Nokea
The nurse determines that a patient is at imminent risk for suicide. Which of the following would be least appropriate to include in the patient?s plan of care?
- A. Listening intently and nonjudgmentally
- B. Validating the patient?s feelings and experience
- C. Instituting strict restriction on the patient?s activity
- D. Using cognitive interventions to foster hope
Correct Answer: C
Rationale: Strict activity restriction (C) is least appropriate for a patient at imminent suicide risk unless there is an immediate safety threat requiring such measures. Listening (A), validating feelings (B), and cognitive interventions (D) are therapeutic and supportive, aligning with best practices for managing suicidal patients.
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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.
The nurse is providing a presentation for a group of health professionals about suicide. Which of the following would the nurse address as a major contributing factor to the rising suicide rate among men?
- A. Substance abuse
- B. Media influences
- C. Lack of conflict resolution skills
- D. Parenting practices
Correct Answer: A
Rationale: Substance abuse (A) is a major contributing factor to the rising suicide rate among men, as it exacerbates mental health issues, impairs judgment, and increases impulsivity, all of which heighten suicide risk. Media influences (B), lack of conflict resolution skills (C), and parenting practices (D) may contribute indirectly but are less significant compared to substance abuse.
A nurse is completing an admission assessment of a young adult woman who has a history of depression and who was brought to the hospital by her boyfriend. In response to the nurse?s question regarding suicidal ideation, the patient discloses that she is thinking about killing herself. Which question would be most appropriate for the nurse to ask next?
- A. What does your boyfriend think about your desire to kill yourself?
- B. What are your spiritual beliefs about suicide?
- C. What will killing yourself accomplish?
- D. What thoughts have you had about how you would kill yourself?
Correct Answer: D
Rationale: When a patient expresses suicidal ideation, the nurse?s priority is to assess the specificity and immediacy of the risk by inquiring about a plan, as this indicates the degree of intent and potential lethality. Asking about specific thoughts on how the patient would kill herself (D) is critical for risk assessment. Options A, B, and C, while potentially relevant later, do not directly assess the immediate risk or plan.
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.
The nurse is working with a patient who will be signing a commitment to treatment statement. After teaching the patient about this statement, the nurse determines the need for additional instruction when the patient states which of the following?
- A. Signing this statement means that I will not commit suicide.
- B. I am agreeing to get emergency treatment if I have suicidal thoughts.
- C. I will be open and honest about my feelings about treatment.
- D. I am agreeing to participate in the necessary treatment for my condition
Correct Answer: A
Rationale: A commitment to treatment statement is a collaborative agreement to engage in treatment and seek help, not a promise not to commit suicide (A), which is unrealistic and oversimplifies the patient?s responsibility. Options B, C, and D accurately reflect components of such a statement.