Suicide (47 Questions)

Which suggestions would a primary health-care provider provide to the family and friends of a client exhibiting suicidal tendencies? Select all that apply. "Always take even minor attempts of suicide seriously." "Instruct the client not to think about attempting suicide." "Be understanding of the client by promising not to tell their secret plans of suicide." "Be supportive of clients when they express feelings of depression." "Communicate concern when the client expresses thoughts about carrying out suicide."

"Always take even minor attempts of suicide seriously." Rationale: It is important for the client's family or friends to take even a slight hint of suicide seriously and take immediate intervention "Be supportive of clients when they express feelings of depression." Rationale: It is very important to support clients when they express feelings of depression. This will make them feel that there is someone to care for them. "Communicate concern when the client expresses thoughts about carrying out suicide." Rationale: Family members or friends should express concern toward a person who attempts to carry out suicide.

The nurse is caring for a client with bipolar disorder on the psychiatric unit. Which statement made by the client would be of most concern and should be brought to the attention of the health-care provider? "I won't be here tomorrow for you to worry about." "I feel a little bit blue today." "I wish I could go home tomorrow." "I hate that I have to be here again."

"I won't be here tomorrow for you to worry about." Rationale: This statement is a verbal clue (indirect statement) and would be of concern to the nurse and should be reported to the health-care provider.

The client whose child died from a self-inflicted gunshot wound is visiting with the nurse for grief counseling. Which statement by the client reflects self-searching? "My child was very selfish to have left me here alone." "If only I could have done something, my child would still be here." "How could my child have done this to my spouse and me?" "I just don't know how my spouse and I will get over this and move on with our lives."

"If only I could have done something, my child would still be here." Rationale: This is a self-searching response to grief. A recurring self-searching response includes, "If only I had done something," "If only I had not done something," "If only. . . .

Which statement made by the student nurse to the registered nurse would reflect an appropriate understanding of gender differences regarding suicide? "More men than women attempt suicide." "Women use more lethal means than men when attempting suicide, such as firearms." "Women succeed more often than men at completing suicide attempts." "Women are more likely to accept help from professionals than men."

"More men than women attempt suicide." Rationale: This statement is false. More women attempt suicide than men. "Women use more lethal means than men when attempting suicide, such as firearms." Rationale: This statement is false. Women use less lethal methods, such as drugs. "Women succeed more often than men at completing suicide attempts." Rationale: This statement is false. Men succeed more often than women in completing suicide attempts. "Women are more likely to accept help from professionals than men." Rationale: This statement is true. Women are more likely to accept help from professionals than men.

A client tells the nurse, "My spouse doesn't even care that our child is gone. Our child died by suicide only 2 months ago, and my spouse doesn't even cry." Which response by the nurse would be most appropriate? "Most people don't cry as a response to death." "You are right. This means your spouse isn't sad over the loss." "I'm sure your spouse misses your child; no two people grieve in the same way." "Your spouse probably feels more angry than sad."

"Most people don't cry as a response to death." Rationale: This is a generalization. This response is not therapeutic nor is it an appropriate response. "You are right. This means your spouse isn't sad over the loss." Rationale: This is an assumption and not a therapeutic statement; this statement may further upset the spouse. "I'm sure your spouse misses your child; no two people grieve in the same way." Rationale: This is the most appropriate statement. It is both therapeutic and educates the spouse about individual differences in grief. "Your spouse probably feels more angry than sad." Rationale: This statement is an assumption and is not an appropriate response.

An adolescent who came to the clinic to talk to the nurse states, "I am worried that my friend may attempt suicide." Which further statement by the youth to the nurse would support this concern? "Another friend was joking around with my friend that he was chunky after he ate two burgers." "My friend got a job working at the movie theater and is juggling a job and school." "My friend recently came out as gay, and his parent did not take it well." "He has to take medication for ADHD, and he still can't focus."

"My friend recently came out as gay, and his parent did not take it well." Rationale: This statement is concerning and supports the individual's feeling about his friend. LGBTQ adolescents are twice as likely to attempt suicide than other adolescents.

Which comment made by the novice nurse indicates a correct understanding regarding the use of no-suicide contracts in the provision of client care? Select all that apply. "No-suicide contracts are not the same as the development of a thorough safety plan." "Contracting with a client is a controversial and often misused strategy." "Evidence has not supported the efficacy of this method as a primary intervention to enhance client safety." "Implementing these contracts should only be used in short-term encounters with clients." "No-suicide contracts should be avoided altogether."

"No-suicide contracts are not the same as the development of a thorough safety plan." Rationale: This statement demonstrates effective learning and understanding of the use of no-suicide contracts in the provision of client care. "Contracting with a client is a controversial and often misused strategy." Rationale: This statement demonstrates effective learning and understanding of the use of no-suicide contracts in the provision of client care. "Evidence has not supported the efficacy of this method as a primary intervention to enhance client safety." Rationale: This statement demonstrates effective learning and understanding of the use of no-suicide contracts in the provision of client care. "Implementing these contracts should only be used in short-term encounters with clients." Rationale: This statement demonstrates ineffective understanding. No-suicide contracts should never be used in short-term encounters with clients. "No-suicide contracts should be avoided altogether." Rationale: This statement demonstrates effective learning and understanding of the use of no-suicide contracts in the provision of client care.

Which student nurse comment indicates to the nurse preceptor an accurate understanding of the relationship between mental disorders and suicidal behavior? "Very few people who carry out or attempt suicide are diagnosed with a mental health disorder." "About a quarter of the people who carry out or attempt suicide have a mental health diagnosis." "About half of the individuals who carry out or attempt suicide are diagnosed with a mental health disorder." "The majority of the people who carry out or attempt suicide are diagnosed with a mental health disorder."

"The majority of the people who carry out or attempt suicide are diagnosed with a mental health disorder." Rationale: Most individuals who carry out or attempt suicide have a diagnosable mental illness; therefore, this student nurse statement indicates a correct understanding regarding the relationship between mental health diagnoses and suicide.

A client tells the nurse, "I think I am going to kill myself." Which response by the nurse would be most appropriate to assess for risk of suicide? "What do you plan to do?" "Why are you going to kill yourself?" "Do you really think you would?" "Don't you think people would be sad?"

"What do you plan to do?" Rationale: The risk of suicide is increased if the client has developed a plan

The nurse is caring for a group of clients. Which characteristic may increase the client's risk of attempting suicide? A client with financial strain A client actively involved in a religious community A client who has had the same job for many years A client without a history of suicidal ideation

A client with financial strain Rationale: Financial strain has been associated with increased suicide risk

The nurse is assessing an adolescent female client who attempted suicide by swallowing an entire bottle of pills. The nurse expects which factor would be the most likely cause for the attempt? A peer posted cruel comments about the adolescent on a social media site. A peer is physically bullying the adolescent at school. The adolescent has recently lost a new job. The adolescent's teacher died by suicide.

A peer posted cruel comments about the adolescent on a social media site. Rationale: Seventeen percent of youth are victims of cyberbullying, and girls are more likely than boys to be victims of psychological bullying. Being bullied via the internet or e-mail (cyberbullying) is associated with increased risk of depression and suicidal ideation among young people

The nurse is providing information to family members of a client who exhibits suicidal tendencies. Which actions would the nurse encourage the family members to perform to assist them in interacting with the client in the home? Select all that apply. Acknowledge and accept their feelings and be an active listener Try to give them hope and remind them that what they are feeling is temporary. Stay with them. Do not leave them alone. Go to where they are, if necessary. Show love and encouragement. Hold them, hug them, touch them. Allow them to cry and express anger. Show tough love and encourage the client to "Snap out of it."

Acknowledge and accept their feelings and be an active listener Rationale: This is an action family members should perform. Try to give them hope and remind them that what they are feeling is temporary. Rationale: This is an action family members should perform. Stay with them. Do not leave them alone. Go to where they are, if necessary. Rationale: This is an action family members should perform. Show love and encouragement. Hold them, hug them, touch them. Allow them to cry and express anger. Rationale: This is an action family members should perform.

Which example would best describe a precipitating stressor in a client's life that could lead to suicide? Death of a child Ending a 2-month relationship Failed attempt of a promotion at work The discovery of a benign mass

Death of a child Rationale: The death of a child is a precipitating stressor in one's life.

The nurse is assessing a 7-year-old female client. Which factor would place this child at risk for completing a suicide attempt? Gender Psychiatric illness on the mother's side No history of psychiatric illness Feelings of hopelessness

Gender Rationale: Men have a great risk for completing suicide than women. Psychiatric illness on the mother's side Rationale: Psychiatric illness on the mother's side places children from ages 3 to 7 years at risk for suicide. No history of psychiatric illness Rationale: Psychiatric illness in the child places the client at risk for suicide. Feelings of hopelessness Rationale: This is not a risk factor for suicide in children ages 3 to 7 years.

The home health nurse is assessing the bedroom of a 54-year-old male client at risk for attempting suicide. Which item, if found in the room, would be of primary concern to the nurse? Belt Gun Pills Razor blade

Gun Rationale: Although suicide rates among women remain constant throughout life, rates among men increase with age. The most recent statistics revealed that in 2018, the highest rate of suicide occurred in the 45- to 64-year-old age group with the highest rates among those 52 to 59 years of age. Additionally, men use more lethal means of suicide, such as a firearm.

The nurse identifies a diagnosis of hopelessness as evidenced by lack of initiative for a client at low risk for suicide. Which interventions would the nurse implement for this client? Select all that apply. Identify stressors that precipitated the crisis Discourage the client from expressing negative feelings Determine coping mechanisms to deal with stressors Provide expressions of hope to the client Maintain one-to-one contact of the client

Identify stressors that precipitated the crisis Rationale: This is an appropriate intervention for a client with a diagnosis of hopelessness. Determine coping mechanisms to deal with stressors Rationale: This is an appropriate intervention for a client with a diagnosis of hopelessness. Provide expressions of hope to the client Rationale: This is an appropriate intervention for a client with a diagnosis of hopelessness.

The nurse is working to identify protective factors for the client exhibiting suicidal tendencies. Which example would demonstrate a protective factor? Limited problem-solving skills Disconnectedness to family Access to highly lethal means of suicide Integration in social networks

Integration in social networks Rationale: Integration in social networks is a protective factor.

Which term would represent the "I" in the IS PATH WARM acronym to assess for suicide? Intervention Individual Ideation Intent

Intervention Rationale: The "I" represents Ideation, not intervention. Individual Rationale: The "I" represents Ideation, not individual. Ideation Rationale: The "I" represents Ideation. The client has suicide ideas that are current and active, especially with an identified plan. Intent Rationale: The "I" represents Ideation, not intent.

Which occupational group does the nurse identify as being at a great risks for suicide? Select all that apply. Physicians Law enforcement officers Teachers Mechanics Engineers

Physicians Rationale: Health-care professionals (especially physicians) is one occupational group believed to be at greater risk for suicide. Law enforcement officers Rationale: Law enforcement officers are one occupational group believed to be at greater risk for suicide. Mechanics Rationale: Health-care professionals (especially physicians), law enforcement officers, dentists, artists, mechanics, lawyers, and insurance agents have all been identified as occupational groups believed to incur greater risks for suicide.

The client reports to the nurse hearing voices that tell the client to attempt suicide. Which immediate action would the nurse take? Move the client to a room close to the nurses' station Place the client on one-to-one contact Place the client in seclusion Monitor the client every 30 minutes

Place the client on one-to-one contact Rationale: The client is at high risk for suicide and should be placed on one-to-one contact.

The nurse is working with parents who are grieving the loss of their child who died by suicide. Which intervention would the nurse perform? Encourage the parents to move on with their lives Provide the parents with resources that provide support Make an appointment for the parents for grief counseling Discuss with the parents the option of having another child

Provide the parents with resources that provide support Rationale: This is an appropriate intervention; by providing the parents with support, the nurse is not forcing the parents to seek help but is providing the tools needed.

The family of a client who has attempted suicide and is to be discharged home from a psychiatric unit asked the nurse what they can do to prepare for the client's return home. Which instructions would the nurse include in the family teaching? Select all that apply. Provide the telephone number of a counselor Ensure the home environment is safe from dangerous items Ignore any discussion the client makes about suicide Ensure the client avoids taking any medications Be a good listener for the client

Provide the telephone number of a counselor Rationale: The family or friend should be provided with the number of a counselor, suicide hotline, and an emergency number. Ensure the home environment is safe from dangerous items Rationale: The friends or family members should ensure the home is safe from any dangerous items before the client returns home. Be a good listener for the client Rationale: It is important to "be there" and allow the client to talk

The nurse is reviewing the components of a safety plan with a client and the client's family. Which measures would be essential elements of a safety plan? Select all that apply. Recognizes warning signs that precede suicide crisis Identifies coping strategies without needing to contact support people Includes a space for a signature agreeing to not harm self by suicide Reminder not to harm self in any way under any circumstances Reminder to call 9-1-1 if suicidal thoughts are occurring

Recognizes warning signs that precede suicide crisis Rationale: This is present on a safety plan, along with coping strategies should these warning signs occur. Identifies coping strategies without needing to contact support people Rationale: This is present on a safety plan, along with supportive friends and family members who may be contacted if a crisis occurs, along with contact information for mental health professionals.

The nurse assesses the room of a school-age client. Which item, if found in the room, is an example of a primary concern for injury? Razors Rope Pills Knife

Rope Rationale: In a recent study, it was found that school-age children ages 5 to 11 years have an increased risk for suicide via suffocation and hanging; therefore, a rope is a primary concern for injury identified by the nurse.

According to recent studies, which client activity reflects the strongest risk factor for suicide? Feelings of hopelessness Self-inflicted injury Treatment for mood disorder Low-risk behavior

Self-inflicted injury Rationale: Self-inflicted injuries are one of the strongest risk factors for suicide.

The nurse identifies the priority nursing diagnosis for a client of "risk for suicide related to feelings of hopelessness secondary to loss of spouse." Which outcome would be most appropriate for this client? The client sets measurable goals for themself. The client states that they have accepted the loss of the spouse. The client expresses a feeling of hope for the future. The client expresses no desire to physically harm themself.

The client expresses no desire to physically harm themself. Rationale: This outcome is most appropriate for the diagnosis of risk for suicide; safety is a priority for this client and the fact that the client has not expressed a desire to physically self-harm indicates a positive outcome.

A nurse is caring for a client with suicidal tendencies. Which client outcome would be the best indicator of the effectiveness of the nursing interventions? The client has avoided self-harm. The client sleeps without any difficulty. The client interacts appropriately with others. The client has a good perception of self.

The client has avoided self-harm. Rationale: If the client has avoided self-harm, then the nursing intervention was successful.

A client with major depressive disorder is hospitalized due to severe suicidal tendencies and is prescribed antidepressant drugs. One day the nurse observes that the client appears to have high energy and confidence. Which deduction would this dramatic clinical change indicate to the nurse? The client may have set a plan for suicide. The client can be discharged from the hospital. The client is improved and can be withdrawn from the therapy. The client should be left alone for some time to improve.

The client may have set a plan for suicide. Rationale: Depressed clients who appear to have recovered from depression are at increased risk of carrying out suicide. Once reaching a secret decision to attempt suicide, the client may stay confident and peaceful.

A new nurse has just started working at a psychiatric facility. Which action by the nurse would require correction from the nurse preceptor? The nurse leaves the client at risk of suicide alone in the room to attend to another client. The nurse removes the fork from the client's tray. The nurse observes the client take their medications. The nurse accompanies the client to art therapy.

The nurse leaves the client at risk of suicide alone in the room to attend to another client. Rationale: This action requires correction. The client at risk of suicide should never be left alone. The nurse removes the fork from the client's tray. Rationale: This action is correct; unsafe objects should be removed from the client's tray and room. The nurse observes the client take their medications. Rationale: This action is correct; medication administration should always be observed. The nurse accompanies the client to art therapy. Rationale: This action is correct; the nurse should accompany the client to art therapy.

The nurse is caring for a client at high risk for suicide who is scheduled for mandated therapy located in another room. Which action would the nurse take? Inform the therapist the client is unable to attend Allow the client to walk to therapy Walk the client to and from therapy Ask the therapist to reschedule when the client is lower risk

Walk the client to and from therapy Rationale: The nurse should walk the client to and from therapy.

The nurse is assessing a client for a suicide plan. Which statement made by the client would indicate an active plan for suicide and be of most concern to the nurse? "I have so much stress taking care of my mom. Maybe if I took a bunch of pills, I would get some help." "None of my friends or family care about me anymore. Maybe it would be better if I died." "One day you won't have to worry about me." "When my kids are at my parents' on Thursday, I am going to go home and shoot myself in the head with my spouse's handgun."

When my kids are at my parents' on Thursday, I am going to go home and shoot myself in the head with my spouse's handgun." Rationale: This statement would be of most concern to the nurse; it indicates an active plan, since the client knows the day, location, and method to implement the plan. The client also has the means.