Nokea
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.
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Which individual in the emergency department should be considered at the highest risk for completing suicide?
- A. An adolescent Asian-American girl with superior athletic and academic skills who has asthma
- B. A 38-year-old single African-American female church member with fibrocystic breast disease
- C. A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes
- D. A 79-year-old single white man with cancer of the prostate gland
Correct Answer: D
Rationale: 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.
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.
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.
Four individuals have given information about their suicide plans. Which plan evidences the highest suicide risk?
- A. Jumping from a 100-foot-high railroad bridge located in a deserted area late at night
- B. Turning on the oven and letting gas escape into the apartment during the night
- C. Cutting the wrists in the bathroom while the spouse reads in the next room
- D. Overdosing on aspirin with codeine while the spouse is out with friends
Correct Answer: A
Rationale: This is a highly lethal method with little opportunity for rescue. The other options are lower lethality methods with higher rescue potential.
A patient recently 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?
- A. Request the public information officer to address inquiries from the local media.
- B. Hold a staff meeting to express feelings and plan the care for other patients.
- C. Ask the patient's roommate not to discuss the event with other patients.
- D. Quickly discharge as many patients as possible to prevent panic.
Correct Answer: B
Rationale: 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.