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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.
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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.
The nurse is reviewing the medical records of several patients diagnosed with major depression. The nurse identifies which patient as least likely to commit suicide?
- A. Divorced man
- B. Widowed woman
- C. Single woman
- D. Married man
Correct Answer: D
Rationale: Social support, particularly from a stable marital relationship, is a protective factor against suicide. A married man (D) is likely to have more social and emotional support, reducing suicide risk compared to those who are divorced (A), widowed (B), or single (C), who may experience greater isolation or loss, increasing vulnerability to suicidal behavior in the context of major depression.
A nurse determines that a patient has poor social skills that have interfered with his ability to engage others, which has contributed to his feelings of purposelessness, hopelessness, and withdrawal. Which of the following would be most important to assist the patient in beginning to social skills?
- A. Self-help group
- B. Recovery group
- C. Nurse-patient relationship
- D. Limit setting
Correct Answer: C
Rationale: The nurse-patient relationship (C) provides a safe, therapeutic environment to model and practice social skills, addressing the patient?s isolation and hopelessness. Self-help (A) and recovery groups (B) are beneficial but less individualized, while limit setting (D) is unrelated to social skill development.
A nurse is performing an assessment of a patient with suicidal ideation. Which question would the nurse most likely ask to determine the degree of planning?
- A. How seriously do you want to die?
- B. Have you attempted suicide before?
- C. Could you stop yourself from killing yourself?
- D. How much do the thoughts distress you?
Correct Answer: C
Rationale: Asking if the patient could stop themselves from killing themselves (C) directly assesses the degree of control and planning, indicating the specificity of their suicidal intent. Other options (A, B, D) provide related information but do not specifically address the plan?s feasibility.
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.