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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.
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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 depressed patient says, 'Nothing matters anymore.' What is the most appropriate response by the nurse?
- A. Are you having thoughts of suicide?'
- B. I am not sure I understand what you are trying to say.'
- C. Try to stay hopeful. Things have a way of working out.'
- D. Tell me more about what interested you before you began feeling depressed.'
Correct Answer: A
Rationale: The nurse must make overt what is covert; that is, the possibility of suicide must be openly addressed. Often, patients feel relieved to be able to talk about suicidal ideation.
What is the most helpful response for a nurse to make when a patient being treated as an outpatient states, 'I am considering suicide.'?
- A. I'm glad you shared this. Please do not worry. We will handle it together.'
- B. I think you should admit yourself to the hospital to get help.'
- C. We need to talk about the good things you have to live for.'
- D. Bringing this up is a very positive action on your part.'
Correct Answer: D
Rationale: This response gives the patient reinforcement and validation for making a positive response rather than acting out the suicidal impulse. It gives neither advice nor false reassurance, and it does not imply stereotypes such as, 'You have a lot to live for.' It uses the patient's ambivalence and sets the stage for more realistic problem-solving strategies.
Which understanding about individuals who attempt suicide will help a nurse plan the care for a suicidal patient?
- A. Every suicidal person is mentally ill.
- B. Every suicidal person is intent on dying.
- C. Every suicidal person is cognitively impaired.
- D. Every suicidal person experiencing hopelessness.
Correct Answer: D
Rationale: Hopelessness is the characteristic common among people who attempt suicide. The incorrect options reflect myths about suicide. Not all who attempt suicide are intent on dying. Not all are mentally ill or cognitively impaired.
A nurse assesses the health status of soldiers returning from a war zone. Screening for which health problems will be a priority?
- A. Schizophrenia
- B. Eating disorder
- C. Traumatic brain injury
- D. Oppositional defiant disorder
- E. Posttraumatic stress disorder
Correct Answer: C,E
Rationale: The incidence of TBI is very high in veterans and this problem is associated with an increased risk of dying by suicide compared with people without brain injuries. Many soldiers also have posttraumatic stress disorder, which contributes to increased suicide risk. The incidence of disorders identified in the distractors would be expected to parallel the general population.