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Which intervention should a nurse recommend for the distressed family and friends of someone who has successfully committed suicide?
- A. Participating in reminiscence therapy
- B. Attending a self-help group for survivors
- C. Contracting for two sessions of group therapy
- D. Completing a psychological postmortem assessment
Correct Answer: B
Rationale: Survivors need outlets for their feelings about the loss and the deceased person. Self-help groups provide peer support while survivors work through feelings of loss, anger, and guilt. Psychological postmortem assessment would not provide the support necessary to work through feelings of loss associated with the suicide of a family member. Reminiscence therapy is not geared to loss resolution. Contracting for two sessions of group therapy would probably not provide sufficient time to work through the issues associated with a death by suicide.
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An adolescent tells the school nurse, 'My friend threatened to take an overdose of pills.' The nurse talks to the friend who verbalized the suicide threat. What is the most critical question for the nurse to ask?
- A. What makes you want to kill yourself?'
- B. Do you have access to medications?'
- C. Have you been taking drugs and alcohol?'
- D. Did something happen with your parents?'
Correct Answer: B
Rationale: The nurse must assess the patient's access to the means to carry out the plan and, if there is access, alert the parents to remove them from the home. The other questions may be important to ask but are not the most critical.
When a person intentionally overdoses on antidepressant drugs, which nursing diagnosis has the highest priority?
- A. Powerlessness
- B. Social isolation
- C. Risk for suicide
- D. Ineffective management of the therapeutic regimen
Correct Answer: C
Rationale: This diagnosis is the only one with life-or-death ramifications and is therefore higher in priority than the other options.
A depressed patient says, 'Nothing matters anymore.' What is the most appropriate response by the nurse?
- A. Are you having thoughts of suicide?'
- B. I am not sure I understand what you are trying to say.'
- C. Try to stay hopeful. Things have a way of working out.'
- D. Tell me more about what interested you before you began feeling depressed.'
Correct Answer: A
Rationale: The nurse must make overt what is covert; that is, the possibility of suicide must be openly addressed. Often, patients feel relieved to be able to talk about suicidal ideation.
An adult after an attempted suicide is hospitalized and takes an antidepressant medication for 5 days. The patient is now more talkative and shows increased energy. Select the highest priority nursing intervention.
- A. Supervise the patient 24 hours a day.
- B. Begin discharge planning for the patient.
- C. Refer the patient to art and music therapists.
- D. Consider the discontinuation of suicide precautions.
Correct Answer: A
Rationale: The patient now has more energy and may have decided on suicide, especially considering the history of the prior suicide attempt. The patient is still a suicide risk; therefore, continuous supervision is indicated. None of the remaining options provides the safety interventions required.
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.