Chapter 16 pg 322

Nursing students were provided serum blood levels of 30 different clients and were asked to identify those most at risk for a future suicide attempt based in the laboratory level alone. Which two of the following factors should the student focus on for statistically significant biological factors? Select two choices

Fish oil nutrients Cytokines

According to the three-step theory, when strong, active suicide ideation is present:

It leads to an attempt only if the individual has the capacity to make an attempt.

Which of the following occupational groups are at highest risk of suicide? 1. Mechanics 2. Priests 3. Teachers 4. Librarians

Mechanics

Which of the following is considered a fact about suicide?

Most suicidal people have ambivalent feelings regarding living or dying

Which statement indicates that the nurse is acting as an advocate for a client who was hospitalized after a suicide attempt and is now nearing discharge?

"Let's review the resources that you may need after discharge."

After a teenager reveals that he is gay, his parent responds by beating him. The next morning, the teenager is found to have committed suicide. Which parental grief responses should a nurse anticipate? Select all that apply. 1. "I can't believe this is happening." 2. "If only I had been more understanding." 3. "How dare he do this to me!" 4. "I'm just going to have to accept that he was gay." 5. "Well, that was a selfish thing to do."

1. "I can't believe this is happening." 2. "If only I had been more understanding." 3. "How dare he do this to me!" 5. "Well, that was a selfish thing to do."

Which strategy should the nurse implement first with a suicidal patient? 1. Ask a direct question such as, "Do you ever think about killing yourself?" 2. Ask the patient to rate his or her mood on a scale from 1 to 10. 3. Establish a trusting nurse-patient relationship. 4. Apply the nursing process to the planning of patient care

1. Ask a direct question such as, "Do you ever think about killing yourself?"

A nursing student is developing a study guide related to historical facts about suicide. Which of the following facts should the student include? Select all that apply. 1. In the Middle Ages, suicide was viewed as a selfish and criminal act. 2. During the Roman Empire, suicide was followed by incineration of the body. 3. Suicide was an offense in ancient Greece, and a common-site burial was denied. 4. During the Renaissance, suicide was discussed and viewed more philosophically. 5. Old Norse traditions set a person who committed suicide adrift in the North Sea

1. In the Middle Ages, suicide was viewed as a selfish and criminal act. 3. Suicide was an offense in ancient Greece, and a common-site burial was denied. 4. During the Renaissance, suicide was discussed and viewed more philosophically.

A nurse is caring for a client threatening to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which factor will guide the nurse's plan of care for the client? 1. The more specific the plan is, the more likely the client will attempt suicide. 2. Clients who talk about suicide never actually commit it. 3. Clients who threaten suicide should be observed every 15 minutes. 4. After a brief assessment, the nurse should avoid the topic of suicide.

1. The more specific the plan is, the more likely the client will attempt suicide.

The treatment team is planning to discharge a previously suicidal client from the hospital. Which assessment information should the nurse recognize as contributing to the teams decision to discharge the client safely?

Able to participate in a plan for safety; family agrees to constant observation

Based on epidemiological factors, who is at the greatest risk for suicide?

An 82-year old Caucasian male

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

Assess suicide risk

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? A. Powerlessness R/T altered mood AEB client statements B. Risk for injury R/T altered mood AEB client statements C. Risk for suicide R/T altered mood AEB client statements D. Hopelessness R/T altered mood AEB client statements

D. Hopelessness R/T altered mood AEB client statements

After years of dialysis, an 84-year-old states, "I'm exhausted, depressed, and so over these attempts to keep me alive." Which question should the nurse ask the spouse when preparing a discharge plan of care? A. "Has there been had any appetite or sleep changes?" B. "How often is your spouse left alone?" C. "Has your spouse been following a diet and exercise program consistently?" D. "How would you characterize your relationship with your spouse?"

B. "How often is your spouse left alone?"

A nurse recently 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? A. Provide a 6-month supply of Elavil to ensure long-term compliance. B. Provide a 3 day supply of Elavil with refills given at follow-up appointments. C. Provide a pill dispenser as a memory aid. D. Provide education regarding the avoidance of foods containing tyramine.

B. Provide a 3 day supply of Elavil with refills given at follow-up appointments.

A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse manager's best reply? A. "Suicide is a medical diagnosis." B. "Suicide is a mental disorder." C. "Suicide is a behavior." D. "Suicide is an antisocial affliction."

C. "Suicide is a behavior."

A nurse discovers a clients suicide note that details the time,place, and means to commit suicide, what is the priority nursing intervention and accompanying rationale for this action?

Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide

A nurse is caring for four clients diagnosed with major depressive disorder. What impact could religion have on the risk for suicide in these clients?

Religious affiliation can be protective against suicide attempts

The predisposing factor, anger turned inward, is a psychological theory of Freuds proposing which of the following?

Suicide occurs because of an earlier repressed desire to kill someone else.

A client was diagnosed with depression resulting from the loss of her twin sister in a skiing accident. Her parents reported that all the client has done since the accident was lay in her bed and cry, asking why she survived the accident. The physician prescribed Prozac to treat the depression and suggested that the parents "keep a close eye on her." After a week, the client began to show some signs of improvement, even coming out of her room to eat with the family. After 2 months, the client committed suicide despite seeming to come out of the depression. What is the likeliest reason?

Suicide risk can increase early treatment with antidepressants

During the planning of care for a suicidal client, which correctly written outcome should be the nurses priority?

The client will remain safe during the hospital stay.

A client is newly admitted to an inpatient psychiatric unit. Which of the following is the most critical assessment when determining risk for suicide?

The client's history of suicide attempts

A stockbroker commits suicide after being convicted of insider trading. While speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information? 1. "Your grieving will subside within 1 year; until then, I recommend antidepressants." 2. "Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area." 3. "The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them." 4. "Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone."

2. "Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area."

Thomas Joiner's Interpersonal Theory of Suicide proposes which of the following?

The concept of suicide ideation and suicide attempts are distinct processes.

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

The second highest rates of suicide are among those 85 years or older.

Which epidemiological factor related to suicide makes it difficult to determine the number of attempts that happen each year? 1. The number of suicide attempts reflects only those who enter treatment. 2. More people attempt suicide than die by suicide each year. 3. Unintentional injuries kill more people than suicide attempts each year. 4. Suicide rates consistently increased from 2000 to 2017

1. The number of suicide attempts reflects only those who enter treatment.

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? 1. The client will not physically harm self. 2. The client will express three positive self-attributes by day 4. 3. The client will reveal a suicide plan. 4. The client will establish a trusting relationship with the nurse.

2. The client will express three positive self-attributes by day 4.

Which datum indicates a suicidal client is participating in a safety plan? 1. Compliance with antidepressant therapy 2. A mood rating of 9/10 3. Disclosing a plan for suicide to staff 4. Expressing feelings of hopelessness to the nurse

3. Disclosing a plan for suicide to staff

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, is much more communicative, and rates mood at 9/10. Which action should be the nurse's priority at this time? 1. Give the client off-unit privileges as positive reinforcement. 2. Encourage the client to share mood improvement in group. 3. Increase frequency of client observation. 4. Request a medication reevaluation.

3. Increase frequency of client observation. - may indicate that client is serious risk for suicide

A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide? 1. Encouraging participation in the milieu to promote hope 2. Developing a strong personal relationship with the client 3. Observing the client at intervals determined by assessed data 4. Encouraging and redirecting the client to concentrate on happier times

3. Observing the client at intervals determined by assessed data

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. Which is the nurse's priority intervention at this time? 1. Obtaining an order for locked seclusion until the client is no longer suicidal 2. Conducting 15-minute checks to ensure safety 3. Placing the client on one-to-one observation while monitoring suicidal ideations 4. Encouraging client to express feelings related to suicide

3. Placing the client on one-to-one observation while monitoring suicidal ideations

A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? 1. "Suicidal threats and gestures should be considered manipulative and/or attention seeking." 2. "Suicide is the act of a psychotic person." 3. "All suicidal individuals are mentally ill." 4. "Fifty to eighty percent of all people who kill themself have a history of a previous attempt."

4. "Fifty to eighty percent of all people who kill themself have a history of a previous attempt."

A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the best nursing reply? 1. "Have you considered doing volunteer work?" 2. "Let's discuss the negative aspects of your life." 3. "Things will look better to you in the morning." 4. "It sounds like you are feeling pretty hopeless."

4. "It sounds like you are feeling pretty hopeless."

The family of a suicidal client is supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? 1. Address only serious suicide threats to avoid the possibility of secondary gain. 2. Promote trust by not sharing suicide attempt information outside the family. 3. Offer a private environment to provide needed time alone at least once a day. 4. Be available to actively listen, support, and accept the client's feelings.

4. Be available to actively listen, support, and accept the client's feelings.