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Which statement by a patient during an assessment interview should alert the nurse to the patient's need for immediate, active intervention?
- A. I am mixed up, but I know I need help.'
- B. I have no one for help or support.'
- C. It is worse when you are a person of color.'
- D. I tried to get attention before I shot myself.'
Correct Answer: B
Rationale: Lack of social support and social isolation increase the suicide risk. The willingness to seek help lowers the risk. Being a person of color does not suggest a higher risk; more whites commit suicide than do individuals of other racial groups. Attention seeking is not correlated with a higher risk of suicide.
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A patient recently hospitalized for 2 weeks committed suicide during the night. Which initial measure will be most helpful for staff members and other patients regarding this event?
- A. Request the public information officer to address inquiries from the local media.
- B. Hold a staff meeting to express feelings and plan the care for other patients.
- C. Ask the patient's roommate not to discuss the event with other patients.
- D. Quickly discharge as many patients as possible to prevent panic.
Correct Answer: B
Rationale: Interventions should be aimed at helping the staff and patients come to terms with the loss and to grow because of the incident. Then, a community meeting should be scheduled to allow other patients to express their feelings and request help. Staff members should be prepared to provide additional support and reassurance to patients and should seek opportunities for peer support. The incorrect options will not control information or may result in unsafe care.
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.
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.
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 nurse counsels a patient with recent suicidal ideation. Which is the nurse's most therapeutic comment?
- A. Let's make a list of all your problems and think of solutions for each one.'
- B. I'm happy you're taking control of your problems and trying to find solutions.'
- C. When you have bad feelings, try to focus on positive experiences from your life.'
- D. Let's consider which problems are most important and focus on discussing them.'
Correct Answer: D
Rationale: The nurse helps the patient develop effective coping skills. He or she assists the patient to reduce the overwhelming effects of problems by prioritizing them. The incorrect options continue to present overwhelming approaches to problem solving.