Nokea
The parents of identical twins ask a nurse for advice when one twin committed suicide a month ago. Now the parents are concerned that the other twin may also have suicidal tendencies. Which comment by the nurse is accurate?
- A. Genetics are associated with suicide risk. Monitoring and support are important.'
- B. Apathy underlies suicide. Instilling motivation is the key to health maintenance.'
- C. Your child is unlikely to act out suicide when identifying with a suicide victim.'
- D. Fraternal twins are at higher risk for suicide than identical twins.'
Correct Answer: A
Rationale: Twin studies suggest the presence of genetic factors in suicide; however, separating genetic predisposition to suicide from predisposition to depression or alcoholism is difficult. Primary interventions can be helpful in promoting and maintaining health and possibly counteracting the genetic load. The incorrect options are untrue statements or oversimplifications.
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Which understanding about individuals who attempt suicide will help a nurse plan the care for a suicidal patient?
- A. Every suicidal person is mentally ill.
- B. Every suicidal person is intent on dying.
- C. Every suicidal person is cognitively impaired.
- D. Every suicidal person experiencing hopelessness.
Correct Answer: D
Rationale: Hopelessness is the characteristic common among people who attempt suicide. The incorrect options reflect myths about suicide. Not all who attempt suicide are intent on dying. Not all are mentally ill or cognitively impaired.
Which statement provides the best rationale for why a nurse should closely monitor a severely depressed patient during antidepressant medication therapy?
- A. As depression lifts, physical energy becomes available to carry out suicide.
- B. Suicide may be precipitated by a variety of internal and external events.
- C. Suicidal patients have difficulty using social supports.
- D. Suicide is an impulsive act.
Correct Answer: A
Rationale: Antidepressant medication has the objective of relieving depression. The risk for suicide is greater as the depression lifts, primarily because the patient has more physical energy at a time when he or she may still have suicidal ideation. The other options have little to do with nursing interventions relating to antidepressant medication therapy.
After failing two tests, a college student cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate. Which behavior provides the strongest clue of an impending suicide attempt?
- A. Calling parents
- B. Excessive crying
- C. Giving away sweaters
- D. Staying alone in a dorm room
Correct Answer: C
Rationale: Giving away prized possessions may signal that the individual thinks he or she will have no further need for the items, such as when a suicide plan has been formulated. Calling parents and crying do not provide clues to suicide, in and of themselves. Remaining in the dormitory would be an expected behavior because the student has nowhere else to go.
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.
A nurse and patient construct a no-suicide contract. Select the preferable wording for the contract.
- A. I will not try to harm myself during the next 24 hours.'
- B. I will not make a suicide attempt while I am hospitalized.'
- C. For the next 24 hours, I will discuss any thoughts of killing or harming myself with staff.'
- D. I will not kill myself until I call my primary nurse or a member of the staff.'
Correct Answer: C
Rationale: The correct answer leaves no loopholes. The wording about not harming oneself and not making an attempt leaves loopholes or can be ignored by the patient who thinks, 'I am not going to harm myself, I am going to kill myself,' or 'I am not going to attempt suicide, I am going to commit suicide.' A patient may call a therapist and leave the telephone to carry out the suicidal plan.