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A patient comes??5comes to the clinic for an evaluation of headache, fatigue, and an overall feeling of being down. When assessing the patient, which statement by the patient would alert the nurse to suspect possible suicide? Select all that apply.
- A. I?ve been drinking about three or four more beers every night.
- B. I?ve been going out with my friends about once or twice a week.
- C. I?m so tired that all I ever want to do is sleep all the time.
- D. Most times, I feel like I?m trapped with no way out.
- E. I?m looking for a new job because my job is so stressful.
Correct Answer: C,D
Rationale: Statements indicating excessive sleepiness (C) and feeling trapped with no way out (D) are red flags for suicide risk, as they suggest severe depression and hopelessness, respectively. Increased alcohol use (A) is a risk factor but less specific without direct suicidal content. Socializing (B) and job stress (E) are not direct indicators of suicidal ideation.
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The nurse is providing a presentation for a group of health professionals about suicide. Which of the following would the nurse address as a major contributing factor to the rising suicide rate among men?
- A. Substance abuse
- B. Media influences
- C. Lack of conflict resolution skills
- D. Parenting practices
Correct Answer: A
Rationale: Substance abuse (A) is a major contributing factor to the rising suicide rate among men, as it exacerbates mental health issues, impairs judgment, and increases impulsivity, all of which heighten suicide risk. Media influences (B), lack of conflict resolution skills (C), and parenting practices (D) may contribute indirectly but are less significant compared to substance abuse.
The nurse is caring for a group of hospitalized patients with various psychiatric diagnoses. The nurse identifies which patient as having the greatest risk for a suicide attempt?
- A. Man with bipolar I disorder
- B. Woman with acute stress disorder
- C. Man with major depressive disorder
- D. Woman with somatoform disorder
Correct Answer: C
Rationale: Major depressive disorder is strongly associated with a high risk of suicide due to persistent feelings of hopelessness, worthlessness, and despair, which are core symptoms. Studies indicate that individuals with major depressive disorder have a significantly higher suicide risk compared to other psychiatric conditions. Bipolar I disorder (A) carries a risk, particularly during depressive episodes, but the risk is generally lower than in major depressive disorder. Acute stress disorder (B) is typically short-term and less associated with suicide. Somatoform disorder (D) focuses on physical symptoms and has a lower direct link to suicide.
After teaching a class about factors that enhance the risk of suicide, the instructor determines the need for additional teaching when the class identifies which of the following?
- A. Family member committing suicide
- B. Cautiousness
- C. Delusions
- D. Loss
Correct Answer: B
Rationale: Cautiousness (B) is not a recognized risk factor for suicide; it may even be protective by reducing impulsivity. Family history of suicide (A), delusions (C), and loss (D) are established risk factors, as they contribute to genetic predisposition, altered thinking, and emotional distress, respectively.
A patient was admitted to the psychiatric unit 3 days ago because of suicidal ideation. His suicidal risk has lessened considerably, and he currently denies having any desire to kill himself. In addition, he is able to identify reasons why he wants to be alive. Which nursing intervention would be most appropriate at this time?
- A. Assigning nursing staff to stay with him during his suicidal crisis
- B. Developing a personal plan for managing suicidal thoughts when they occur
- C. Advising the patient that he should consider electroconvulsive therapy treatments
- D. Administering psychotropic drugs that decrease the patient?s serotonin levels
Correct Answer: B
Rationale: Since the patient?s risk has decreased and he is identifying reasons to live, developing a personal plan for managing suicidal thoughts (B) is appropriate to empower him and prevent future crises. Constant supervision (A) is unnecessary given the reduced risk. Electroconvulsive therapy (C) is not indicated without severe, treatment-resistant depression. Decreasing serotonin (D) would worsen depression.
The nurse is working with a patient who will be signing a commitment to treatment statement. After teaching the patient about this statement, the nurse determines the need for additional instruction when the patient states which of the following?
- A. Signing this statement means that I will not commit suicide.
- B. I am agreeing to get emergency treatment if I have suicidal thoughts.
- C. I will be open and honest about my feelings about treatment.
- D. I am agreeing to participate in the necessary treatment for my condition
Correct Answer: A
Rationale: A commitment to treatment statement is a collaborative agreement to engage in treatment and seek help, not a promise not to commit suicide (A), which is unrealistic and oversimplifies the patient?s responsibility. Options B, C, and D accurately reflect components of such a statement.