敌意，却对他表现得过分友好。这体现了哪种防御机制？

  1. A否认
  2. B置换（转移）
  3. C合理化
  4. D反向形成
4.临床心理学困难

一名学生相信"如果我不完美，我就一文不值"。在贝克的模型中，这一信念最恰当的归类是：

  1. A使人易感的功能失调性假设或核心信念
  2. B需要使用抗精神病药的幻觉
  3. C一种称为升华的防御机制，把痛苦引向受社会重视的工作
  4. D精神分裂症的阴性症状
5.药理学中等

A patient with a fentanyl patch is given home-care advice. Which instruction is correct?

  1. AApply each new patch over the same skin area
  2. BThrow used patches loose into the household bin with the packaging
  3. CCut the patch in half if the pain is mild
  4. DAvoid heating pads, hot baths and saunas over or near the patch
6.药理学困难

某药半衰期为 6 小时，血浆浓度为 80 mg/L。假设为一级消除且不再给药，18 小时后浓度是多少？

  1. A26.7 mg/L
  2. B20 mg/L
  3. C40 mg/L
  4. D10 mg/L

3溶液

1.精神科护理

答案: A · The member whose symptoms are seen as the family's problem

为什么是这个答案

Family systems theory sees the family as a unit in which each member affects the others. The "identified patient" carries the symptoms, but the therapy looks at patterns in the whole family.

答案

A · The member whose symptoms are seen as the family's problem
2.精神科护理

答案: B · Protect the airway and keep him safe from injury

为什么是这个答案

During a seizure, the nurse protects the airway, removes nearby hazards, does not restrain or put anything in the mouth, and calls for help. Alcohol withdrawal seizures are most likely in the first 48 hours.

答案

B · Protect the airway and keep him safe from injury
3.临床心理学

答案: D · 反向形成

为什么是这个答案

反向形成把无法接受的冲动转变为其对立面，而且往往表现得很夸张。

答案

D · 反向形成
4.临床心理学

答案: A · 使人易感的功能失调性假设或核心信念

为什么是这个答案

贝克区分了表层的负性自动思维与更深层的图式和条件性假设。这类信念处于潜伏状态，直到被与之相符的应激源（如失败）激活。

答案

A · 使人易感的功能失调性假设或核心信念
5.药理学

答案: D · Avoid heating pads, hot baths and saunas over or near the patch

为什么是这个答案

Heat increases fentanyl absorption and can cause overdose. Sites are rotated, patches are never cut, and used patches are folded sticky sides together and disposed of safely, away from children and pets.

答案

D · Avoid heating pads, hot baths and saunas over or near the patch
6.药理学

答案: D · 10 mg/L

为什么是这个答案

18 小时是三个半衰期。浓度减半三次：80 → 40 → 20 → 10 mg/L。

答案

D · 10 mg/L

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