Deck 11: Suicide Prevention

Question 1

A nurse is caring for a client who has threatened to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which information would determine the nurse's plan of care for this client?

A) The more specific the plan is, the more likely the client will attempt suicide.
B) Clients who talk about suicide rarely actually commit it.
C) Clients who threaten suicide should be observed every 15 minutes
D) After a brief assessment, the nurse would avoid the topic of suicide.

Answer 1

The more specific the plan is, the more likely the client will attempt suicide.

Question 2

A client is admitted to an inpatient unit after a suicide attempt. The health-care provider prescribes amitriptyline (Elavil) for the client. Which would the nurse expect to be initiated to maintain this client's safety upon discharge?

A) Provide a 6-month supply of Elavil to ensure long-term compliance.
B) Provide a 3-day supply of Elavil with refills contingent on follow-up appointments.
C) Provide a pill dispenser as a memory aid.
D) Provide education regarding the avoidance of foods containing tyramine.

Answer 2

Provide a 3-day supply of Elavil with refills contingent on follow-up appointments.

Question 3

During a one-to-one session with a client, the client states, "Nothing will ever get better," and, "Nobody can help me." Which nursing diagnosis is most appropriate for this client?

A) Powerlessness R/T altered mood AEB client statements
B) Risk for injury R/T altered mood AEB client statements
C) Risk for suicide R/T altered mood AEB client statements
D) Hopelessness R/T altered mood AEB client statements

Answer 3

Hopelessness R/T altered mood AEB client statements

Question 4

The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information would the nurse provide?

A) Address only serious suicide threats to avoid the possibility of secondary gain.
B) Promote trust by verbalizing a promise to keep suicide attempt information within the family.
C) Offer a private environment to provide needed time alone at least once a day.
D) Be available to actively listen, support, and accept feelings.

Question 5

A stockbroker commits suicide after being convicted of insider trading. In speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information?

A) "Your grieving will subside within 1 year; until then, I recommend antidepressants."
B) "Support groups are available specifically for survivors of suicide, and I would be glad to work with the health-care provider to locate one in this area."
C) "The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them."
D) "Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone."

Question 6

A nurse is caring for four clients diagnosed with major depressive disorder. When considering each client's belief system, the nurse would conclude which client would potentially be at higher risk for suicide than the other clients?

A) Roman Catholic
B) Protestant
C) Atheist
D) Muslim

Question 7

During the planning of care for a suicidal client, which correctly written outcome would be a nurse's first priority?

A) The client will not physically harm self.
B) The client will express hope for the future by day three.
C) The client will establish a trusting relationship with the nurse.
D) The client will remain safe during the hospital stay.

Question 8

Which client data indicates that a suicidal client is participating in a plan for safety?

A) Compliance with antidepressant therapy
B) A mood rating of 9/10
C) Disclosing a plan for suicide to staff
D) Expressing feelings of hopelessness to nurse

Question 9

A client diagnosed with major depressive disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. Which would be the nurse's priority intervention at this time?

A) Obtaining an order for locked seclusion until client is no longer suicidal
B) Conducting 15-minute checks to ensure safety
C) Placing the client on one-to-one observation while monitoring suicidal ideations
D) Encouraging the client to express feelings related to suicide

Question 10

The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the team's decision?

A) No previous admissions for major depressive disorder
B) Vital signs stable; no psychosis noted
C) Adheres to medication regimen; able to problem-solve life issues
D) Participates in a plan for safety; family agrees to constant observation

Question 11

A suicidal client says to the nurse, "There's nothing to live for anymore." Which is the most appropriate nursing reply?

A) "Why don't you consider doing volunteer work in a homeless shelter?"
B) "Let's discuss the negative aspects of your life."
C) "Things will look better in the morning."
D) "It sounds like you are feeling pretty hopeless."

Question 12

The nurse discovers a client's suicide note that details the time, place, and means to commit suicide. Which would be the priority nursing intervention and the rationale for this action?

A) Administering lorazepam (Ativan) prn, because the client is angry about the discovery of the note
B) Establishing room restrictions, because the client's threat is an attempt to manipulate the staff
C) Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide
D) Calling an emergency treatment team meeting, because the client's threat must be addressed

Question 13

A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide?

A) Encouraging participation in the milieu to promote hope
B) Developing a strong personal relationship with the client
C) Observing the client at intervals determined by assessed data
D) Encouraging and redirecting the client to concentrate on happier times

Question 14

After years of dialysis, an 84-year-old client states, "I'm exhausted, depressed, and done with these attempts to keep me alive." Which question would the nurse ask the client's spouse when preparing a discharge plan of care?

A) "Have there been any changes in appetite or sleep?"
B) "How often is your spouse left alone?"
C) "Has your spouse been following a diet and exercise program consistently?"
D) "How would you characterize your relationship with your spouse?"

Question 15

Which documented intervention would the nurse implement first when caring for a severely depressed client?

A) Communicate therapeutically.
B) Observe the client.
C) Provide a hazard-free environment.
D) Assess suicide risk.

Question 16

Which information would the nursing instructor include about suicide in the elderly population when teaching nursing students?

A) Elderly people use less lethal means to commit suicide.
B) Although the elderly comprise less than 13 percent of the population, they account for 15 percent of all suicides.
C) Suicide is the second leading cause of death among the elderly.
D) It is normal for elderly individuals to express a desire to die, because they have come to terms with their mortality.

Question 17

A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, rates mood at 9/10, and is much more communicative. Which action would be the nurse's priority at this time?

A) Give the client off-unit privileges as positive reinforcement.
B) Encourage the client to share mood improvement in group.
C) Increase frequency of client observation.
D) Request that the psychiatrist reevaluate the current medication protocol.

Question 18

Which statement best describes the classification of suicide?

A) Suicide is a DSM-5 diagnosis.
B) Suicide is a mental disorder.
C) Suicide is a behavior.
D) Suicide is an antisocial affliction.

Question 19

Which statement made by a nursing student indicates that learning regarding suicide has been successful?

A) "Suicidal threats and gestures would be considered manipulative and/or attention-seeking."
B) "Suicide is the act of a psychotic person."
C) "All suicidal individuals are mentally ill."
D) "Between 50 and 80 percent of all people who kill themselves have a history of a previous attempt."

Question 20

Which is a correctly written, appropriate outcome for a client with a history of suicide attempts who is currently exhibiting symptoms of low self-esteem by isolating self?

A) The client will not physically harm self.
B) The client will express three positive self-attributes by day four.
C) The client will reveal a suicide plan.
D) The client will establish a trusting relationship.

Question 21

According to statistics, which ethnic group is at highest risk for suicide?

A) African American
B) Alaskan Native
C) Asian
D) White

Question 22

Which of the following is most critical to assess when determining risk for suicide for a client newly admitted to an inpatient psychiatric unit?

A) Family history of depression
B) The client's orientation to reality
C) The client's history of suicide attempts
D) Family support systems

Question 23

A father finds his teenage child has carried out suicide by hanging the morning after they have an argument. Which paternal grief responses would a nurse anticipate? (Select all that apply.)

A) "I can't believe this is happening."
B) "If only I had been more understanding."
C) "How dare he do this to me!"
D) "I'm just going to have to accept that he was gay."
E) "Well, that was a selfish thing to do."