Question 1

A nurse is caring for four clients diagnosed with major depressive disorder. What impact could religion have on the risk for suicide in these clients?&#10;A) Religious affiliation has no impact on suicide risk.&#10;B) One's type of religion can eliminate suicide risk.&#10;C) Religious affiliation can be protective against suicide attempts.&#10;D) One's type of religion is more important than social support.&#10;

Accepted Answer

1.This is incorrect. Religious affiliation may have some impact on suicide risk.
2.This is incorrect. One's type of religion does not eliminate suicide risk.
3.This is correct. Religious affiliation can be protective against suicide attempts.
4.This is incorrect. Religious affiliation is not necessarily more important than social support systems in suicide risk.

Question 2

Which epidemiological factor related to suicide makes it difficult to determine the number of attempts that happen each year?&#10;A) The number of suicide attempts reflects only those who enter treatment.&#10;B) More people attempt suicide than die by suicide each year.&#10;C) Unintentional injuries kill more people than suicide attempts each year.&#10;D) Suicide rates consistently increased from 2000 to 2017.&#10;

Accepted Answer

1.This is correct. When people who attempt suicide do not enter treatment settings, they are not counted in the number of suicide attempts, making it difficult to fully understand the number of attempts each year.
2.This is incorrect. The number of people who die by suicide each year does not make it difficult to determine the number of attempts each year.
3.This is incorrect. Unintentional injuries do not relate to the number of attempts that happen each year.
4.This is incorrect. Increased suicide rates do not determine the number of attempts each year.

Question 3

A client was diagnosed with depression resulting from the loss of her twin sister in a skiing accident. Her parents reported that all the client has done since the accident was lay in her bed and cry, asking why she survived the accident. The physician prescribed Prozac to treat the depression and suggested that the parents "keep a close eye on her." After a week, the client began to show some signs of improvement, even coming out of her room to eat with the family. After 2 months, the client committed suicide despite seeming to come out of the depression. What is the likeliest reason?

A) The Prozac prescription was not effective.
B) Suicide risk can increase early in treatment with antidepressants.
C) The client was not kept under direct supervision.
D) A preexisting mental illness was compounded by the death of her sister.

Suicide risk can increase early in treatment with antidepressants.

Accepted Answer

1.This is incorrect. In fact, the Prozac prescription was effective in elevating the client's mood.
2.This is correct. Suicide risk may increase early in treatment with antidepressants. One possible reason is that as an individual's energy returns, he or she may have an increased ability to act out self-destructive wishes.
3.This is incorrect. Direct supervision may have prevented the suicide; however, the most likely reason for the increased risk was related to treatment with an antidepressant.
4.This is incorrect. Nothing in the scenario indicates that the client had a preexisting mental illness.

Question 4

A student nurse has just entered a psychiatric rotation. The student asks a nursing instructor, "How will we know if someone may get violent?" Which is the most appropriate reply by the nursing instructor?

A) "You can't really say for sure. There are limited indicators of potential violence."
B) "Certain behaviors indicate a potential for violence, such as rigid posture, clenched fists, and raised voice."
C) "Any client can become violent, so be aware of your surroundings at all times."
D) "When a client suddenly becomes quiet, is withdrawn, and maintains a flat affect, this is an indicator of potential violence."

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Accepted Answer

1.This is incorrect. There are many indicators of potential violence, many of which are considered "prodromal."
2.This is correct. The most appropriate statement by the instructor is "Certain behaviors indicate a potential for violence. They are labeled as a 'prodromal syndrome' and include rigid posture, clenched fists, and raised voice." Rigid posture, clenched fists, and raised voice are predictors of violent behavior.
3.This is incorrect. Although the prudent nurse and student would be aware of their surroundings, there are indicators of potential violence that the staff should know to promote safety.
4.This is incorrect. This behavior is not typically a sign for the "prodromal syndrome" of pending violence.

Question 5

The nurse is discussing the concept of anger versus aggression with clients during a counseling session. Which of the following statements best differentiates between anger and aggression?&#10;A) &#34;Aggression is a physiological arousal state due to a painful experience, where anger is a learned behavior.&#34;&#10;B) &#34;Anger is a normal, healthy emotional response to a negative stimulus, where aggression is an expression of anger.&#34;&#10;C) &#34;Aggression is a normal emotional response to a negative stimulus, where anger is an emotional expression of aggression.&#34;&#10;D) &#34;There is no difference between anger and aggression; they are essentially the same phenomenon.&#34;&#10;

Accepted Answer

1.This is incorrect. Aggression is a learned behavior in response to anger, which is a physiological state of arousal.
2.This is correct. Anger is a normal emotion that is typically experienced as an almost-automatic inner response to negative stimuli such as emotional pain, frustration, or fear. Aggression is a behavioral response of anger intended to inflict pain to or injury to others.
3.This is incorrect. Aggression is not a normal emotional response to a negative stimulus, as it is typically a violent act toward a person or object in response to anger.
4.This is incorrect. Anger and aggression are significantly different.

Question 6

During the debriefing after a violent episode, the client states that they acted out on their perceived threat from which of the staff behaviors?&#10;A) The staff member administered the client's prn medications when the client showed signs of &#34;prodromal syndrome.&#34;&#10;B) The staff member attempted to soothe the client by stroking their arm and shoulder and talking in a firm tone.&#10;C) The staff member called for assistance and asked the ward secretary to contact the client's physician.&#10;D) The nurse separated the client from the others with signs of &#34;prodromal syndrome.&#34;&#10;

Accepted Answer

1.This is incorrect. Administering the prn medication to alleviate the symptoms of potential violence may not increase the violent behavior.
2.This is correct. Touching the client may be perceived as a threat and provoke further violence.
3.This is incorrect. Asking for assistance to prevent violence would not have increased the likelihood of an outburst or increased behavioral issues.
4.This is incorrect. This would be an appropriate response to "prodromal syndrome" by removing others from potential harm.

Question 7

A client arrives at the primary care physician with complaints of increased symptoms of colitis. During the intake interview, the patient mentions having two migraines in the past 3 weeks and asks for a new medication, stating, "It doesn't seem like the current medication is working as well as I expected." In reviewing the client's medical record, it is noted that the client was prescribed medication for depression and a referral to a marriage counselor at her last visit 2 months ago. Which of the following might the nurse suspect?

A) Maladaptive expression of anger
B) Hypersensitivity to migraine medication
C) Exhibiting signs of domestic abuse
D) Operant conditioning

Accepted Answer

1.This is correct. The patient presents with a diagnosis of colitis and depression and has recently received medications for depression and migraines. These symptoms are manifestations of ineffective expression of anger. The symptoms will not go away if the cause (ineffective anger expression) is not resolved.
2.This is incorrect. Medication that does not appear to be effective does not necessarily indicate a hypersensitivity.
3.This is incorrect. There is no mention of physical evidence of domestic abuse.
4.This is incorrect. Operant conditioning refers to a specific behavior that is reinforced. It may be true that patient has learned to suppress her feelings of anger, but that is not indicated in the scenario.

Question 8

The nurse determines that the goal has been met when the client with anger issues is able to___________________.&#10;A) Take medications on a routine basis.&#10;B) Transfer tension into artwork.&#10;C) Decide what to have for dinner.&#10;D) Speak in front of a large crowd.&#10;

Accepted Answer

1.This is incorrect. This would not determine successful management of anger.
2.This is correct. The client is able to transfer tension generated by the anger into constructive activities instead of violent behavior. This is a positive outcome.
3.This is incorrect. This is not an appropriate determination of anger management.
4.This is incorrect. Although low self-esteem may be a manifestation of anger issues, this would not be a positive outcome of an intervention for anger management.

Question 9

___________ ____________ is a personal signal of threat or injustice against the self. The signal elicits coping responses to deal with the distress.&#10;A) Passive-aggressiveness&#10;B) Anger arousal&#10;C) Impulsive behavior&#10;D) Exaggerated control&#10;

Accepted Answer

1.This is incorrect. Passive-aggressive behavior is an indication of conflict and unresolved anger.
2.This is correct. Anger arousal is a personal signal of threat or injustice against the self. The signal elicits coping responses to deal with the distress.
3.This is incorrect. Impulsive behavior may be an indicator of destructive anger.
4.This is incorrect. It is a sign of aggression when an individual uses power to control or intimidate others.

Deck 6: Suicide Prevention