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When assessing a patient's plan for suicide, what aspect has priority?
- A. Patient's financial and educational status
- B. Patient's insight into suicidal motivation
- C. Availability of means and lethality of method
- D. Quality and availability of patient's social support
Correct Answer: C
Rationale: If a person has definite plans that include choosing a method of suicide readily available, and if the method is one that is lethal (i.e., will cause the person to die with little probability for intervention), the suicide risk is considered high. These areas provide a better indication of risk than the areas mentioned in the other options.
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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.
Which individual in the emergency department should be considered at the highest risk for completing suicide?
- A. An adolescent Asian-American girl with superior athletic and academic skills who has asthma
- B. A 38-year-old single African-American female church member with fibrocystic breast disease
- C. A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes
- D. A 79-year-old single white man with cancer of the prostate gland
Correct Answer: D
Rationale: High risk factors include being an older adult, single, and male and having a co-occurring medical illness. Cancer is one of the somatic conditions associated with increased suicide risk. Protective factors for African-American women and Hispanic individuals include strong religious and family ties. Asian Americans have a suicide rate that increases with age.
A nurse answers a suicide crisis line. A caller says, 'I live alone in a home several miles from my nearest neighbors. I have been considering suicide for 2 months. I have had several drinks and now my gun is loaded. I'm going to shoot myself in the heart.' How would the nurse assess the lethality of this plan?
- A. No risk
- B. Low level
- C. Moderate level
- D. High level
Correct Answer: D
Rationale: The patient has a highly detailed plan, a highly lethal method, the means to carry it out, lowered impulse control because of alcohol ingestion, and a low potential for rescue.
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.
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.