Question 1

A nurse admitted a client to an inpatient unit after a suicide attempt. A health-care provider orders amitriptyline (Elavil) for the client. Which intervention related to this medication should be initiated to maintain this client's safety upon discharge?

Accepted Answer

Providing a 3-day supply of Elavil with refills contingent on follow-up appointments would be the best choice. This helps to ensure that the client continues to receive medication, but also allows for regular follow-up with a healthcare provider to monitor for any potential side effects or changes in the client's mental health status. Providing long-term supplies or pill dispensers may increase the risk of overdose or misuse, and avoiding foods containing tyramine is not directly related to the safe use of amitriptyline.

Question 2

Which is a correctly written, appropriate outcome for a client with a history of suicide attempts who is currently exhibiting symptoms of low self-esteem by isolating self?

Accepted Answer

Option A is too narrow and does not address the underlying issue of low self-esteem, while option C is a negative outcome and not appropriate to aim for. Option D is important but does not address the specific issue of low self-esteem leading to isolation. Option B is appropriate because it addresses the client's specific symptoms and focuses on building self-esteem and social connections.

Question 3

The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide?

Accepted Answer

The nurse should provide information on being available to actively listen, support, and accept the feelings of the family member after discharge. This can help the family feel supported and better equipped to care for their loved one. The other options do not provide helpful information and may potentially harm the client.

Question 4

A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse manager's best reply?

Accepted Answer

Suicide is a behavior, not a mental disorder or diagnosis. It is the act of intentionally taking one's own life. It can be a result of mental illness or various life stressors, but it is not classified as a mental disorder itself. "Antisocial affliction" is not an appropriate term to describe suicide.

Question 5

A stockbroker commits suicide after being convicted of insider trading. In speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information?

Accepted Answer

The nurse is offering information and support to the family that is appropriate and helpful for their situation by providing information about support groups for those who have lost a loved one to suicide. The other options are not appropriate or helpful suggestions for the family, and may even be harmful. Antidepressants should not be recommended without a thorough assessment by a healthcare provider, and it is not appropriate to give a timeline for grief or suggest that the family will "get over it" in a year. Writing a letter expressing anger may not be helpful or therapeutic for everyone, and may cause more harm than good. And finally, it is not helpful to suggest that the family should avoid discussing the suicide with anyone, as this can cause additional feelings of shame and isolation.

Question 6

A client diagnosed with major depressive disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. What should be the nurse's priority intervention at this time?

Accepted Answer

Placing the client on one-to-one observation while monitoring suicidal ideations is the priority intervention in this situation. This intervention ensures that the client is under constant supervision to prevent self-harm while also monitoring for suicidal ideations. Obtaining an order for locked seclusion may be necessary if the client becomes actively suicidal, but it is not the initial priority. Conducting 15-minute checks may not be frequent enough to prevent self-harm, and encouraging the client to express their feelings may not be effective unless the client agrees to safety planning.

Question 7

A nursing student is developing a plan of care for a suicidal client. Which documented intervention should the student implement first?

Accepted Answer

The first step in caring for a suicidal client is to assess their suicide risk. This allows the nurse to determine the appropriate interventions and level of care needed. Once the risk has been assessed, the nurse can then provide a hazard-free environment, observe the client's behaviors and communication, and communicate therapeutically as part of the overall plan of care.

Question 8

A nurse is caring for four clients diagnosed with major depressive disorder. When considering each client's belief system, the nurse should conclude which client would potentially be at highest risk for suicide?

Accepted Answer

Research has shown that individuals with no religious affiliation (such as atheists) may have a higher risk of suicide compared to those who identify with a particular religion. However, it is important to note that suicide risk is not solely based on religious affiliation and other factors such as severity of depression should also be considered.

Question 9

During the planning of care for a suicidal client, which correctly written outcome should be a nurse's first priority?

Accepted Answer

The answer of During the planning of care for a...

Question 10

A nurse is caring for a client who has threatened to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which information would determine the nurse's plan of care for this client?

Accepted Answer

The more specific the plan is, the more likely the client will attempt suicide. This indicates a higher risk and necessitates immediate intervention and close monitoring.

Question 11

A nurse discovers a client's suicide note that details the time, place, and means to commit suicide. What should be the priority nursing intervention and the rationale for this action?

Accepted Answer

Placing this client on one-to-one suicide precautions is the priority nursing intervention. The more specific the plan is, the more likely the client will attempt suicide. Therefore, the client needs to be closely monitored to prevent this from happening. Administering lorazepam or establishing room restrictions may not effectively address the situation and could potentially worsen the client's mental state. Calling an emergency treatment team meeting may be necessary but is not the priority nursing intervention.

Question 12

A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the most appropriate nursing reply?

Accepted Answer

This response acknowledges the client's feelings and shows empathy, which can help the client feel validated and heard. It also opens the door for further discussion and exploration of the client's emotions. Option A is not appropriate as it is suggesting a solution before fully understanding the client's situation. Option B focuses on negative aspects and could make the client feel worse. Option C minimizes the client's feelings and is not helpful in addressing their suicidal ideation.

Question 13

The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the team's decision?

Accepted Answer

The client's ability to participate in a plan for safety and the agreement of the family for constant observation indicate that the client may have adequate support and resources to prevent further suicidal ideation or attempts after discharge. The other options do not provide information relevant to the client's risk for suicide post-discharge.

Question 14

After years of dialysis, an 84-year-old states, "I'm exhausted, depressed, and done with these attempts to keep me alive." Which question should the nurse ask the spouse when preparing a discharge plan of care?

Accepted Answer

Knowing how often the patient is left alone can provide information on the need for additional support or caregiving arrangements. The other questions may be important to ask, but they do not directly address the patient's expressed desire to discontinue dialysis.

Question 15

During a one-to-one session with a client, the client states, "Nothing will ever get better," and "Nobody can help me." Which nursing diagnosis is most appropriate for a nurse to assign to this client at this time?

Accepted Answer

The client's statements indicate a lack of hope for the future, which aligns with the nursing diagnosis of hopelessness.

Question 16

A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred?

Accepted Answer

This statement accurately reflects a key statistic about suicide and indicates that the student has learned that suicide is not solely a result of mental illness or manipulation/attention-seeking behavior. The other options reflect common misconceptions about suicide that the instructor would need to correct.

Question 17

A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, rates mood at 9/10, and is much more communicative. Which action should be the nurse's priority at this time?

Accepted Answer

A sudden improvement in mood and affect can be a warning sign for suicidal clients, as it may indicate that they have made a decision to attempt suicide. Increasing the frequency of client observation can help to identify any potential suicidal ideation or behavior, and ensure the safety of the client. Off-unit privileges and sharing in group can be positive interventions, but safety should always be the top priority. Requesting a medication protocol evaluation may also be necessary, but it is not the priority action in this situation.

Question 18

Which nursing intervention strategy is most important to implement initially with a suicidal client?

Accepted Answer

Asking a direct question about suicidal thoughts is crucial to assess the immediate risk and ensure the client's safety.

Question 19

A nursing instructor is teaching about suicide in the elderly population. Which information should the instructor include?

Accepted Answer

Elderly individuals, despite being a smaller percentage of the population, account for a disproportionately higher percentage of suicides.

Question 20

A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide?

Accepted Answer

Observing the client at intervals determined by assessed data is the most appropriate intervention to lower the risk of suicide. This allows for close monitoring of the client's behavior and can help identify any warning signs of suicidal thoughts or behavior. Encouraging participation in the milieu, developing a strong personal relationship, and redirecting the client's thoughts are all important interventions, but do not directly address the client's risk for suicide.

Quiz 12: Suicide Prevention