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A college student who attempted suicide by overdose is hospitalized. When the parents are contacted, they respond, 'There must be a mistake. This could not have happened. We've given our child everything.' What emotional response does the parents' reaction reflect?
- A. Denial
- B. Anger
- C. Anxiety
- D. Projection
Correct Answer: A
Rationale: The parents' statements indicate denial. Denial or minimization of suicidal ideation or attempts is a defense against uncomfortable feelings. Family members are often unable to acknowledge suicidal ideation in someone close to them. The feelings suggested in the distractors are not clearly described in the scenario.
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A new nurse says to a peer, 'My new patient is diagnosed with bipolar disorder. At least I won't have to worry about suicide risk.' Which response by the peer would be most helpful?
- A. Let's reconsider your plan. Suicide risk is high in patients diagnosed with bipolar disorder.'
- B. Suicide is a risk for any patient diagnosed with bipolar disorder who uses alcohol or drugs.'
- C. The thought processes of patients diagnosed with bipolar disorder are usually too disorganized to attempt suicide.'
- D. Racing thoughts during mania often prompt suicide among patients diagnosed with bipolar disorder.'
Correct Answer: A
Rationale: Epidemiological surveys have demonstrated that 90% of suicide completers had a diagnosable psychiatric condition at the time of the event. People with mood disorders, especially major depressive disorder and bipolar disorder, are responsible for approximately 50% of completed suicides. The correct response is the most global answer.
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?
- A. History of earlier suicide attempt
- B. Co-occurring medical illness
- C. Recent stressful life event
- D. Self-imposed isolation
- E. Shame or humiliation
Correct Answer: C,D,E
Rationale: 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.
When a person intentionally overdoses on antidepressant drugs, which nursing diagnosis has the highest priority?
- A. Powerlessness
- B. Social isolation
- C. Risk for suicide
- D. Ineffective management of the therapeutic regimen
Correct Answer: C
Rationale: This diagnosis is the only one with life-or-death ramifications and is therefore higher in priority than the other options.
What feeling experienced by a patient should be assessed by the nurse as most predictive of elevated suicide risk?
- A. Hopelessness
- B. Sadness
- C. Anxiety
- D. Anger
Correct Answer: A
Rationale: Of the feelings listed, hopelessness is most closely associated with increased suicide risk. Depression, aggression, impulsivity, and shame are other feelings noted as risk factors for suicide.
A nurse assesses a patient who reports a 3-week history of depression and crying spells. The patient says, 'My business is bankrupt, and I was served with divorce papers.' Which subsequent statement by the patient alerts the nurse to a concealed suicidal message?
- A. I wish I were dead.'
- B. Life is not worth living.'
- C. I have a plan that will fix everything.'
- D. My family will be better off without me.'
Correct Answer: C
Rationale: Verbal clues to suicide may be overt or covert. The incorrect options are overt references to suicide. The correct option is more veiled. It alludes to the patient's suicide as being a way to 'fix everything' but does not say it outright.