Deck 19: Self-Protective Responses and Suicidal Behavior

Question 1

A suicidal patient was found attempting to hang himself in the bathroom shower.What nursing intervention would best address the patient's current need for safety while maintaining his self-esteem?

A) Assign a staff member to remain with the patient at all times.
B) Place the patient in the seclusion room with 15-minute checks.
C) Request that the patient remain with the patient group at all times.
D) Tell the patient that he may use the bathroom only with staff supervision.

Answer 1

Assign a staff member to remain with the patient at all times.

Question 2

A nurse is caring for a patient who has been noncompliant with the prescribed diabetic diet and exercise regimen.The nurse promotes compliance by enhancing the patient's:

A) sense of control.
B) sense of well-being.
C) fear of the sequelae of illness.
D) dependence on health care workers.

Answer 2

sense of control.

Question 3

What nursing diagnosis should be considered when caring for a patient who has engaged in direct or indirect self-destructive behavior?

A) Death anxiety
B) Chronic low self-esteem
C) Disturbed body image
D) Disturbed personal identity

Answer 3

Chronic low self-esteem

Question 4

A person calls the crisis hotline and says,"Nobody can help me now.I just want to say goodbye to somebody before I do it." The best response to this statement would be:

A) "I can help you. Will you let me try?"
B) "You're still alive, so you can still get help."
C) "You sound very discouraged. What are you planning to do?"
D) "I'll arrange transportation so you can come here and tell me about the problem."

Question 5

An assessment has been made that a patient is highly suicidal.One-to-one constant supervision with unit restriction has been ordered.How will this order be implemented?

A) By observing the patient while awake, both on and off the unit
B) By observing the patient at all times while revoking any off-unit privileges
C) By obtaining a no-suicide contract while removing all harmful objects from the environment
D) By observing the patient every 15 minutes around the clock while documenting whereabouts and activity level

Question 6

A patient who _____ should be assessed as using indirect self-destructive behavior.

A) scratches both wrists with safety pins
B) drinks nearly 1 quart of whiskey per day
C) took an overdose of sedative-hypnotic drugs
D) calls a friend when contemplating suicide

Question 7

During an admission a nurse suspects a patient is having suicidal ideations.The best course of action is to:

A) ask the patient if thoughts of suicide have occurred.
B) ask the patient's significant other if the patient is suicidal.
C) arrange for involuntary commitment to avoid harm to self or others.
D) avoid the subject to avoid pushing the patient into further thoughts of self-harm.

Question 8

A patient with depression tells a nurse,"I hope someone will make sure my family gets my jewelry when I'm gone." This statement can be assessed as a suicide:

A) attempt.
B) gesture.
C) threat.
D) plan.

Question 9

A patient who was hospitalized after a serious suicide attempt is scheduled to be discharged to home.During the hospitalization the patient has been compliant with all aspects of the treatment plan.It is reasonable to believe the patient will continue to comply with treatment because the patient:

A) is beginning to demonstrate positive behavioral changes.
B) continues to need to seek praise from multidisciplinary team members.
C) states, "I'm trying to change. I can't do it all at once but I want to continue to try."
D) verbally promises to go to every meeting that the group schedules after the planned discharge.

Question 10

A psychiatric technician states,"This patient has frequently threatened suicide but has never attempted it.The patient should be sent home instead of encouraging the threats." The nurse supports admitting the patient by responding:

A) "There is no family to provide the social support that is vital to safety."
B) "Any suicide threat deserves serious attention and concern for safety."
C) "You seem to have a real problem when patients lose emotional control."
D) "Nursing staff are encouraged to share their concerns with the physician."

Question 11

Which remark by a nurse best represents an attempt to assess the patient's current ability to organize and enact a suicide wish?

A) "What is your educational background?"
B) "What plan do you have for committing suicide?"
C) "Have you ever thought about or tried to hurt yourself?"
D) "Are your self-destructive thoughts constant or intermittent?"

Question 12

When evaluating the effectiveness of the care provided for a self-destructive patient,the best approach is to:

A) identify maladaptive coping behaviors.
B) involve the patient in the process of evaluation.
C) make sure the staff has followed the original care plan.
D) modify the plan as little as possible to avoid confusing the patient.

Question 13

A person who has been fired from a job calls the mental health clinic and tells a nurse,"I feel so overwhelmed that I don't see any other answer but to die." Another voice can be heard in the background.Which action should the nurse take?

A) Convince the caller to drive to the hospital.
B) Get the caller's address, go to the home, and take the caller to the hospital.
C) Stay on the telephone and send the police to bring the caller to the hospital.
D) Ask to speak to the other person and alert them to the caller's suicide threat.

Question 14

A nurse is working with a patient with depression whose identical twin committed suicide.In assessing this patient for suicidal risk,the nurse should consider that this patient:

A) is at increased risk for suicide.
B) has the same risk as the general population.
C) cannot be assigned a level of risk based on such limited data.
D) is at low risk because the patient has experienced the trauma of suicide.

Question 15

The major difference between self-injury and suicide lies in whether the patient has:

A) a need to control or a need to be controlled.
B) the wish to relieve tension or the wish to die.
C) been diagnosed with a developmental disorder or psychosis.
D) a tendency toward indirect or direct expression of self-destructive urges.

Question 16

Patients of which demographic group have the highest suicide rate in the United States?

A) Female between the ages of 13 and 19 years
B) Male between the ages of 19 and 27 years
C) Female age 65 years or older
D) Male age 50 years or older

Question 17

A nurse performing an admission interview identifies a need for one-to-one supervision when the patient admits to having suicidal ideations with a plan.The best way to inform the patient of the planned intervention is to say:

A) "We cannot trust you to remain safe, so someone will always be with you."
B) "It is our policy to have a staff member stay with all new admissions to the unit."
C) "The hospital can't let you hurt yourself. Someone will stay with you at all times to protect you from self-harm."
D) "I understand your impulse to harm yourself. A staff member will stay with you to help you control that impulse."

Question 18

A nurse caring for a hospitalized suicidal patient on one-to-one supervision should initially focus on:

A) mobilizing social support for the patient and family.
B) facilitating awareness, expression, and labeling of feelings.
C) helping the patient test new mechanisms for coping with stress.
D) talking to the patient about the effect suicide would have on family members.

Question 19

A nurse assessing a patient who has been noncompliant with the prescribed diabetic diet and exercise regimen should consider planning strategies to overcome patient use of:

A) denial.
B) projection.
C) dissociation.
D) displacement.

Question 20

The nursing diagnosis for a patient who is depressed and suicidal at admission is "risk for suicide." The most appropriate outcome for this diagnosis at discharge from the hospital is,"The patient will:

A) increase feelings of self-worth."
B) not harm self while hospitalized."
C) be able to problem solve effectively."
D) develop a trusting relationship with one staff member."

Question 21

A patient who has recently lost a spouse calls the crisis line and reports suicidal ideations that involve jumping off a bridge over the river when no one is around.What level of lethality would a nurse assess for this plan?

A) Low
B) Moderate
C) High
D) Lethality cannot be determined from this data.

Question 22

A priority for nurses working with psychiatric patients would be the assessment of suicide risk for individuals who have the tendency to be: (Select all that apply.)

A) blaming.
B) hostile.
C) hopeless.
D) impulsive.
E) controlling.

Question 23

A patient was admitted after an unsuccessful suicide attempt.The patient is overheard saying,"Next time,I'll make sure no one interrupts me." Which level of suicide precautions should be ordered?

A) Occasional safety checks
B) Verbal contract for safety
C) Every-15-minute safety checks
D) One-to-one supervision for safety