suicide/depression/bipolar

a,c,e

A nurse is assessing a client who has a major depressive disorder. The nurse should identify which of the following client statements as an overt comment about suicide? a. my family will be better off if I am dead b. the stress in my life is too much to handle c. I wish my life was over d. I dont feel like I can ever be happy again e. if I kill myself then my problems will go away

c (A thorough assessment of Ms. B is necessary to establish​ client-centered goals.​ "Spiritually misguided" is not an appropriate goal for a suicidal client. Discussing feelings of​ power, positive feelings of​ self, and expressing a desire to live are appropriate goals for a suicidal client.)

Ms B. is a​ 63-year-old woman who has attempted suicide and is having a thorough assessment. Which client goal would be inappropriate for this​ client's plan of​ care? a Discusses feelings of power b Expresses positive feelings of self c Verbalizes feelings of spiritual misguidance d Begins to feel she wants to live

d (Rationale Asking the client whether he ever thinks of harming himself when the client is feeling down is an appropriate question for the nurse to ask when assessing for thoughts of suicide. Asking about​ guns, funeral​ plans, or giving away possessions are not appropriate questions to ask a client while assessing for thoughts of suicide. Making funeral plans and giving away possessions are behaviors that might indicate the client is considering suicide and can be asked later if appropriate.)

The nurse identifies a client with risk factors for suicide. Which question would be appropriate for the nurse to ask when assessing the client​'s thoughts about​ suicide? a ​"Do you have weapons in your​ home?" ​b "Have you made funeral​ plans?" ​c "Have you been giving away your​ possessions?" ​d "Do you ever think of harming yourself when you​'re feeling​ down?"

a,b,c,d (Family history of mood​ disorders, history of suicidal attempts or​ ideation, history of family member committing​ suicide, and history of depression are all assessment data the nurse should obtain from a client at risk for suicide. Asking about head injuries is not relevant at this time.)

What information is important for the nurse to obtain during the assessment of a client at risk for​ suicide? Select all that apply. a History of family member committing suicide b History of depression c Family history of mood disorders d History of suicidal ideation e History of head injuries

a,c,d,e (Rationale A family history of mood​ disorders, history of suicidal attempts or​ ideation, history of family member committing​ suicide, and history of depression are all assessment data the nurse should obtain. A family history of neurological disorders isn​'t relevant at this time.)

Which assessment information is important for the nurse to obtain in a potentially suicidal ​client? Select all that apply. a History of suicidal ideation b Family history of neurological disorder c History of depression d History of suicide attempts e Family history of mood disorders

a (Rationale Nurses should monitor for suicidal ideations in clients who are taking selective serotonin reuptake inhibitors​ (SSRIs) like Zoloft. SSRIs should not be taken with St. John​'s wort as adverse reactions can occur. Dry month is a temporary side effect and is not permanent. SSRIs typically do not cause weight gain.)

Which comment by the client indicates an understanding of the nurse​'s teaching regarding sertraline​ (Zoloft)? ​ ​ a "This medicine can exacerbate suicidal thinking. " b "This medication will cause me to gain weight. " c "I can take my medicine with St. John​'s wort. " d "Dry mouth is a permanent side effect

b (the greatest risk is self harm as a result of carrying out plan. the priority assessment is to determine how lethal the method is, how available the method is and how detailed the plan is)

A nurse is caring for a client who states " I plan to commit suicide". Which of the following assessments should the nurse address as the priority? a. clients educational and economic background b. lethality of the method and availability of means c. quality of clients social supports d. clients insight into the reasons for the decision

4 3 2 1 ( The nurse first assesses and treats the bleeding gunshot wound. Next, the nurse removes any objects the client could use to harm himself and ensures the client will have constant observation. The nurse then assesses the clients immediate risk for suicide and bases subsequent decisions on the level of risk. Once the wound is treated the nurse contacts the crisis intervention team)

A wife brings her husband to the ER with a bleeding gunshot wound to the leg. The wife tells the nurse that her husband was trying to commit suicide. In what order should the nurse perform the actions from first to last? Use all options, no commas 1. assess current suicide risk 2. ensure constant observation 3. remove potentially harmful objects from the area 4 assess the gunshot wound

b (Rationale Talking with a staff member is an important part of safety. The nurse or another staff member can assess if the client will act on his thoughts and assist with methods to cope with suicidal thoughts. Reading a​ book, keeping a journal of​ feelings, or playing checkers with other clients does not allow the client to express suicidal thoughts to the nurse.)

Which activity should the nurse recommend to the client on an inpatient unit when the client has thoughts of​ suicide? a Playing a checkers with other clients b Talking with the nurse c Keeping track of feelings in a journal d Reading a book

c (Rationale The risk for suicide is high in those over the age of​ 65, and the most common method for suicide by those in this age group is​ firearms; thus, this client​'s having handguns quickly and easily available indicates an increased risk. Older adult clients tend not to commit suicide by suffocation or falls. The scatter rugs and​ non-functioning smoke detectors are safety issues to be​ addressed, but do not indicate that this client is at increased risk for suicide. The use of oxygen is not an indication for possible suicide.)

The home care nurse is concerned that a​ 75-year-old widowed male client is at risk for suicide. Which data caused the nurse to come to this conclusion when conducting the home​ assessment? a Wears oxygen at home b Multiple scatter rugs throughout the home c Handguns located in the bedroom and living room d Malfunctioning smoke detectors

c (Rationale: Individuals in the age group of 25 to 64 are at more risk for suicide than older adults. Men in the United States are more likely to die from suicide, while women are twice as likely to attempt suicide and suicide is currently the seventh leading cause of death in men. Although suicide attempts are higher for females, they typically use less lethal methods with a chance for rescue, such as an overdose or cutting their wrists. Even though women with borderline personality disorder may attempt suicide more frequently than men, women with borderline personality disorder typically use less lethal methods that create an opportunity for rescue. Involvement in extracurricular activities creates a sense of belonging and acceptance that acts as a protective factor against suicide.)

The mental health nurse is giving a presentation in a rural community to increase the awareness of suicide risks. Which population group has a high risk for suicide and is an appropriate target audience? a Women with borderline personality disorder b Divorced or single elderly females c Middle-aged men with a terminal disease d Adolescent males on a football team

b,d,e (Signs of improvement in the suicidal client after the treatment plan has been implemented include verbalizing a range of options other than​ suicide, making​ long-term plans or discussing future​ events, and responding positively to antidepressant​ and/or antipsychotic medications. Other improvements would include showing more​ energy, not​ less, and demonstrating a wider range of affective responses to situations that occur on the unit.)

The nurse has implemented the treatment plan of a suicidal client. Which are signs of improvement for this​ client? Select all that apply. a Having the same affective response to situations that occur on the unit b Responding to antidepressant​ and/or antipsychotic medications c Showing less energy d Making​ long-term plans e Verbalizing a range of options other than suicide

d (Rationale: The statement "I just recently shared with my parents that I am gay," would indicate to the nurse that they are at a higher risk for suicide because gay and bisexual men are four times as likely to attempt suicide compared to heterosexual men. The statements regarding a client's wife or girlfriend indicate to the nurse the patient is heterosexual and while they are still at risk for attempting suicide the risk is not as great as the risk for that of a gay or bisexual male. Catholicism and Islam strongly forbid suicide, therefore, making the statement that the client is Catholic would be an incorrect choice.)

The nurse is admitting a male client to the mental health unit. The client is being admitted for depression and suicidal ideation. During the admission assessment, which statement by the client does the nurse recognize as placing the client at a higher risk for attempting suicide? a "I am a Catholic." b "My wife and I recently separated." c "My girlfriend doesn't understand me." d "I just recently shared with my parents that I am gay."

a (Rationale The suicide threat might include behavior​ changes, mood​ swings, personality​ changes, changes in work or school​ performance, withdrawal from friends and​ family, and significant attitude changes. Suicidal ideation is the step before a suicide​ threat; it occurs when the client thinks about suicide as a possible solution to life​'s problems. Watching horror movies and reading books about what happens after death are not characteristics of suicide threats.)

The nurse is concerned that a client is threatening to commit suicide. Which behavior did the nurse observe in this​ client? a Refusing to talk with friends and family b Watching horror movies c Reading books about what happens after death d Talking about ways to commit suicide

d (Rationale Suicide is the leading cause of death in persons aged 15dash-24 ​years; this client has an added stressor of job​ loss, which puts the student at risk. Suicide is the fourth leading cause of death for adults aged 45dash-54 and the seventh leading cause of death for adults aged 55dash-64 years.)

The nurse is determining which clients would benefit from interventions to prevent suicide. Based on age​ alone, which client is at the highest risk for​ suicide? a A​ 62-year-old male client with an elevated PSA level b A​ 54-year-old male client diagnosed with shin splints from playing tennis c A​ 46-year-old female client whose husband has asked for a divorce d A​ 23-year-old college student who was fired from​ part-time employment

a,b,d,e (Rationale Interventions should redirect the client from suicidal thoughts to alternatives to suicide. This would include talking openly about suicidal​ thoughts, taking threats of suicide​ seriously, implementing suicide​ precautions, and searching the client​'s room. Discussing ways to successfully commit suicide would not redirect the client to alternatives to suicide.)

The nurse is planning care for a client who recently made an unsuccessful suicide attempt. Which interventions would the nurse include in this client​'s plan of ​care? Select all that apply. a Talking openly about suicidal thoughts b Taking threats of suicide seriously c Discussing ways to successfully commit suicide d Implementing suicide precautions e Searching the client​'s room

b,c,d (RationaleInformation that the nurse will use to understand this​ client's risk for future suicide attempts includes amount and frequency of alcohol​ ingestion, which can affect the​ client's judgment,​ client's race and​ culture, and​ client's age. Adolescents have an increased risk for suicidal attempts. Information that will not help the nurse understand the​ client's risk for future suicide attempts includes the​ client's education level and the number of siblings in the family.)

The nurse is planning care for an Asian American adolescent male client who has attempted suicide twice. Which information will the nurse use to understand the client​'s risk for future suicide​ attempts? Select all that apply. a Client​'s education level b Client​'s race and culture c Amount and frequency of alcohol ingestion d Client​'s age e Number of siblings in the family

a (Rationale The priority for this client is to ensure safety. The nurse would remove any items from the bedside that the client could use to harm​ self, including a disposable razor. While administering an​ antidepressant, updating the​ family, and reviewing admission paperwork are appropriate nursing​ interventions, these are not priorities for this client.)

The nurse is providing care to a client who attempted suicide prior to being admitted to the mental health care unit. Which intervention is a priority for this​ client? a Removing the disposable razor from the bedside b Updating the family c Reviewing admission paperwork d Administering​ antidepressants, per order

a,b,d,e (The type of therapy will depend on the client and the therapist. The most common forms of therapy are group​ therapy, one-on-one​ therapy, and family therapy. All three forms can be combined to help clients work through their suicidal thoughts and behaviors. The presence of family members is useful because they can serve as a supporting role to the suicidal client. In​ addition, family therapy can help the family understand the suicidal client​'s feelings and thoughts of suicide. Writing therapy is therapeutic for the suicidal client to work through suicidal thoughts or imaginations. Journal writing will allow the suicidal client to see the positive progression from start to finish. Couples therapy is not indicated for suicide.)

What therapeutic approaches can be most beneficial for a client with suicidal​ thoughts? Select all that apply. a Individual therapy b Family therapy c Couples therapy d Group therapy e Writing therapy

b (It is​ important, as a nursing​ intervention, to take all threats from a suicidal client seriously. Other interventions include talking freely and openly about suicidal​ thoughts, searching the client​'s room for things that could be used to assist the client in committing​ suicide, and making a "No ​Self-Harm, No Suicide " contract between the healthcare team and the client.)

Which is the least appropriate nursing intervention when caring for a suicidal​ client? a Searching the client​'s room b Disregarding threats c Talking freely about suicidal thoughts c Making a "No ​Self-Harm, No Suicide " contract

c (Rationale To determine the seriousness of the suicidal​ ideation, the nurse must ask directly about the intent and the plan. The nurse needs to determine whether the client has a concrete plan and will act on his thoughts. Asking about a living will is not appropriate at this time. Asking about the family isn​'t getting to the issue of suicidal ideation. The length of time is not a priority question for this client.)

Which question should the nurse ask to best determine the seriousness of a client​'s suicidal​ ideation? a "Does your family know you​'re ​here? b "How long have you been thinking about harming ​yourself? " c "How are you planning to harm ​yourself? " d "Have you made a living ​will?

4 (the statement by the person who says I have found a solution to this mess contains suicidal ideation, and that person is more of a safety risk than the other clients even though the others may need interventions as well. The potentially suicidal client has the greatest need for nursing intervention)

Which reaction to learning about a diagnosis of being HIV positive would put the client at the greatest need of intervention by the nurse? 1 A person who is angry hostile and alienated from the family 2 a person who is obsessed with cleanliness and showers many times a day 3. a person who is unable to make decisions and is helpless and tearful 4. a person who says "I have found a solution for this mess"

c (Nurses working with suicidal clients should be direct but respectful when asking questions. Asking direct questions does not cause the client to act in a suicidal manner. A question like "do you have a plan for killing yourself " is more effective than using phrases such as "hurting yourself " in place of suicide. Asking about the client having a will or if the spouse is aware of where the client​ is, is not relevant. It is not important to know how long the client may have thought about harming​ himself; it is important to know whether the client has a current plan.)

Which statement by the nurse is a direct and respectful question when interviewing a suicidal​ client? a "How many years have you been thinking of hurting​ yourself? b "Have you made a ​will? " c "Do you have a plan for killing ​yourself? " d "Does your spouse know where you ​are?

a,b,d (not all meds are lethal enough that access to a months supply should be limited. it is unrealistic and potentially distressing to the client and family to have client under constant surveillence)

Which strategies would be helpful in preventing suicide for clients about to be discharged from a psych inpatient unit? Select all that apply a. at discharge, give all depressed clients a card containing crisis phone line number for their area b. have all clients who have expressed suicidal ideation just prior to or during hospitalization make a written personal suicide prevention plan c. require all clients who had previous suicidal ideation plan, or attempt, refill their meds every 2 weeks instead of monthly d. educate family and friends of previously suicidal clients in ways to help clients remain safe after discharge e. suggest that family and friends of previously suicidal clients know the clients whereabouts at all times

d (Suicide is the seventh leading cause of death for men. Women are twice as likely to attempt suicide. Adolescents commit suicide at 6.9 per​ 100,000. The elderly are the highest risk group for completing suicide.)

Suicide is the seventh leading cause of death for which​ group? a Adolescents b Elderly c Women d Men

a (Rationale: A sudden interest in firearms is a strong indicator of impending suicide. The client may be experiencing uncomfortable side effects of medications, such as disturbed thoughts or disturbed sensory perceptions, which would cause a failure to follow the treatment plan. Accusing the guardian of poisoning the food describes paranoid behavior but does not indicate suicidal ideation. Even though changing a will could be a sign of impending suicide, this client is more likely experiencing disturbed thought processes than to be contemplating suicide. )

The guardian of a client diagnosed with paranoid schizophrenia is concerned that the client is at risk for suicide. The nurse should assess which behaviors as a significant sign that the client is contemplating suicide? a The client has been asking how to load a gun. b The client refuses to take the prescribed antipsychotic medication. c The client accuses the guardian of poisoning the food. d The client states, "Everything goes to the cat when I die."

b (Mood stabilizers are used for clients with bipolar disorder to help maintain a balance in mood. Antipsychotics treat schizophrenia by treating hallucinations and delusions. Antidepressants balance neurotransmitters in the brain that affect mood and emotional response. Tranquilizers are not a usual treatment for bipolar disorder to balance mood.)

What medications do you expect a primary healthcare provider would prescribe for a client suffering from bipolar​ disorder? a Antipsychotics b Mood stabilizers c Tranquilizers d Antidepressants

a,b,d,e (Rationale Chronic​ self-destructive behavior can be described as a behavior that is harmful to self and is habitual. These behaviors include​ alcohol, drug​ abuse, and smoking cigarettes. Taking therapeutic doses of an​ over-the-counter medication is not considered a chronic​ self-destructive behavior.)

uring an​ assessment, the nurse learns that a​ 53-year-old female client engages in multiple chronic​ self-destructive behaviors. Which data did the nurse assess in this client to come to that​ conclusion? Select all that apply. a Smokes three packs of cigarettes a day b Drinks a​ six-pack of beer each day c Takes 400 mg of ibuprofen twice a day d Takes diazepam​ (Valium) 10 mg four times a day for leg cramps e Smokes marijuana with husband and friends every evening after dinner

d (Rationale: The priority nursing diagnosis for this client would be Risk for Self-Harm. The client has demonstrated that they are a potential to harm themselves by taking the scissors back to the room. Although the client also demonstrates helplessness, powerlessness, and a low self-esteem, it is imperative to assure the safety of the client.)

A client admitted to the hospital for a recent suicide attempt attends group therapy. Upon returning from group, the nurse finds that the client has taken a pair of scissors from the therapy room. When the nurse approaches the client, the client states, "I have no reason to live. I am worthless and have no desire to go on." The nurse should recognize which diagnosis as a priority diagnosis for this client? a Hopelessness b Powerlessness c Disturbed self-esteem d Risk for Self-Harm

d (Rationale Antipsychotics treat schizophrenia by treating hallucinations and delusions. Mood stabilizers are used for clients with bipolar disorder. Antidepressants are used for depression.​ Anxiolytics, or antianxiety​ medications, are not appropriate for this client.)

A client is brought to the hospital by police and admitted involuntarily. The client is diagnosed with schizophrenia. Which medication would the nurse expect the healthcare provider to prescribe for this​ client? a Mood stabilizers b Anxiolytics c Antidepressants d Antipsychotics

c (Rationale The nurse needs to ask the client whether he is going to hurt himself to decide the client​'s capability to cope with the voices and to evaluate the client​'s impulse control. The nurse​'s assessment will then conclude the course of action to take regarding the client​'s safety. Asking when the client hears the voices and how long the client has heard them is important but not as important as determining whether the client will act on what the voices are saying.​ Asking, "Why are the voices starting ​again? would be inappropriate because the client may not know why and may not be able to answer the nurse.)

A client lives in a group home and visits the community mental health center regularly. During one visit with the​ nurse, the client​ states, "The voices are telling me to hurt myself again. " Which question by the nurse is most important to​ ask? a "How long have you heard the ​voices? " b "Why are the voices starting ​again? " c "Are you going to hurt ​yourself? " d "When do you hear the ​voices?

a (Rationale: Asking if the client has a plan ascertains whether the client is planning another suicide attempt. The best clinical predictors for suicide risk are previous attempts and a sense of hopelessness or desperation. Information about major losses is not as important as determining the client's immediate suicide risk. The most important question to ask is about the client's present status, not events of the past months. Asking if the client feels angry, overwhelmed, or hopeless would be unnecessary given the client's statements clearly expressing feelings of hopelessness.)

A client who attempted suicide 5 years ago with an overdose was brought to the emergency department by a friend. The client states, "I just don't feel like living anymore. No one would care if I lived or died." What question should the nurse ask next? a "Do you have a plan for suicide at this time?" b "What major losses have you experienced in the past 6 months?" c "Do you feel angry, overwhelmed, or hopeless?" d "Have you experienced any major life crises in the past 6 months?"

d

A client with depression is admitted to the mental health unit because of attempted suicide. Which​ short-term goal should be given high priority for this​ client? a The client will establish healthy and mutually caring relationships. b The client will identify and discuss actual and perceived losses. c The client will learn strategies to promote relaxation and​ self-care. d The client will seek out the nurse when feeling​ self-destructive.

2,3,4,6 (recurrent depression represents a major consideration in suicide prevention because of a high prevalence. Impulsive behaviors, overwhelming guilt, chronic illness, and repressed anger are factors that contribute to suicide potential. Psychomotor retardation and decreased physical activity are symptoms of depression, but these do not typically lead to suicide because the client does not have the energy and cognitive ability to harm self)

After interviewing a client diagnosed with recurrent depression, a nurse determines the clients potential to commit suicide. Which factors listed below might contribute to the clients risk of suicide? 1. psychomotor retardation 2. impulsive behaviors 3. overwhelming feelings of guilt 4. chronic debilitating illness 5. decreased physical activity 6. repression of anger

b (Rationale Cognitive behavior therapy for suicide prevention​ (CBT-SP) may be used for adolescents who have attempted suicide or have severe suicidal thoughts.​ CBT-SP works by helping the adolescent identify healthy coping mechanisms and avoid all types of​ self-harm. Electroconvulsive therapy​ (ECT) is electric current that passes through the brain inducing a seizure and is not indicated. Transcranial magnetic stimulation uses magnetic fields that pass through the skull causing cerebral cells to fire and is not useful for the client. Acupuncture is insertion of thin needles in the skin at strategic points on the body and is not appropriate therapy for this client.)

An adolescent client is involuntarily committed for attempting suicide. Which intervention can help the client identify healthy coping​ mechanisms? a Transcranial magnetic stimulation ​b Cognitive-behavior therapy c Acupuncture d Electroconvulsive therapy

1,2,4 ( a person who is admitted to a psych hospital may voluntarily sign out of the hospital unless the health care team determines they are a risk to themselves or others. The health care team evaluates the clients condition before discharge. If there is reason to believe that the client may harm self or others a hearing can be held to determine if the admission status should be changed from voluntary to involuntary. Not all discharge requires a hearing. The client still has rights after committing himself. The client does not need a lawyer to leave the hospital. A court hearing is held only if the client may pose a threat to self or others and requires further treatment)

In the ER a client reveals to the nurse a lethal plan for committing suicide and agrees to a voluntary admission to the psych unit. Which information would the nurse discuss with the client to answer the question "How long do I have to stay here?" Select all that apply 1. You may leave the hospital any time unless your homicidal or suicidal or unable to meet your basic needs 2. lets talk more after the health care team has assessed you 3. Once you've signed the papers you have no say. 4. Because you have stated that you want to hurt yourself, you must be safe bfore being discharged. 5. you need a lawyer to help you make that decision. 6. All clients need a court hearing before leaving the hospital.

a (Family history of mood​ disorders, history of suicidal attempts or​ ideation, a history of a family member committing​ suicide, and a history of depression are all assessment data the nurse should obtain. History of seasonal​ allergies, learning​ difficulties, and seizures are not significant medical history to obtain for a suicidal client.)

Maryann D is a​ 45-year-old female who is being assessed because her husband is concerned that she is suicidal and depressed. Which assessment information is important for the nurse to obtain from Mrs.​ Dodge? a Family history of mood disorders b History of learning difficulties c Family history of seasonal allergies d History of seizures

a (Individuals with bipolar disorder are typically treated with mood stabilizers. Selective serotonin reuptake inhibitors​ (SSRI) are used to treat clients with depression. Antipsychotics treat schizophrenia by treating hallucinations and delusions. Antianxiety medications relieve symptoms of anxiety.)

Mr. G comes to the mental health clinic and reports that he feels so down and lacks any energy. The nurse knows that this client has a history of bipolar disorder. The nurse would expect Mr. G to be on what medication for his bipolar​ disorder? a Mood stabilizers b Selective serotonin reuptake inhibitors​ (SSRI) c Antipsychotics d Antianxiety

a,e (a,e The risk of suicide may actually increase, especially during the initial phase of treatment, and more often in children, adolescents, and young adults. Patients should be observed closely for changes in behavior or mood that may indicate suicidality.)

The healthcare provider is teaching a group of students about suicide assessment and prevention. Which of the following will be included in the teaching? Select all that apply. a When medication improves a patient's mood, they may attempt suicide. b If a patient is unsuccessful in a suicide attempt, another attempt is unlikely. c There are often no warning signs before a patient commits suicide. d It's important not to ask a patient whether they are having suicidal thoughts. e A patient who talks about suicide may be signaling others for help.

c (Rationale: Fictional portrayals of suicide can glamorize the event and present an unrealistic or attractive picture of suicidal behavior. Community resources including phone numbers for mental health centers and hotlines can help clients resist the impulse to commit suicide and provide the family with needed assistance. Alternative coping behaviors that have been successfully used in the past can help clients to problem-solve and develop a list of appropriate measures to take in the future when suicidal thoughts recur. National statistics and books about suicide can broaden the clients' knowledge regarding suicide and provide reliable information, which may help prevent future suicidal behavior.)

The nurse is leading a group for depressed clients who have attempted suicide in the past. Which topic is not appropriate to discuss with this group? a Community resources including phone numbers for mental health centers and hotlines b Alternative coping behaviors that have been successfully used in the past c Movies that dramatize suicidal behavior d National statistics and books about suicide

b (Rationale:Medications will help decrease the frequency and intensity of suicidal thoughts. Medications may treat the underlying cause but do not necessarily reduce the risk for suicide. Medication does not prevent suicide; in fact, many times when clients regain their energy from medications, they are at increased risk for suicide. A client may not be at risk currently because of medication, but that does not rule out an attempt in the future, so the nurse should not tell the family not to worry.)

The nurse working with the family of a client with suicidal ideations is asked if the medication the client is taking will prevent suicide. Which response by the nurse would be most appropriate? a "Clients who take the medication as prescribed are at decreased risk for suicide." b "Medication helps decrease the frequency and intensity of suicidal thoughts." c "Medication helps treat an underlying mood disorder associated with suicidal thinking and therefore prevents suicide." d "The client states that no more attempts will be made at suicide, so you don't need to worry."

a (high risk factors that have been related to suicide include hopelessness, Caucasian race, male gender, advanced age, living alone, previous attempts, family history of suicide/attempts

When developing appropriate assignments for the staff, which client should the nurse manager judge to be at highest risk for suicide completion? a. an 85 year old caucasian man who lives alone after his wifes death b. a 34 year old single latino woman who has recently been diagnosed with cancer c. a 15 year old girl of african descent whose boyfriend broke up with her d a 52 year old asian man who was terminated from his job because of downsizing.

a.b.d.e (Because suicide is an escape​ from, or an end​ to, what is perceived to be an intolerable​ situation, crisis, or​ relationship, motivating factors include bullies in school or​ workplace, job​ loss, loss of loved​ one, and depression. The need for attention is not identified as a motivating factor.)

Which are factors that often motivate a person to commit​ suicide? Select all that apply. a Bullying in school or workplace b Losing a job c Needing attention d Losing a loved one e Suffering depression

c ( Feedback Rationale: "I am thankful for my husband and children" indicates that the client is able to list reasons to live. Talking about possible ways to commit suicide is not a positive outcome; the client may be researching methods for committing suicide. Constant family supervision is not a positive outcome, because the client is not taking personal responsibility for safety. Preferring death over dealing with pain is not a positive outcome; the client is unwilling or unable to cope effectively with painful feelings. )

Which client statement indicates a positive outcome to treatment for suicidal behavior? a "It helps me feel better to talk about possible ways to commit suicide." b "I know my family realizes that I should never be left alone." c "I am thankful for my husband and children." d "It's a lot harder to deal with my pain than it would be to face my death."

d (The suicide threat is more serious than suicidal ideation and might include behavior​ changes, mood​ swings, personality​ changes, changes in work or school​ performance, withdrawal from friends and​ family, and significant attitude changes. Suicidal ideation occurs when the client thinks about suicide as a possible solution to​ life's problems. Suicide attempts occur when a person actually tries to take her own life. The person may​ live, but future attempts are likely. Suicide is when someone successfully takes her own life.)

You are assessing Doreen​ Hampshire, a​ 25-year-old woman who has mood​ swings, has regularly been calling in sick to​ work, and has withdrawn from her friends. Which best describes this phase of a suicidal​ client? a Suicidal ideation b Suicide attempt c Suicide d Suicide threat

c (Rationale The nurse should concisely explain the benefit of the medication to the client to increase the possibility of compliance. The client has the right to refuse​ treatment, which in this instance is the medication.The nurse would not threaten the client by stating that a shot will be given when there is no primary healthcare provider prescription. Giving written medication information to a client with acute mania is poor nursing judgment because a client with acute mania cannot benefit from written information due to his impaired ability to focus and concentrate.)

A client with acute​ mania, who has previously threatened​ suicide, has been admitted to the inpatient unit voluntarily. The nurse approaches the client with medication to be taken orally as prescribed by the primary healthcare provider. The client​ states, "I don​'t need that stuff. " Which is the best response by the​ nurse? ​ a "I will get you some written information about the medication. " b "I will give you a shot if you don​'t take this medication by mouth. " c "The medication will help stabilize your mood. " d "You are not allowed to refuse medications.

4,5,6 ( When working with the family of a depressed client it is helpful for the nurse to be aware of the clients families communication style, role expectations and current family stressors. This information can help identify family difficulties and teaching points that could benefit the client and family. Information concerning physical pain, personal responsibilities and employment skills would not be helpful because these area are not directly related to their experience of having a depressed family member)

A nurse interviews the family of a client hospitalized with severe depression and suicidal ideation. What family assessment information is essential to know when formulating an effective plan of care? 1. physical pain 2. personal responsibilities 3 employment skills 4 communication patterns 5 role expectations 6 current family stressors

a,c,e

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 a current suicidal ideation e. teaching middle school educators about warning indicators for suicide

2,3,5 ( ECT is used to treat acute depressive illnesses in an attempt to reverse life-threatening situations, such as disturbing delusions, agitation, and attempted suicide or when conventional therapies are unsuccessful. It is also used when the client can not tolerate antidepressants since other regimens for depression can take weeks to be effective. )

A nurse is caring for a client with severe depression. In which conditions would the nurse anticipate the use of ECT? select all that apply 1. The client has dementia 2. The client cannot tolerate MAOI's 3. The client has not responded to conventional therapy 4. The client is undergoing stressful life changes 5. The client is having acute suicidal thoughts.

d

A nurse is conducting a class for a group of newly licensed nurses on caring for clients with risk for suicide. Which of the following information should the nurse include in the teaching?a. a clients verbal threat of suicide is an attention seeking behaviorb. interventions are ineffective for clients who really want to kill themselvesc. using the term suicide increases the clients risk for an attemptd. a no-suicide contract decreases the clients risk for suicide