Ch 16 (Suicide): pre-lecture quiz & chapter quiz

The nurse is conducting an interview with an adult client who is being treated for major depression. What question should the nurse prioritize in an effort to determine the client's risk for suicide?

"Do you ever feel like your situation is hopeless?"

Which question should the nurse ask to assess the client's degree of suicide planning when the client states, "Everyone would be better off without me. I will just use my gun to end it all!"?

"Do you have access to a firearm?"

A psychiatric nurse's colleague has expressed a reluctance to assess a client's risk for suicide, stating, "The last thing I want to do is to plant the thought in the client's head and bring on a suicide attempt." What is the nurse's best response?

"Evidence shows that talking about suicide with clients doesn't cause suicide attempts."

The nurse is providing care for a client who deliberately overdosed on acetaminophen several days ago. The nurse should assess the current severity of the client's suicidal ideation by asking what question?

"How often are you having thoughts about suicide this morning?"

The nurse provides care for a client who is depressed and expresses hopelessness with the current situation. Which client statement indicates a need to implement safety precautions?

"I haven't been able to sleep for the past week because I am anxious."

The nurse is seeing a client for counselling in a mental health clinic. The nurse notes the client has new superficial cuts to the inside of the upper forearm. Which is the best way for the nurse to discuss this observation with the client?

"I notice some cuts on your arm. Am I correct to think that things have been difficult?"

A psychiatric-mental health nurse is conducting an in-service education program about suicide for a group of nurses working at a community mental health center. The nurse determines that the teaching was successful based on which statement by the group?

"Suicide has profound effects on those connected to the individual."

A client with a diagnosis of depression tells the nurse that the client's mood was especially bad this morning but that the client pushed through it to attend a support group. How can the nurse best validate the client?

"That shows an admirable level of perseverance on your part. Well done!"

When conducting a suicide risk assessment with a client, the nurse should identify the client as a high imminent risk if which statement is made?

"There are no solutions to my problems."

The nurse is assessing a client with depression and a colleague suggests that the client be encouraged to sign a no-suicide contract. What is the nurse's best response to the colleague?

"There's no demonstrated benefit of no-suicide contracts, though they're not believed to be harmful."

The nurse is facilitating a support group for people who have lost a family member or friend to suicide. When discussing strategies for coping with grief, which should the nurse include? Select all that apply.

-Completing a daily journal entry before bedtime -Writing out the events leading up to the loved one's suicide -Cognitive behavioral therapy

Family education concerning the safe care of a client with a history of suicide attempts includes what? Select all that apply.

-Signs and symptoms that indicate a mood change that could indicate the client is suicidal -Techniques to help the client cope with known triggers -Information regarding the stressors that trigger the client's suicidal ideations -List of emergency service telephone numbers

A psychiatric mental health nurse is using the IS PATH WARM mnemonic in order to assess a client for warning signs of suicide. Within this framework, what assessment findings should the nurse document? Select all that apply.

-The client states that she frequently experiences insomnia -The client has recently exhibited impulsive behavior -The client states that she often "turns to the bottle"

When conducting a risk assessment for suicide, the nurse most likely identifies which client as having the greatest risk for completing suicide?

A 50-year-old male client who lives on a farm outside the city

The nurse is working in a psychiatric-mental health facility and assessing the clients' risk for suicidal behaviors. Which client would be at highest risk?

A client with schizophrenia who has had a previous suicide attempt

The nurse is preparing a community education session on suicide awareness. Which point should the nurse include in the presentation?

A firearm in the home increases the risk that a person will complete suicide.

The nurse who is conducting a suicide risk assessment with a client determines the lethality of the plan is as high if which condition is present?

A male client keeps a loaded firearm in the closet

A psychiatric-mental health nurse performs weekly visits to a youth center. The nurse should recognize the highest risk of suicide among what client of the center?

A teenage boy who is often bullied after disclosing that he is gay

The community mental health nurse is providing care for a large number of clients. What client should the nurse monitor most closely for the warning signs of suicide?

A young male with schizophrenia who is in danger of becoming homeless

The nurse is told by a client that the client is having suicidal thoughts. Which intervention has lowest priority?

Administering a mental status exam to assess for psychosis

The nurse conducts a seminar regarding suicide at the community center. Which fact about suicide should the nurse include in the teaching session?

An active suicidal ideation is often short term and specific to the situation

The parent of a suicidal adolescent is concerned that "only crazy people commit suicide." When helping the parent understand a daughter's suicidal behavior, the nurse would explain what?

Analysis of suicide notes reveals that most people who commit suicide are extremely unhappy.

The nurse caring for a client who is high risk for suicide on a psychiatric inpatient unit can help the client re-establish a sense of control by including what in the client's care?

Asking the client about diet preferences for meals

When it is noted in the medical record that the client is diagnosed as parasuicidal, which of the following is the most effective nursing intervention?

Assess the client for indications of self-induced injuries

The policies and procedures at a community psychiatric-mental health center include an emphasis on case finding. How can a nurse at the center best perform case finding?

Assessing all clients carefully to identify those at risk for suicide

The nurse has been asked to assess a client to determine if the client has a suicide plan. Which question would assist the nurse in assessing this area?

"Are you thinking about killing yourself right now?"

A nurse is assessing a client who has a previous history of suicide attempts. The nurse is applying the IS PATH WARM mnemonic. When addressing the "S" within this framework, the nurse should document what finding?

"Client states that he drinks between one and two bottles of wine daily."

A client has just been admitted to the inpatient psychiatry unit following a suicide attempt. During the client's first 24 hours of care, what outcome should be identified?

Client will express that the client feels safe on the unit

Which psychiatric medication is most protective against suicidal thinking and behavior for clients with schizophrenia?

Clozapine

A recent sentinel event involving a suicide attempt on a psychiatric-mental health unit has prompted a reevaluation of practices on the unit. What action is most likely to reduce the incidence of suicide on the unit.

Conducting a survey the unit facilities and practices to ensure items that can be used for hanging are unavailable

A client with a diagnosis of schizophrenia has been admitted to the psychiatric mental health unit following a suicide attempt. Shortly after admission, the client has agreed to a commitment to treatment statement (CTS). What effect will the CTS have on the client's inpatient care?

The client explicitly agrees to participate in all aspects of treatment

The nurse is assessing a 42-year-old client who is experiencing depression. The client's mother died by suicide 20 years ago. Which statement regarding this client's risk for suicide is correct?

The client has a greater risk for suicide than the general population

The nurse has been contacted by the parent of an adolescent who has posted a note on social media about the desire to kill oneself. Which additional sign is a warning that there is an acute risk of suicide for the client?

The client has been stealing prescription medication from home.

The nurse is assessing a client for warning signs of suicide. Which would be a concern?

The client has engaged in risky behaviors and tends to be impulsive.

The nurse is working with an inpatient who has a history of suicide attempts. What action by the client should the nurse follow up on because it may constitute a suicide planning behavior?

The client has requested extra bedding despite the warm weather

A client has been treated following a suicide attempt. When providing anticipatory guidance during the client's discharge education, the nurse should teach the client that:

The client is likely to experience stigma around the suicide attempt from some people.

The nurse is assessing a client who has presented to the emergency department in emotional distress. What client data represents the greatest risk for suicide?

The client overdosed on pills 2 years earlier

The nurse is working with an outpatient who has a history of depression and suicide attempts. What assessment finding should the nurse interpret as indicating a high degree of planning for a future attempt?

The client recently purchased a large bottle of over-the-counter analgesics

For which client would the nurse be obligated to take immediate and focused action to prevent imminent death?

The client with depression who has been using alcohol and owns a gun

When assessing suicide risk, the safest and most effective way to complete the assessment is to include which health professionals?

The client's interdisciplinary team

Which statement most accurately describes the relationship between psychiatric illness and suicide risk?

The vast majority of people who commit suicide have a diagnosed mental disorder.

The correct definition for suicide is what?

The voluntary and intentional act of killing oneself

Which is an accurate statement regarding women and suicide?

They are less likely to complete suicide than men.

Women make how many suicide attempts for every attempt by their male counterparts?

Three

T/F: In contemporary society, suicide is so rejected and stigmatized that people with strong suicidal thoughts often do not seek treatment.

True

T/F: A commitment to treatment contract should never be used in the community even when the patient is competent to enter the agreement.

false

T/F: Women are more likely to complete a suicide due to selection of more lethal methods.

false

T/F: Young African Americans have the highest suicide rate in the nation.

false

T/F: The denial of suicidal ideation is enough evidence to determine the absence of suicide risk.

fasle

The use of ________ is the most common method of suicide among White people.

firearms

______, a key concept in suicidal behavior, is a state of despair characterized by feelings of inadequacy, isolation, and inability to act on one's own behalf.

hopelessness

Social _________ is a primary risk factor for suicide.

isolation

Nurses who work with suicidal patients are at risk for developing ______ trauma, so they must regularly share their experiences and feelings with one another.

secondary

Those who complete suicide often have extremely low levels of the neurotransmitter _________.

serotonin

Which mental health disorder has the most significant risk factor for suicide?

Depression

A client on the psychiatric mental health unit completed suicide. A nurse who cared for the client has been experiencing insomnia and anxiety attacks since the event. What is the nurse's first action?

Dialogue with a trusted colleague about these feelings

A client has been successfully treated on the psychiatric mental health unit following a suicide attempt. In preparation for discharge, the nurse should prioritize what action?

Ensuring a plan is in place for the client's community-based care

A nurse is reviewing the medical record of a young client to determine the client's risk for suicide. Which factor would alert the nurse to an increased risk for this client?

Experiencing unemployment that has lasted a year

Which statement regarding gender and suicide is correct?

Females engage in suicidal behaviors more frequently than males.

The majority of suicides among men are attributed to:

Firearms

A 32-year-old client is admitted to the inpatient unit for depression with suicidal thoughts. During the nursing assessment, why it is important for the nurse to assess and explore if there is any family member who has committed suicide?

Genetic predisposition

When teaching prevention to the parents of a 15-year-old client who recently attempted suicide by taking an overdose of alprazolam, the nurse describes which behavioral clue?

Giving away valued personal items

A client who is depressed tells the nurse, "If I'm honest, I really see suicide as the only way out." In order to challenge the client's belief, the nurse should ...

Help the client to identify and explore other options.

A patient is being treated for depression on the psychiatric mental health unit. The nurse can best promote the patient's development of an effective crisis management plan by:

Helping the patient create a written outline of strategies that can be applied.

The tendency for suicide to have a "contagious" effect is most likely to occur among what age group?

High school students

Which is the priority nursing action to prevent suicide and promote mental health?

Identify a client who is thinking about suicide.

A nurse is preparing a client for discharge. As part of the discharge process, the nurse provides education to the client regarding safety from self-harm. Which intervention should the nurse employ?

Include family members to provide a better understanding of symptoms of the illness

To care for an acutely suicidal client, which is the most effective initial mode of treatment?

Inpatient care

A psychiatric-mental health nurse is conducting a suicide assessment with a client. Why is it important to conduct a lethality assessment?

It may assist in predicting how likely a person is to die by suicide

The nurse recognizes the importance of transcultural considerations in the assessment and care of clients at risk for suicide. Which of the following statements most accurately describes an aspect of these considerations?

Most suicide victims in the United States are white males.

A nurse maintains a safe environment for a client who is suicidal by ...

Observing the client frequently.

The nurse is caring for an adolescent client who returned to the psychiatric unit from therapeutic pass with superficial cuts to the insides of both forearms. The nurse knows the client is engaging in which self-harm behavior?

Parasuicide

The nurse is seeing an adolescent female client who has superficial cuts to both wrists and ankles. The client denies the desire to kill herself but reports recent family stress due to her parents recently separating. Which phenomena explains the client's response to stress?

Parasuicide

A client on the inpatient psychiatric-mental health unit was discovered attempting to asphyxiate himself or herself using a blanket. Which measure should the care team prioritize in the client's immediate care?

Placing the client under constant observation

A visitor comes to see a client who has suicidal ideations. Upon entering the unit, the nurse notices that the visitor has brought the client a can of their favorite soda. Which action should the nurse take at this time?

Pour the soda into a plastic cup

The primary nursing goal for a client who is admitted for suicidal ideation or attempt would be what?

Prevent self-destructive behavior.

Which is the greatest predictor of a future suicide attempt?

Previous attempt

The nurse is caring for an inpatient who has a diagnosis of depression and who describes pervasive thoughts of suicide this morning. In order to redirect this patient's current mindset, the nurse should:

Provide the patient with meaningful and appropriate distraction

After assessing a client, the nurse identifies that the client is at risk for suicide. Which would be the nurse's priority intervention?

Remove means of suicide from the client's access

A 20-year-old college student has been admitted to the emergency department after taking an overdose of Acetaminophen (Tylenol). Which of the following nursing diagnoses should be prioritized in the care of this client after she is medically stabilized?

Risk for Violence, Self-Directed, related to recent suicide attempt

What is the primary nursing concern related to a depressed client who has been taking amitriptyline 50 mg three times a day for the past 3 weeks?

Risk for self-injury

Which of the following is a primary risk factor for suicide?

Social isolation

What is a myth regarding suicide?

Suicidal people are fully intent on dying.

Trying to kill oneself and surviving the ordeal is identified as what?

Suicide attempt

Which term describes a nonfatal, self-inflicted destructive act with an explicit or implicit intent to die?

Suicide attempt