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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 nurse is reviewing the medical record of a patient who has attempted suicide. Which of the following would the nurse identify as relating to a psychological cause?
- A. History of childhood trauma
- B. Cluster B personality disorder
- C. Social isolation
- D. Suicide contagion
Correct Answer: B
Rationale: Cluster B personality disorder (B), such as borderline or antisocial personality disorder, is a psychological cause of suicide risk due to emotional instability and impulsivity. Childhood trauma (A) is a historical or environmental factor, social isolation (C) is a social factor, and suicide contagion (D) is an external influence, not a psychological cause.
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.
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.
The nurse is caring for a 30-year-old white man whose wife has recently died. The patient has been diagnosed with clinical depression and is demonstrating insufficient coping skills. Which action by the nurse would be most important?
- A. Refer the patient for long-term psychotherapy.
- B. Determine the patient?s risk of psychosis.
- C. Determine if anyone in the patient?s family has had depression.
- D. Ask the patient if he is thinking about killing himself.
Correct Answer: D
Rationale: Given the recent loss and diagnosis of clinical depression, assessing for suicidal ideation (D) is the most critical action to ensure patient safety, as loss and depression are significant suicide risk factors. Psychotherapy referral (A) is important but not immediate. Assessing for psychosis (B) or family history (C) is relevant but secondary to suicide risk assessment.
After teaching a group of students about the various concepts involving suicide, the instructor determines that the teaching was successful when the students describe parasuicide as which of the following?
- A. Voluntary act of killing oneself
- B. All suicide-related behaviors and suicidal thoughts
- C. Nonfatal act with the intent to die
- D. Voluntary attempt without death as the aim
Correct Answer: D
Rationale: Parasuicide (D) refers to intentional self-harm without the aim of death, distinguishing it from suicide (A), suicidality (B), or nonfatal acts with lethal intent (C). It often serves as a coping mechanism or cry for help.