Question 1

Select the most helpful response for a nurse to make when a patient being treated as an outpatient states,"I am considering committing suicide."

Accepted Answer

This response gives the patient reinforcement and validation for making a positive response rather than acting out the suicidal impulse.It gives neither advice nor false reassurance,and it does not imply stereotypes such as,"You have a lot to live for." It uses the patient's ambivalence and sets the stage for more realistic problem-solving strategies.

Question 2

Which statement by a patient during an assessment interview should alert the nurse to the patient's need for immediate,active intervention?

Accepted Answer

Lack of social support and social isolation increase the suicide risk.The willingness to seek help lowers the risk.Being a person of color does not suggest a higher risk;more whites commit suicide than do individuals of other racial groups.Attention seeking is not correlated with a higher risk of suicide.

Question 3

A nurse counsels a patient with recent suicidal ideation.Which is the nurse's most therapeutic comment?

Accepted Answer

The nurse helps the patient develop effective coping skills.He or she assists the patient to reduce the overwhelming effects of problems by prioritizing them.The incorrect options continue to present overwhelming approaches to problem solving.

Question 4

Which changes in brain biochemical function is most associated with suicidal behavior?

Accepted Answer

Research suggests that low levels of serotonin may play a role in the decision to commit suicide.The other neurotransmitter alterations have not been implicated in suicidal crises.

Question 5

Which intervention should a nurse recommend for the distressed family and friends of someone who has committed suicide?

Accepted Answer

Survivors need outlets for their feelings about the loss and the deceased person.Self-help groups provide peer support while survivors work through feelings of loss,anger,and guilt.Psychologic postmortem assessment would not provide the support necessary to work through feelings of loss associated with the suicide of a family member.Reminiscence therapy is not geared to loss resolution.Contracting for two sessions of group therapy would probably not provide sufficient time to work through the issues associated with a death by suicide.

Question 6

Which understanding about individuals who attempt suicide will help a nurse plan the care for a suicidal patient? Every suicidal person should be considered:

Accepted Answer

Hopelessness is the characteristic common among people who attempt suicide.The incorrect options reflect myths about suicide.Not all who attempt suicide are intent on dying.Not all are mentally ill or cognitively impaired.

Question 7

A person intentionally overdoses on antidepressant drugs.Which nursing diagnosis has the highest priority?

Accepted Answer

This diagnosis is the only one with life-or-death ramifications and is therefore higher in priority than the other options.

Question 8

An adult attempts suicide after declaring bankruptcy.The patient is hospitalized and takes an antidepressant medication for 5 days.The patient is now more talkative and shows increased energy on the unit.Select the highest priority nursing intervention.

Accepted Answer

The patient now has more energy and may have decided on suicide,especially considering the history of the prior suicide attempt.The patient must be supervised 24 hours per day;the patient is still a suicide risk.

Question 9

A depressed patient says,"Nothing matters anymore." What is the most appropriate response by the nurse?

Accepted Answer

The nurse must make overt what is covert;that is,the possibility of suicide must be openly addressed.Often,patients feel relieved to be able to talk about suicidal ideation.

Question 10

An adolescent tells the school nurse,"My friend threatened to take an overdose of pills." The nurse talks to the friend who verbalized the suicide threat.The most critical question for the nurse to ask would be:

Accepted Answer

The nurse must assess the patient's access to the means to carry out the plan and,if there is access,alert the parents to remove them from the home.The other questions may be important to ask but are not the most critical.

Question 11

When assessing a patient's plan for suicide,what aspect has priority?

Accepted Answer

If a person has definite plans that include choosing a method of suicide readily available,and if the method is one that is lethal (i.e. ,will cause the person to die with little probability for intervention),the suicide risk is considered high.These areas provide a better indication of risk than the areas mentioned in the other options.

Question 12

A tearful,anxious patient at the outpatient clinic reports,"I should be dead." The initial task of the nurse conducting the assessment interview is to:

Accepted Answer

Establishing rapport will allow the nurse to obtain relevant assessment data such as the presence of a suicide plan,the lethality of a suicide plan,and the presence of risk factors for suicide.

Question 13

A nurse assesses a patient who reports a 3-week history of depression and crying spells.The patient says,"My business is bankrupt,and I was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a concealed suicidal message?

Accepted Answer

Verbal clues to suicide may be overt or covert.The incorrect options are overt references to suicide.The correct option is more veiled.It alludes to the patient's suicide as being a way to "fix everything" but does not say it outright.

Question 14

Which statement provides the best rationale for why a nurse should closely monitor a severely depressed patient during antidepressant medication therapy?

Accepted Answer

Antidepressant medication has the objective of relieving depression.The risk for suicide is greater as the depression lifts,primarily because the patient has more physical energy at a time when he or she may still have suicidal ideation.The other options have little to do with nursing interventions relating to antidepressant medication therapy.

Question 15

The feeling experienced by a patient that should be assessed by the nurse as most predictive of elevated suicide risk is:

Accepted Answer

Of the feelings listed,hopelessness is most closely associated with increased suicide risk.Depression,aggression,impulsivity,and shame are other feelings noted as risk factors for suicide.

Question 16

A college student who attempts suicide by overdose is hospitalized.When the parents are contacted they respond,"There must be a mistake.This could not have happened.We've given our child everything." The parents' reaction reflects:

Accepted Answer

The parents' statements indicate denial.Denial or minimization of suicidal ideation or attempts is a defense against uncomfortable feelings.Family members are often unable to acknowledge suicidal ideation in someone close to them.The feelings suggested in the distracters are not clearly described in the scenario.

Question 17

A nurse uses the SAD PERSONS scale to interview a patient.This tool provides data relevant to:

Accepted Answer

The SAD PERSONS tool evaluates 10 major risk factors in suicide potential: sex,age,depression,previous attempt,ethanol use,rational thinking loss,social supports lacking,organized plan,no spouse,and sickness.The tool does not have appropriate categories to provide information on the other options listed.

Question 18

A nurse and patient construct a no-suicide contract.Select the preferable wording.

Accepted Answer

The correct answer leaves no loopholes.The wording about not harming oneself and not making an attempt leaves loopholes or can be ignored by the patient who thinks,"I am not going to harm myself,I am going to kill myself," or "I am not going to attempt suicide,I am going to commit suicide." A patient may call a therapist and leave the telephone to carry out the suicidal plan.

Question 19

A college student failed two tests.Afterward,the student cried for hours and then tried to telephone a parent but got no answer.The student then gave several expensive sweaters to a roommate.Which behavior provides the strongest clue of an impending suicide attempt?

Accepted Answer

Giving away prized possessions may signal that the individual thinks he or she will have no further need for the items,such as when a suicide plan has been formulated.Calling parents and crying do not provide clues to suicide,in and of themselves.Remaining in the dormitory would be an expected behavior because the patient has nowhere else to go.

Question 20

A person attempts suicide by overdose,is treated in the emergency department,and is then hospitalized.What is the best initial outcome? The patient will:

Accepted Answer

Suicide self-restraint relates most directly to the priority problem of risk for self-directed violence.The other outcomes are related to hope,coping,and self-esteem.

Quiz 23: Suicidal Thoughts and Behavior