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Four individuals have given information about their suicide plans. Which plan evidences the highest suicide risk?
- A. Jumping from a 100-foot-high railroad bridge located in a deserted area late at night
- B. Turning on the oven and letting gas escape into the apartment during the night
- C. Cutting the wrists in the bathroom while the spouse reads in the next room
- D. Overdosing on aspirin with codeine while the spouse is out with friends
Correct Answer: A
Rationale: This is a highly lethal method with little opportunity for rescue. The other options are lower lethality methods with higher rescue potential.
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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.
A college student failed two examinations. The student cried for hours and then tried to call a parent but got no answer. The student then suspended access to his social networking web site. Which suicide risk factors are present?
- A. History of earlier suicide attempt
- B. Co-occurring medical illness
- C. Recent stressful life event
- D. Self-imposed isolation
- E. Shame or humiliation
Correct Answer: C,D,E
Rationale: Failing examinations in the academic major constitutes a recent stressful life event. Shame and humiliation related to the failure can be hypothesized. The inability to contact parents can be seen as a recent lack of social support, as can the roommate's absence from the dormitory. Terminating access to one's social networking site represents self-imposed isolation. This scenario does not provide data regarding a history of an earlier suicide attempt, a family history of suicide, or of co-occurring medical illness.
An adult after an attempted suicide is hospitalized and takes an antidepressant medication for 5 days. The patient is now more talkative and shows increased energy. Select the highest priority nursing intervention.
- A. Supervise the patient 24 hours a day.
- B. Begin discharge planning for the patient.
- C. Refer the patient to art and music therapists.
- D. Consider the discontinuation of suicide precautions.
Correct Answer: A
Rationale: The patient now has more energy and may have decided on suicide, especially considering the history of the prior suicide attempt. The patient is still a suicide risk; therefore, continuous supervision is indicated. None of the remaining options provides the safety interventions required.
When assessing a patient's plan for suicide, what aspect has priority?
- A. Patient's financial and educational status
- B. Patient's insight into suicidal motivation
- C. Availability of means and lethality of method
- D. Quality and availability of patient's social support
Correct Answer: C
Rationale: If a person has definite plans that include choosing a method of suicide readily available, and if the method is one that is lethal (i.e., will cause the person to die with little probability for intervention), the suicide risk is considered high. These areas provide a better indication of risk than the areas mentioned in the other options.
A tearful, anxious patient at the outpatient clinic reports, 'I should be dead.' The initial task of the nurse conducting the assessment interview is to focus on what?
- A. Assessing the lethality of any suicide plan
- B. Encouraging expression of anger
- C. Establishing a rapport with the patient
- D. Determining risk factors for suicide
Correct Answer: C
Rationale: Establishing rapport will allow the nurse to obtain relevant assessment data such as the presence of a suicide plan, the lethality of a suicide plan, and the presence of risk factors for suicide.