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Which change in brain biochemical function is most associated with suicidal behavior?
- A. Dopamine excess
- B. Serotonin deficiency
- C. Acetylcholine excess
- D. Gamma-aminobutyric acid deficiency
Correct Answer: B
Rationale: Research suggests that low levels of serotonin may play a role in the decision to commit suicide. The other neurotransmitter alterations have not been implicated in suicidal crises.
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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.
A nurse assesses five newly hospitalized patients. Which patients have the highest suicide risk?
- A. An 82-year-old white man
- B. A 17-year-old white female adolescent
- C. A 39-year-old African-American man
- D. A 29-year-old African-American woman
- E. A 22-year-old man with a traumatic brain injury
Correct Answer: A,B,E
Rationale: Whites have suicide rates almost twice those of nonwhites, and the rate is particularly high for older adult men, adolescents, and young adults. Other high-risk groups include young African-American men, Native-American men, older Asian Americans, and persons with traumatic brain injury.
A person attempts suicide by overdose, is treated in the emergency department, and then hospitalized. What is the best initial patient outcome?
- A. Will verbalize a will to live by the end of the second hospital day.
- B. Can describe two new coping mechanisms by the end of the third hospital day.
- C. Accurately delineate personal strengths by the end of first week of hospitalization.
- D. Exercise suicide self-restraint by refraining from gestures or attempts to harm self for 24 hours.
Correct Answer: D
Rationale: Suicide self-restraint relates most directly to the priority problem of risk for suicide. The incorrect outcomes are related to hope, coping, and self-esteem.
A staff nurse tells another nurse, 'I evaluated a new patient using the modified SAD PERSONS scale and got a score of 10. I'm wondering if I should send the patient home.' Select the best reply by the second nurse.
- A. That action would seem appropriate.'
- B. A score over 8 requires immediate hospitalization.'
- C. I think you should strongly consider hospitalization for this patient.'
- D. Give the patient a follow-up appointment. Hospitalization may be needed soon.'
Correct Answer: B
Rationale: The modified SAD PERSONS scale score of 0 to 5 suggests home care with follow-up. A score of 6 to 8 requires psychiatric consultation. A score over 8 calls for hospitalization.
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.