Deck 22: Suicide: Prevention and Intervention

Question 1

Which statement made by a patient who attempted suicide 5 days ago would cause the nurse to observe his behavior more closely?

A) "When I'm discharged, maybe my son will let me stay with him."
B) "I'm not sure I will ever really enjoy the things we did before I lost her."
C) "It puzzles me that anyone would want to kill themselves but I certainly did."
D) "My wife and I would have celebrated our thirty-sixth wedding anniversary today."

Answer 1

"My wife and I would have celebrated our thirty-sixth wedding anniversary today."

Question 2

Which finding related to a teenager who has been diagnosed with depression is most significant when planning care?

A) Her father recently remarried.
B) Her mother died from suicide 1 year ago.
C) She has expressed a dislike for her new stepmother.
D) She ran away from home twice during the past month.

Answer 2

Her mother died from suicide 1 year ago.

Question 3

Which statement by a young adult would alert the nurse to increased suicide risk?

A) "I have a necktie in my room that I can use to hang myself."
B) "If I fail one more class, I'm going to have to think about ending it."
C) "When I leave home to live on my own, I'm going to buy myself a gun."
D) "When I took two bottles of Mom's pills, I had to have my stomach pumped."

Answer 3

"I have a necktie in my room that I can use to hang myself."

Question 4

A patient has been displaying advanced thought of suicide.Which action reflects this behavior?

A) Acknowledging thoughts of dying
B) Expresses verbal expressions of 'severe sadness'
C) Wrists are bleeding from cuts with a butter knife
D) Found unconscious with empty pills bottles nearby

Question 5

The nurse working at the crisis center received a call from a patient who stated he was depressed and wanted to die.Further investigation revealed that the patient had within reach all of the items listed below that he could use "to get the job done." Which item would cause the nurse the most concern?

A) A garden hose
B) A loaded gun
C) Two bottles of Prozac
D) A bottle of an alcoholic beverage

Question 6

The nurse is planning care for a patient who was admitted to the hospital after threatening to harm himself when he was stopped by the police for speeding.He was intoxicated at the time of admission and was assessed as being depressed,anxious,and hostile.Which patient outcome is the priority?

A) Patient will remain free from self-harm although hospitalized.
B) Patient will report suicidal ideation or desire to harm self to the staff.
C) Patient will accept referral to the hospital-based substance abuse program.
D) Patient will recognize and interrupt unconscious intentions to harm self.

Question 7

The nurse presenting a suicide prevention lecture would decide who the target population is based on what fact?

A) Females have the highest risk for suicide.
B) Children are considered a high-risk group for committing suicide.
C) The highest suicide rate is among the Caucasian middle-age population.
D) Rates of suicide are highest among the older population, age 80 and older.

Question 8

The Emergency Department nurses were discussing a patient who seeks help almost every holiday by expressing suicidal ideation or making a suicide gesture.One of the nurses stated,"I don't think he is serious about hurting himself.Maybe we should not see him the next time he comes." Which response from the charge nurse is accurate in dealing with the patient who may be using suicidal behavior as a ploy to enter the hospital?

A) "He obviously needs the support he gets at the hospital."
B) "We should avoid showing any warmth the next time he comes in."
C) "Telling him we cannot see him may be the answer to stop this behavior."
D) "Each episode must be individually evaluated, and all options must be explored."

Question 9

A patient diagnosed with cancer of the prostate was admitted after his wife reported he was trying to mix a lethal dose of medications and alcohol to drink.Which patient outcome is a priority to this situation?

A) Patient will participate in all unit activities.
B) Patient will recognize that depression is treatable.
C) Patient will learn ways to handle his unresolved anger.
D) Patient will admit to suicidal thoughts when asked by staff.

Question 10

A patient was admitted and prescribed antidepressants for severe depression with feelings of hopelessness,helplessness,and suicidal ideation.When would the patient be at greatest risk for suicide during hospitalization?

A) Within the first hour after admission and when family leaves
B) At night after visitors leave and patients are allow in their room
C) Within the first 24 hours after admission and as discharge approaches
D) Within 48 hours of first expressing suicidal ideation and as therapy progresses

Question 11

An older adult is admitted to the hospital for severe depression.The nurse,gathering data for a medical and psychiatric history,learns of a suicide attempt 4 years ago after the death of a spouse.Based on this information,it is likely that the patient:

A) Will avoid attempting suicide again after the past experience
B) Will try to minimize the seriousness of the suicide attempt
C) May express suicidal ideation or make a suicide attempt
D) Will report that he has recently written a will

Question 12

Which approach listed in the plan of care of a suicidal patient is considered a cognitive technique?

A) Intense psychotherapy to deal with childhood issues
B) Group therapy with patients with similar problems
C) Limitation of negative thought patterns and increase of realistic self-evaluation
D) Inclusion of significant others and family in the plan of care

Question 13

A family member of a suicidal patient asks,"Are there any medications that can prevent a person from committing suicide?" Which statement best answers the question?

A) If people want to harm themselves, they eventually will.
B) Antipsychotic medications are used primarily for suicide prevention.
C) Antidepressants treat mood disorders that accompany suicidal ideation.
D) There are no medications available that specifically affect suicidal behavior.

Question 14

Which suicide is an example of Durkheim's anomic suicide?

A) A Muslim who was disgraced by a family member
B) A woman whose life savings were embezzled from her
C) A suicide bomber who blows up a bus in the middle East
D) A convicted rapist who has been given a life sentence

Question 15

A patient who is a policewoman tells the nurse she is depressed and can no longer deal with the stress of her job.She mentions that employee assistance counseling failed to change her hopeless attitude.She states that she will use her police revolver to shoot herself in the head during the day when no one is at home and the home is locked.Which formulation by the triage nurse is correct?

A) Plan explicit. Imminence high. Method highly lethal and accessible. Rescue potential low.
B) Plan vague. Imminence moderate. Method somewhat lethal and accessible. Rescue potential moderate.
C) Plan complete. Imminence low. Method low lethality but accessible. Rescue potential high.
D) Plan nebulous. Imminence low. Method low lethality but accessible. Rescue potential high.

Question 16

The nurse administering an antidepressant to a suicidal patient understands that the brain abnormality the medication addresses is:

A) Atrophy of the brain
B) Enlarged lateral ventricles
C) Irregularities in the serotonin system
D) Abnormal electroencephalogram (EEG) readings

Question 17

On day 4 of hospitalization after a suicide attempt,the patient tells the nurse,"You don't have to worry about me any longer.Today was the turning point.You can stop the suicide precautions." Which action indicates the nurse's use of intuition in responding to this patient?

A) Reporting the patient's statements and the nurse's own feelings to the staff and suggest increased vigilance
B) Reporting only the patient's statements and evaluate the outcome, Patient will report lack of suicidal ideation as attained.
C) Conferring with the patient's family members to obtain their evaluation of the patient and his behavior and follow their lead
D) Suggesting that the level of suicide precautions be lowered from one-to-one supervision to observing the patient every 30 minutes

Question 18

The nurse asks a patient admitted with a diagnosis of major depression,"Do you feel like hurting yourself at this time?" What is the primary rationale for obtaining this information when nothing in the referral note implied that the patient was suicidal?

A) It is likely that he is hiding the desire to harm himself.
B) This information must be reported to the patient's physician.
C) Specific safety measures must be implemented when self-harm is a danger.
D) Patient safety is always the primary responsibility of the unit's nursing staff.

Question 19

Which statement made by the patient who attempted suicide best indicates that the criterion for discharge has been met?

A) "I know who to call if I get depressed again."
B) "I've learned that there is hope and I don't have to hurt."
C) "I have good friends who are willing to help me with my problems."
D) "I do not feel like harming myself anymore and that feels so comforting."

Question 20

Which intervention would the nurse implement when a patient's frontal lobe is affected?

A) Educating the patient on the affects of dopamine
B) Helping the patient identify reasons for crying
C) Assessing the patient for any suicidal ideations
D) Evaluating the affects of medication on motivation

Question 21

To maximize therapeutic care to a newly admitted suicidal patient on days 1 and 2 of hospitalization,the nurse will:

A) Select appropriate community resources for referral.
B) Identify patient areas of weakness and deficiency.
C) Encourage the patient to express psychological pain.
D) Refute delusional thinking by logical argument and reinforcement.

Question 22

A newly admitted patient with depression has been determined as suicidal and in need of one-to-one supervision.What is the best statement to inform the patient of the plan of care?

A) "A staff member will be with you at all times to watch you for suicide gestures."
B) "On this unit, a staff member stays with each new admission for the first 24 hours."
C) "We understand the impulse to attempt self-harm may be strong, so someone will stay with you to help you control the impulse."
D) "We are not sure you would be willing to tell a staff member if the urge to commit suicide becomes strong, so to prevent hospital liability someone will stay with you."

Question 23

A suicidal patient agreed on day 2 of hospitalization to write and sign a "no self-harm contract." As a result of this contract,the health care team should plan to:

A) Discontinue suicide precautions.
B) Base the level of observation on staff assessment.
C) Reduce observation to observing the patient every hour.
D) Reduce one-to-one observation to observing the patient every 15 minutes.

Question 24

When assigning the suicidal patient to a room on the unit,the nurse should select a:

A) Single room near the exit
B) Double room near the exit
C) Single room near the nurse's station
D) Double room near the nurse's station

Question 25

A suicidal patient tells the nurse,"There's no other way out for me.I have so many problems that there's nothing to do but cash it in." Which statement by the nurse would be a helpful approach?

A) "I can see that things are bad. It's good you recognized your limitations."
B) "Let's look at the problem you consider most urgent to see about a solution."
C) "We'll begin problem-solving together as soon as you stop feeling suicidal."
D) "Your thinking is flawed. I'll teach you to think differently and be less depressed."

Question 26

There are several suicidal patients on the psychiatric unit.When meal trays are returned to the kitchen,a serrated-edge knife is missing.The nurse to whom the aide reports this should:

A) Acknowledge the information and be watchful for the remainder of the shift.
B) Ask each of the patients on suicide precautions where the knife is hidden.
C) Report the information to the charge nurse and suggest a unit search.
D) Report the information to security and let them handle the matter.

Question 27

The health care team is planning care for a patient hospitalized following a suicide attempt.Which statement by a team member should serve as a basis for planning?

A) "A patient who has made a recent suicide attempt is at low risk for another attempt."
B) "A patient who has made a recent suicide attempt is at very high risk for another attempt."
C) "A patient who has made a recent suicide attempt requires ongoing assessment to determine the level of risk."
D) "A patient who has made a recent suicide attempt may be at risk for 24 hours until medication takes effect."