EXAM 2: Psych Suicide Precautions/Behavior

Which race/ethnicity's have a high rate of suicide?

-African American (more men than women) -Asian American -Native American (alcohol plays a big role) -Latin American

Which question by the nurse is the most appropriate to assess for suicidal ideation? A. "are you having thoughts about killing yourself?" B. " Have you ever harmed yourself?" C. "Has anyone in your family hurt themselves?" D. "What do you think about when you are very sad?"

A. "are you having thoughts about killing yourself?"

What religions have the lowest rate of suicide?

Catholic and Jewish

Which psychiatric diagnosis causes most suicides?

depression

If they say yes to wanting/thinking about committing suicide, what should you do for follow up assessments?

-Assess plan & lethality -Assess access to means -Assess for A/V hallucinations -MSE -Assess for behavioral or verbal clues -Assess support system -Assess mood (ambivalence) -Assess for precipitating stressor (grief, finances, etc)

What are some effective questions to ask when assessing for suicide?

-Have you ever had feelings about thinking you were better off dead? -Have you ever had thoughts of killing yourself?

What are some inpatient interventions for a suicidal patient?

-No harm contract -Watch clients swallow meds -Remove all dangerous objects -1:1 observation -Reduce sx distress -Improve coping strategies -Involve significant others -Assess for SI throughout hospitalization -Encourage participation in activities -Contingency plan

What are five predisposing factors for suicide?

-Psychiatric Diagnosis -Personality Traits -Sociological Theory -Genetics/Family History -Biochemical Factors (lack of serotonin NTM)

When do teens most often commit suicide? With what?

-after school -with a gun

What are some risk factors for suicide?

-divorced/widowed/never married -highest and lowest socioeconomic status -family hx -physical disorder or terminal illness -psychiatric disorder/substance abuse -teens (LGBT) -elders -hx of attempted suicide

What are some sociological factors that predispose a person for suicide?

-loss of a relationship/social support -loss of status (losing job...etc) -environmental influences (how do others handle stress)

What are some personality traits that predispose a person for suicide?

-negative thinking -hopelessness -impulsive/violent/agressive

What are some protective factors to help someone not commit suicide?

-religion - actively practicing -social support -access to medical care -having a child (having a feeling of responsibility) -having good coping skills -restricted access to lethal means

What are some nursing diagnosis for suicidal patients?

-risk for suicide -powerlessness -chronic low self esteem -ineffective individual/family coping

Which client is most at risk for committing suicide? A. A 75-year-old client with metastatic cancer B. A 71-year-old client with a cardiac disorder C. A 24-year-old client who just had an argument with her roommate D. A 30-year-old newly divorced client who states she has custody of the children

A. A 75-year-old client with metastatic cancer

Which assessment data would be most associated with the highest risk of suicide? A. Client has a specific plan to use the gun in the basement by putting the barrel to his mouth and pulling the trigger. B. Client will take a large amount of pills purchased at the pharmacy when "things get too bad." C. Client's parents have found a knotted cord in the garage. D. Client states, "At some point, I will get myself to the river and jump in."

A. Client has a specific plan to use the gun in the basement by putting the barrel to his mouth and pulling the trigger.

Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations? A. Monitor the client at close, but irregular, intervals. B. Encourage the client to participate in group therapy. C. Enlist friends and family to assist the client to remain safe after discharge. D. Remind the client that it takes 4-6 weeks for antidepressants to be fully effective.

A. Monitor the client at close, but irregular, intervals.

The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority nursing intervention should the nurse include in the plan of care? A. One-to-one suicide precautions B. Suicide precautions with 30-minute checks C. Checking the whereabouts of the client every 15 minutes D. Asking the client to report suicidal thoughts immediately

A. One-to-one suicide precautions

The nurse is caring for a client who is at risk for suicide. What is the priority nursing action for this client? A. Provide authority, action, and participation. B. Display an attitude of detachment, confrontation, and efficiency. C. Demonstrate confidence in the client's ability to deal with stressors. D. Provide hope and reassurance that the problems will resolve themselves.

A. Provide authority, action, and participation.

Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal? A. The adolescent gives away a DVD and a cherished autographed picture of a performer. B. The adolescent runs out of the therapy group, swearing at the group leader, and runs to her room. C. The adolescent becomes angry while speaking on the telephone and slams down the receiver. D. The adolescent gets angry with her roommate when the roommate borrows the client's clothes without asking.

A. The adolescent gives away a DVD and a cherished autographed picture of a performer.

A client notifies a staff member of current suicidal ideations. Which intervention by the nurse would take priority? A. Place the client on a one-to-one observation. B. Determine if the client has a specific plan to commit suicide. C. Assess for past history of suicide attempts. D. Notify all staff-member and place the client on suicide precautions.

B. Determine if the client has a specific plan to commit suicide.

The police arrive at the emergency department with a client who has lacerated both wrists. What is the initial nursing action? A. Administer an antianxiety agent. B. Examine and treat the wound sites. C. Secure and record a detailed history. D. Encourage and assist the client to ventilate feelings.

B. Examine and treat the wound sites.

A client is admitted to the mental health unit after an attempted suicide by hanging. The nurse can best ensure client safety by which action? A. Requesting that a peer remain with the client at all times B. Removing the client's clothing and placing the client in a hospital gown C. Assigning a staff member to the client who will remain with the client at all times D. Admitting the client to a seclusion room where all potentially dangerous articles are removed

C. Assigning a staff member to the client who will remain with the client at all times

A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse, "I'm finally cured." How should the nurse interpret this behavior as a cue to modify the treatment plan? A. Suggesting a reduction of medication B. Allowing increased "in-room" activities C. Increasing the level of suicide precautions D. Allowing the client off-unit privileges as needed

C. Increasing the level of suicide precautions

Who has the highest rate of suicide in the elder population?

Caucasian men 85 and older *majority have been to their PCP within one week of suicide

A depressed client on an inpatient unit says to the nurse, "My family would be better off without me." What is the nurse's best response? A. "Have you talked to your family about this?" B. "Everyone feels this way when they are depressed." C. "You will feel better once your medication begins to work." D. "You sound very upset. Are you thinking of hurting yourself?"

D. "You sound very upset. Are you thinking of hurting yourself?"

What day of the week is most common for suicides?

Monday

What age group has seen an increase in suicide within the past decade?

age 35-65

Which of the risk factors trumps all other risk factors for suicide?

being under the influence of a substance

What season do most suicides occur?

spring (more energy to complete suicide)