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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.
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A patient who has attempted suicide has an underlying diagnosis of depression. Which of the following would the nurse anticipate being ordered for the patient?
- A. Selective serotonin reuptake inhibitor
- B. Mood stabilizer
- C. Tricyclic antidepressant
- D. Atypical antipsychotic
Correct Answer: A
Rationale: Selective serotonin reuptake inhibitors (SSRIs) (A) are first-line treatments for depression due to their efficacy and favorable side-effect profile. Mood stabilizers (B) are used for bipolar disorder, tricyclic antidepressants (C) are less commonly used due to side effects, and atypical antipsychotics (D) are not primary treatments for depression.
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.
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.
A nurse is with an adolescent who tells the nurse that she has nothing to live for and she just wishes she was dead. Which nursing action would be the priority?
- A. Going to the patient?s psychiatrist to tell him of the girl?s suicidal ideation
- B. Staying with the patient to explore more of her thoughts about suicide
- C. Putting the patient in seclusion with a staff assigned to watch her at all times
- D. Ascertaining the client?s beliefs about what happens when you die
Correct Answer: B
Rationale: The priority is to ensure the patient?s safety by staying with her and exploring her suicidal thoughts (B), which allows for immediate risk assessment and therapeutic engagement. Notifying the psychiatrist (A) is important but secondary to direct patient contact. Seclusion (C) is inappropriate unless the patient poses an immediate danger, and exploring beliefs about death (D) is less urgent than assessing current risk.
A family member of an adolescent who has expressed a desire to commit suicide asks the nurse, What might predict the possibility of future suicide attempts? Which of the following would the nurse include in the response?
- A. Unemployment
- B. Death of a spouse
- C. Previous suicide attempt
- D. Polydrug use
Correct Answer: C
Rationale: A previous suicide attempt is the strongest predictor of future suicide attempts, as it indicates a history of engaging in life-threatening behavior and suggests persistent suicidal ideation or unresolved risk factors. While unemployment (A), death of a spouse (B), and polydrug use (D) are risk factors, they are less specific predictors compared to a documented prior attempt.