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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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A nurse has just completed a suicide risk assessment of a 76-year-old widowed man. In addition to documenting the presence or absence of suicidal thoughts, plan, and means, the nurse would also document which of the following?
- A. Use of substances 6 hours before the assessment
- B. Speech patterns
- C. Availability of support resources
- D. Amount of sleep in past 24 hours
Correct Answer: C
Rationale: Documenting the availability of support resources (C) is essential in a suicide risk assessment, as social support is a key protective factor that can mitigate risk. Substance use (A), speech patterns (B), and sleep (D) may be relevant but are less directly tied to risk assessment compared to support resources.
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.
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 group of nursing students is reviewing information about suicide and associated concepts. The group demonstrates understanding of the information when they identify which of the following as the probability that a person will successfully complete suicide?
- A. Parasuicide
- B. Suicidal ideation
- C. Suicidality
- D. Lethality
Correct Answer: D
Rationale: Lethality (D) refers to the probability that a person will successfully complete suicide, based on the method?s potential to cause death. Parasuicide (A) involves nonfatal acts, suicidal ideation (B) is thoughts of suicide, and suicidality (C) is a broader term encompassing suicidal thoughts and behaviors.
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.