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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.
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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.
After failing two tests, a college student cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate. Which behavior provides the strongest clue of an impending suicide attempt?
- A. Calling parents
- B. Excessive crying
- C. Giving away sweaters
- D. Staying alone in a dorm room
Correct Answer: C
Rationale: Giving away prized possessions may signal that the individual thinks he or she will have no further need for the items, such as when a suicide plan has been formulated. Calling parents and crying do not provide clues to suicide, in and of themselves. Remaining in the dormitory would be an expected behavior because the student has nowhere else to go.
Which intervention should a nurse recommend for the distressed family and friends of someone who has successfully committed suicide?
- A. Participating in reminiscence therapy
- B. Attending a self-help group for survivors
- C. Contracting for two sessions of group therapy
- D. Completing a psychological postmortem assessment
Correct Answer: B
Rationale: Survivors need outlets for their feelings about the loss and the deceased person. Self-help groups provide peer support while survivors work through feelings of loss, anger, and guilt. Psychological postmortem assessment would not provide the support necessary to work through feelings of loss associated with the suicide of a family member. Reminiscence therapy is not geared to loss resolution. Contracting for two sessions of group therapy would probably not provide sufficient time to work through the issues associated with a death by suicide.
A nurse counsels a patient with recent suicidal ideation. Which is the nurse's most therapeutic comment?
- A. Let's make a list of all your problems and think of solutions for each one.'
- B. I'm happy you're taking control of your problems and trying to find solutions.'
- C. When you have bad feelings, try to focus on positive experiences from your life.'
- D. Let's consider which problems are most important and focus on discussing them.'
Correct Answer: D
Rationale: The nurse helps the patient develop effective coping skills. He or she assists the patient to reduce the overwhelming effects of problems by prioritizing them. The incorrect options continue to present overwhelming approaches to problem solving.
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.