ATI MH Ch 30 Suicide

2. A nurse is caring for a client who states, "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority? A. Client's educational and economic background B. Lethality of the method and availability of means C. Quality of the client's social support D. Client's insight into the reasons for the decision

2. A. This is an appropriate assessment for the nurse to include. However, it is not the priority. B. CORRECT: The greatest risk to the client is self‑harm as a result of carrying out a suicide plan. The priority assessment is to determine how lethal the method is, how available the method is, and how detailed the plan is. C. This is an appropriate assessment for the nurse to include. However, it is not the priority. D. This is an appropriate assessment for the nurse to include. However, it is not the priority.

3. A nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community. Which of the following interventions should the nurse include as a primary intervention? (Select all that apply.) A. Conducting a suicide risk screening on all new clients B. Creating a support group for family members of clients who completed suicide C. Educating high school teens about suicide prevention D. Initiating one‑on‑one observation for a client who has current suicidal ideation E. Teaching middle‑school educators about warning indicators of suicide

3. A. CORRECT: Primary interventions include suicide prevention through the use of screenings to identify individuals at risk. Conducting a suicide risk screening on all new clients is an example of a primary intervention. B. C reating a support group for family members of clients who completed suicide is an example of a tertiary intervention. C. CORRECT: Primary interventions include suicide prevention through the use community education. Educating high school teens about suicide prevention is an example of a primary intervention. D. I nitiating one‑on‑one observation for a client who has current suicidal ideation is an example of a secondary intervention. E. CORRECT: Primary interventions include suicide prevention through the use community education. Educating middle‑school teachers to recognize the warning indicators of suicide is an example of a primary intervention.

4. A nurse is caring for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care? A. Assign the client to a private room. B. Document the client's behavior every hour. C. Allow the client to keep perfume in her room. D. Ensure that the client swallows medication.

4. A. Clients who are suicidal should not be assigned a private room. B. Client's behavior should be documented every 15 min or according to facility policy. C. Remove perfume from the client's room. D. CORRECT: Ensure that the client swallows medication to prevent hoarding of medication for an attempted overdose.

5. A nurse is conducting a class for a group of newly licensed nurses on caring for clients who are at risk for suicide. Which of the following information should the nurse include in the teaching? A. A client's verbal threat of suicide is attention‑seeking behavior. B. Interventions are ineffective for clients who really want to commit suicide. C. Using the term suicide increases the client's risk for a suicide attempt. D. A no‑suicide contract decreases the client's risk for suicide.

5. A. I t is a myth that a threat of suicide or suicide attempt is attention‑seeking behavior. B. I t is a myth that interventions are ineffective for clients who really want to commit suicide. Suicide precautions are shown to be effective in reducing the risk of a completed suicide. C. I t is a myth that using the term suicide increases the client's risk for a suicide attempt. The nurse should discuss suicide openly with the client. D. CORRECT: The use of a no‑suicide contract decreases the client's risk for suicide by promoting and maintaining trust between the nurse and the client. However, it should not replace other suicide prevention strategies.

1. A nurse is assessing a client who has major depressive disorder. The nurse should identify which of the following client statements as an overt comment about suicide? (Select all that apply.) A. "My family will be better off if I'm dead." B. "The stress in my life is too much to handle." C. "I wish my life was over." D. "I don't feel like I can ever be happy again." E. "If I kill myself then my problems will go away."

A. CORRECT: This statement is an overt comment about suicide in which the client directly talks about his perception of an outcome of his death. The nurse should assess the client further for a suicide plan. B. This statement is a covert comment in which the client identifies a problem but does not directly talk about suicide. The nurse should assess the client further for suicidal ideation. C. CORRECT: This statement is an overt comment about suicide in which the client directly talks about his wish to no longer be alive. The nurse should assess the client further for a suicide plan. D. This statement is a covert comment in which the client identifies a problem but does not directly talk about suicide. The nurse should assess the client further for suicidal ideation. E. CORRECT: This statement is an overt comment about suicide in which the client directly talks about his perception of an outcome of his completed suicide. The nurse should assess the client further for a suicide plan.