Question 1

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,is much more communicative,and rates mood at 9/10.Which action should be the nurse's priority at this time?

Accepted Answer

The sudden improvement in mood and affect may indicate a potential risk for suicide as the client may have the energy to carry out suicidal ideation or plan. Increasing the frequency of observation will allow the nurse to closely monitor the client for any suicidal thoughts or behavior and provide appropriate intervention if needed. Giving positive reinforcement or encouraging group sharing may not be appropriate at this time as the client's safety is the nurse's priority. While reevaluating the medication protocol may be necessary, it is not the immediate priority in this situation.

Question 2

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

Accepted Answer

Option B is the most appropriate choice as it provides the family with a resource that may be helpful in coping with their grief. Suicide survivor support groups can be an effective way to connect with others who have experienced a similar loss and provide a safe space for them to discuss their emotions without fear of judgment. Option A is inappropriate as it is not ethical for the nurse to make such a prediction about the family's grieving process, nor should the nurse recommend antidepressants without a thorough evaluation by a healthcare provider. Option C is also inappropriate as it suggests that expressing anger towards the brokerage firm is the only way to cope with grief, which is not necessarily true or appropriate for all individuals. Option D is not appropriate as it suggests that the family should hide the suicide and may perpetuate stigma surrounding mental illness and suicide.

Question 3

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?

Accepted Answer

Option A is relevant to ensuring the client's safety but does not address the low self-esteem and isolation. Option C is a negative outcome and not appropriate to include in the plan of care. Option D is a necessary step in building rapport, but it does not address the specific issue of low self-esteem and isolation. Option B addresses the client's low self-esteem and isolation by setting a specific goal for the client to express positive self-attributes. This outcome is measurable and achievable within a specific time frame, making it a suitable objective for the plan of care.

Question 4

A nurse recently admitted a client to an inpatient unit after a suicide attempt.The health-care provider orders amitriptyline (Elavil)for the client.Which intervention related to this medication should be initiated to maintain this client's safety upon discharge?

Accepted Answer

Providing a 1-week supply of Elavil with refills given at follow-up appointments is the best choice to maintain the client's safety upon discharge. This allows for monitoring of the client's response to the medication and ensures that they do not have access to a large quantity of medication that could be abused or used in a suicide attempt. Additionally, a pill dispenser may not be necessary if the client is able to manage their medication independently. Education regarding the avoidance of foods containing tyramine is not necessary with amitriptyline.

Question 5

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 is the nurse's priority intervention at this time?

Accepted Answer

Placing the client on one-to-one observation is the priority intervention to ensure the client's safety and prevent self-harm. This intervention will allow for constant monitoring of the client's suicidal ideations and ensure that the client does not act on these thoughts. The other options may be necessary interventions, but they are not the priority over ensuring immediate safety.

Question 6

A nurse is caring for four clients diagnosed with Major Depressive Disorder.When considering each client's belief system,the nurse should conclude which client would potentially be at highest risk for suicide?

Accepted Answer

Research suggests that individuals who report no religious affiliation or identify as atheist may have a higher risk of suicidal ideation and behavior compared to those who identify with a religion. Therefore, the client who is an Atheist may be at highest risk for suicide.

Question 7

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

Accepted Answer

A specific plan indicates a higher risk of suicide attempt, necessitating immediate and thorough intervention.

Question 8

A nursing instructor is teaching about suicide in the elderly population.Which information does the instructor include?

Accepted Answer

Elderly individuals, despite making up a smaller portion of the population, have a disproportionately higher rate of suicide. This is a significant public health concern and contradicts the misconception that suicide is less common among the elderly.

Question 9

A nursing student is developing a plan of care for a suicidal client.Which intervention should the student implement first?

Accepted Answer

Assessing the client's suicide risk is the first and most crucial step in developing a plan of care for a suicidal client. This will help determine the level of intervention needed and prioritize other interventions.

Question 10

Which strategy should the nurse implement first with a suicidal client?

Accepted Answer

Asking a direct question about suicidal thoughts is crucial for assessing the client's risk and need for immediate intervention. It allows the nurse to gather essential information quickly and accurately to determine the next steps in care.

Question 11

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

Accepted Answer

Option D reflects empathy and acknowledges the client's feelings. It is important for the nurse to validate the client's emotions and offer support. Option A suggests a potential solution to the client's problems, but it may not address the underlying issues causing the suicidal ideation. Option B focuses on negative aspects of the client's life, which may increase feelings of hopelessness. Option C dismisses the client's emotions and may come across as invalidating.

Question 12

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?

Accepted Answer

The ability to participate in a plan for safety and the family's agreement for constant observation are important factors in determining whether a suicidal client can be safely discharged. The other options, such as no previous admissions for major depressive disorder or vital signs being stable, are important but may not be sufficient on their own to justify a discharge decision.

Question 13

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

Accepted Answer

The best nursing intervention to lower the client's risk for suicide is to observe the client at intervals determined by assessed data. This allows the nurse to monitor the client's mood, behavior, and response to treatment, and intervene if necessary to prevent suicidal ideation or behavior. Encouraging participation in the milieu and redirecting the client's thoughts can also be helpful interventions, but they are not the best option for specifically lowering suicide risk. Developing a strong personal relationship with the client may be important for overall therapeutic alliance, but it alone is not enough to prevent suicide.

Question 14

A nursing instructor is teaching about suicide.Which student statement indicates that learning has occurred?

Accepted Answer

Option D is the correct answer as it reflects the accurate statistic that 50 to 80 percent of all people who commit suicide had previously attempted it. Options A, B, and C are incorrect as they perpetuate common myths and stigmas surrounding suicide and mental illness.

Question 15

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

Accepted Answer

The most immediate and important priority for a suicidal client is to maintain their safety. Therefore, the correct outcome would be for the client to remain safe during their hospital stay. While establishing a trusting relationship with the nurse and expressing hope for the future are important goals, they should not take priority over the client's immediate safety. The outcome of the client not physically harming themselves is also important, but this may not be achievable or measurable within a short period of time, such as a hospital stay.

Question 16

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

Accepted Answer

Placing the client on one-to-one suicide precautions is the priority nursing intervention because the suicide note details a specific plan for the client to take their life. The more specific the plan, the higher the risk of the client attempting suicide. Administering medication or establishing room restrictions may not address the immediate danger of the client's suicidal ideation. Calling an emergency treatment team meeting may be necessary, but it is not the priority intervention in this scenario.

Question 17

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

Accepted Answer

The answer of After years of dialysis,an 84-year-old states,"I'm exhausted,depressed,and...

Question 18

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

Accepted Answer

The best course of action in this situation is to provide active listening, support, and acceptance of the client's feelings. This will not only help the client feel heard and validated, but it will also help the family members feel more comfortable and informed about their loved one's care. Addressing only serious suicide threats may lead the client to feel that their concerns are not being taken seriously, while promising confidentiality to the family may not be ethical or practical. While offering a private environment can be helpful, it is not always necessary or feasible in every care setting.

Question 19

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

Accepted Answer

The client's statements "Nothing will ever get better" and "Nobody can help me" directly reflect feelings of despair and a lack of hope, making "Hopelessness R/T altered mood AEB client statements" the most appropriate nursing diagnosis.

Question 20

A new nursing graduate asks the psychiatric nurse manager how to best classify suicide.Which is the nurse manager's best reply?

Accepted Answer

Suicide is a behavior, not a specific mental disorder. It may be associated with various mental health conditions, but the act of suicide itself is a behavior.

Quiz 17: Suicide Prevention

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,is much more communicative,and rates mood at 9/10.Which action should be the nurse's priority at this time?