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A person attempts suicide by overdose, is treated in the emergency department, and then hospitalized. What is the best initial patient outcome?
- A. Will verbalize a will to live by the end of the second hospital day.
- B. Can describe two new coping mechanisms by the end of the third hospital day.
- C. Accurately delineate personal strengths by the end of first week of hospitalization.
- D. Exercise suicide self-restraint by refraining from gestures or attempts to harm self for 24 hours.
Correct Answer: D
Rationale: Suicide self-restraint relates most directly to the priority problem of risk for suicide. The incorrect outcomes are related to hope, coping, and self-esteem.
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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.
A nurse uses the modified SAD PERSONS scale to interview a patient. This tool provides data relevant to assessing what?
- A. Current stress level
- B. Mood disturbance
- C. Suicide potential
- D. Level of anxiety
Correct Answer: C
Rationale: The modified SAD PERSONS tool evaluates major risk factors in suicide potential: sex, age, depression, previous attempt, ethanol use, rational thinking loss, stated future intent, organized plan, separated/widowed/divorced, and sickness. The tool does not have appropriate categories to provide information on the other options listed.
An adolescent tells the school nurse, 'My friend threatened to take an overdose of pills.' The nurse talks to the friend who verbalized the suicide threat. What is the most critical question for the nurse to ask?
- A. What makes you want to kill yourself?'
- B. Do you have access to medications?'
- C. Have you been taking drugs and alcohol?'
- D. Did something happen with your parents?'
Correct Answer: B
Rationale: The nurse must assess the patient's access to the means to carry out the plan and, if there is access, alert the parents to remove them from the home. The other questions may be important to ask but are not the most critical.
A nurse assesses a patient who reports a 3-week history of depression and crying spells. The patient says, 'My business is bankrupt, and I was served with divorce papers.' Which subsequent statement by the patient alerts the nurse to a concealed suicidal message?
- A. I wish I were dead.'
- B. Life is not worth living.'
- C. I have a plan that will fix everything.'
- D. My family will be better off without me.'
Correct Answer: C
Rationale: Verbal clues to suicide may be overt or covert. The incorrect options are overt references to suicide. The correct option is more veiled. It alludes to the patient's suicide as being a way to 'fix everything' but does not say it outright.
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.