Question 1

The parents of identical twins ask a nurse for advice.One twin committed suicide a month ago.Now the parents are concerned that the other twin may also have suicidal tendencies.Which reply by the nurse would be most helpful?

Accepted Answer

Twin studies suggest the presence of genetic factors in suicide;however,separating genetic predisposition to suicide from predisposition to depression or alcoholism is difficult.Primary interventions can be helpful in promoting and maintaining health and possibly counteracting the genetic load.The incorrect options are untrue statements or oversimplifications.

Question 2

A staff nurse tells another nurse "I evaluated a new patient using the SAD PERSONS scale and got a score of 10.I'm wondering if I should send the patient home." Select the best reply by the second nurse.

Accepted Answer

A SAD PERSONS scale score of 0 to 5 suggests home care with follow-up.A score of 6 to 8 requires psychiatric consultation.A score over 8 calls for hospitalization.

Question 3

A new nurse says to a peer,"My newest patient has schizophrenia.At least I won't have to worry about suicide risk." Which response by the peer would be most helpful?

Accepted Answer

Up to 10% of patients with schizophrenia die from suicide,usually related to depressive symptoms occurring in the early years of the illness.Depressive symptoms are related to suicide among patients with schizophrenia.Patients with schizophrenia usually have auditory,not visual,hallucinations.Although the use of drugs and alcohol compounds the risk for suicide,it is independent of schizophrenia.

Question 4

A nurse assesses five newly hospitalized patients.Which patients have the highest suicide risk? Select all that apply.

Accepted Answer

Whites have suicide rates almost twice those of nonwhites,and the rate is particularly high for older adult men,adolescents,and young adults.Other high risk groups include young African-American men,Native-American men,older Asian Americans,and persons with traumatic brain injury.

Question 5

Four individuals have given information about their suicide plans.Which plan evidences the highest suicide risk?

Accepted Answer

This is a highly lethal method with little opportunity for rescue.The other options are lower lethality methods with higher rescue potential.

Question 6

Which individual in the emergency department should be considered at the highest risk for completing suicide?

Accepted Answer

High-risk factors include being an older adult,single,and male and having a co-occurring medical illness.Cancer is one of the somatic conditions associated with increased suicide risk.Protective factors for African-American women and Hispanic individuals include strong religious and family ties.Asian Americans have a suicide rate that increases with age.

Question 7

A patient with suicidal impulses is on the highest level of suicide precautions.Which measures should the nurse incorporate into the patient's plan of care? Select all that apply.

Accepted Answer

One-on-one observation is necessary for anyone who has limited control over suicidal impulses.Plastic dishes on trays and the removal of potentially harmful objects from the patient's possession are measures included in any level of suicide precautions.The remaining options are used in less stringent levels of suicide precautions.

Question 8

A patient who was hospitalized for 2 weeks committed suicide during the night.Which initial measure will be most helpful for staff members and other patients regarding this event?

Accepted Answer

Interventions should be aimed at helping the staff and patients come to terms with the loss and to grow because of the incident.Then,a community meeting should be scheduled to allow other patients to express their feelings and request help.Staff members should be prepared to provide additional support and reassurance to patients and should seek opportunities for peer support.The incorrect options will not control information or may result in unsafe care.

Question 9

A college student failed two examinations.The student cried for hours and then tried to call a parent but got no answer.The student then suspended access to his social networking web site.Which suicide risk factors are present? Select all that apply.

Accepted Answer

Failing examinations in the academic major constitutes a recent stressful life event.Shame and humiliation related to the failure can be hypothesized.The inability to contact parents can be seen as a recent lack of social support,as can the roommate's absence from the dormitory.Terminating access to one's social networking site represents self-imposed isolation.This scenario does not provide data regarding a history of an earlier suicide attempt,a family history of suicide,or of co-occurring medical illness.

Question 10

A severely depressed patient who has been on suicide precautions tells the nurse,"I am feeling a lot better,so you can stop watching me.I have taken too much of your time already." Which is the nurse's best response?

Accepted Answer

When a patient seeks to have precautions lifted by professing to feel better,the patient may be seeking greater freedom in which to attempt suicide.Changing the treatment plan requires careful evaluation of outcome indicators by the staff.The incorrect options will not cause the patient to admit to a suicidal plan,do not convey concern for the patient,or suggest that the patient is not a partner in the care process.

Question 11

A nurse answers a suicide crisis line.A caller says,"I live alone in a home several miles from my nearest neighbors.I have been considering suicide for 2 months.I have had several drinks and now my gun is loaded.I'm going to shoot myself in the heart." How would the nurse assess the lethality of this plan?

Accepted Answer

The patient has a highly detailed plan,a highly lethal method,the means to carry it out,lowered impulse control because of alcohol ingestion,and a low potential for rescue.

Question 12

A nurse assesses the health status of soldiers returning from Afghanistan.Screening for which health problems will be a priority? Select all that apply.

Accepted Answer

Traumatic brain injury and posttraumatic stress disorder each occur in approximately 20% of soldiers returning from Afghanistan.Some soldiers have both problems.The incidence of disorders identified in the distracters would be expected to parallel the general population.

Quiz 23: Suicidal Thoughts and Behavior