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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.
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What is the most helpful response for a nurse to make when a patient being treated as an outpatient states, 'I am considering suicide.'?
- A. I'm glad you shared this. Please do not worry. We will handle it together.'
- B. I think you should admit yourself to the hospital to get help.'
- C. We need to talk about the good things you have to live for.'
- D. Bringing this up is a very positive action on your part.'
Correct Answer: D
Rationale: This response gives the patient reinforcement and validation for making a positive response rather than acting out the suicidal impulse. It gives neither advice nor false reassurance, and it does not imply stereotypes such as, 'You have a lot to live for.' It uses the patient's ambivalence and sets the stage for more realistic problem-solving strategies.
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.
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 patient with suicidal impulses is on the highest level of suicide precautions. Which measures should the nurse incorporate into the patient's plan of care?
- A. Allow no glass or metal on meal trays.
- B. Remove all potentially harmful objects from the patient's possession.
- C. Maintain arm's length, one-on-one nursing observation around the clock.
- D. Check the patient's whereabouts every hour. Make verbal contact at least three times each shift.
- E. Check the patient's whereabouts every 15 minutes and make frequent verbal contacts.
- F. Keep the patient within visual range while he or she is awake. Check every 15 to 30 minutes while the patient is sleeping.
Correct Answer: A,B,C
Rationale: One-on-one observation is necessary for anyone who has limited control over suicidal impulses. Plastic dishes on trays and the removal of potentially harmful objects from the patient's possession are measures included in any level of suicide precautions. The remaining options are used in less stringent levels of suicide precautions.
A nurse assesses the health status of soldiers returning from a war zone. Screening for which health problems will be a priority?
- A. Schizophrenia
- B. Eating disorder
- C. Traumatic brain injury
- D. Oppositional defiant disorder
- E. Posttraumatic stress disorder
Correct Answer: C,E
Rationale: The incidence of TBI is very high in veterans and this problem is associated with an increased risk of dying by suicide compared with people without brain injuries. Many soldiers also have posttraumatic stress disorder, which contributes to increased suicide risk. The incidence of disorders identified in the distractors would be expected to parallel the general population.