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What feeling experienced by a patient should be assessed by the nurse as most predictive of elevated suicide risk?
- A. Hopelessness
- B. Sadness
- C. Anxiety
- D. Anger
Correct Answer: A
Rationale: Of the feelings listed, hopelessness is most closely associated with increased suicide risk. Depression, aggression, impulsivity, and shame are other feelings noted as risk factors for suicide.
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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.
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.
A nurse uses the modified SAD PERSONS scale to interview a patient. This tool provides data relevant to assessing what?
- A. Current stress level
- B. Mood disturbance
- C. Suicide potential
- D. Level of anxiety
Correct Answer: C
Rationale: The modified SAD PERSONS tool evaluates major risk factors in suicide potential: sex, age, depression, previous attempt, ethanol use, rational thinking loss, stated future intent, organized plan, separated/widowed/divorced, and sickness. The tool does not have appropriate categories to provide information on the other options listed.
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.
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.