Question 1

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, rates mood at 9/10, and is much more communicative. Which action should be the nurse's priority at this time?

Accepted Answer

A)  Give the client off-unit privileges as positive reinforcement.
B)  Encourage the client to share mood improvement in group.
C)  Increase frequency of client observation.
D)  Request that the psychiatrist reevaluate the current medication protocol. C

Question 2

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?

Accepted Answer

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

Question 3

A client is newly admitted to an inpatient psychiatric unit. Which assessment data are critical in determining an increased risk for suicide?

Accepted Answer

A)  Monitoring the client continually for 1 hour after admission
B)  Encouraging the client to discuss feelings
C)  Asking the client about any history of suicide attempts
D)  Removing hazardous materials from the environment C

Question 4

A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide?

Accepted Answer

A)  Encouraging participation in the milieu to promote hope
B)  Developing a strong personal relationship with the client
C)  Observing the client at intervals determined by assessed data
D)  Encouraging and redirecting the client to concentrate on happier times

Question 5

Which nursing intervention strategy is most appropriate to implement initially with a suicidal client?

Accepted Answer

A)  Ask a direct question such as, "Do you ever think about killing yourself?"
B)  Ask client, "Please rate your mood on a scale from 1 to 10."
C)  Establish a trusting nurse-client relationship.
D)  Apply the nursing process to the planning of client care.

Question 6

A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse manager's best reply?

Accepted Answer

A)  "Suicide is a DSM-IV-TR diagnosis."
B)  "Suicide is a mental disorder."
C)  "Suicide is a behavior."
D)  "Suicide is an antisocial affliction."

Question 7

Which client data indicate that a suicidal client is participating in a plan for safety?

Accepted Answer

A)  Compliance with antidepressant therapy
B)  A mood rating of 9/10
C)  Disclosing a plan for suicide to staff
D)  Expressing feelings of hopelessness to nurse

Question 8

A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the most appropriate nursing reply?

Accepted Answer

A)  "Why don't you consider doing volunteer work in a homeless shelter."
B)  "Let's discuss the negative aspects of your life."
C)  "Things will look better in the morning."
D)  "It sounds like you are feeling pretty hopeless."

Question 9

A client has been brought to the emergency department for signs and symptoms of Chronic Obstructive Pulmonary Disease (COPD). The client has a history of a suicide attempt 1 year ago. Which nursing intervention would take priority in this situation?

Accepted Answer

A)  Assessing the client's pulse oximetry and vital signs
B)  Developing a plan for safety for the client
C)  Assessing the client for suicidal ideations
D)  Establishing a trusting nurse-client relationship

Question 10

In planning care for a suicidal client, which correctly written outcome should be a nurse's first priority?

Accepted Answer

A)  The client will not physically harm self.
B)  The client will express hope for the future by day 3.
C)  The client will establish a trusting relationship with the nurse.
D)  The client will remain safe during the hospital stay.

Question 11

Which statement indicates that the nurse is acting as an advocate for a client who has recently made a suicide attempt?

Accepted Answer

A)  "I must observe you continually for 1 hour in order to keep you safe."
B)  "Let's confer with the treatment team about the triggers to your attempt that we discussed."
C)  "You must have been very upset to do what you did today."
D)  "Are you currently thinking about harming yourself?"

Question 12

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?

Accepted Answer

A)  Provide a 6-month supply of Elavil to ensure long-term compliance.
B)  Provide a 1-week supply of Elavil with refills contingent on follow-up appointments.
C)  Provide a pill dispenser as a memory aid.
D)  Provide education regarding the avoidance of foods containing tyramine.

Question 13

A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred?

Accepted Answer

A)  "Suicidal threats and gestures should be considered manipulative and/or attention-seeking."
B)  "Suicide is the act of a psychotic person."
C)  "All suicidal individuals are mentally ill."
D)  "50% to 80% of all people who kill themselves have a history of a previous attempt."

Question 14

A nurse discovers a client's suicide note that details the time, place, and means to commit suicide. What should be the priority nursing intervention, and the rationale for this action?

Accepted Answer

A)  Administering lorazepam (Ativan)  prn because the client is angry about the discovery of the note
B)  Establishing room restrictions because the client's threat is an attempt to manipulate the staff
C)  Placing this client on one-to-one suicide precautions because the more specific the plan, the more likely the client will attempt suicide
D)  Calling an emergency treatment team meeting because the client's threat must be addressed

Question 15

A stockbroker commits suicide after being convicted of insider trading. Which information should a nurse share with the grieving family?

Accepted Answer

A)  "Keep in mind that your grieving will only last for 1 year."
B)  "To deal with your grief, try using coping strategies that have worked for you in the past."
C)  "You need to write a letter to the brokerage firm to express your anger with them."
D)  "It would be best if you avoid discussing the suicide."

Question 16

A nurse is caring for four clients diagnosed with major depression. When considering the client's belief system, which client would potentially be at highest risk for suicide?

Accepted Answer

A)  Roman Catholic
B)  Protestant
C)  Atheist
D)  Muslim

Question 17

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

Accepted Answer

A)  Elderly people use less lethal means to commit suicide.
B)  While the elderly make up less than 13% of the population, they account for 16% of all suicides.
C)  Suicide is the second leading cause of death in the elderly.
D)  It is normal for elderly individuals to express a desire to die because they have come to terms with their mortality.

Question 18

The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide?

Accepted Answer

A)  Address only serious suicide threats to avoid the possibility of secondary gain.
B)  Promote trust by verbalizing a promise to keep suicide attempt information within the family.
C)  Offer a private environment to provide needed time alone at least once a day.
D)  Be available to actively listen, support, and accept feelings.

Question 19

After a teenager reveals that he is gay, the father responds by beating him. The next morning, the teenager is found hanging in his closet. Which paternal emotions should a nurse anticipate? (Select all that apply.)

Accepted Answer

A)  Shock and disbelief
B)  Guilt and remorse
C)  Anger and resentment
D)  Bargaining and depression
E)  Denial and rationalization

Question 20

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. What should be the nurse's priority intervention at this time?

Accepted Answer

A)  Obtaining an order for locked seclusion until client is no longer suicidal
B)  Conducting 15-minute checks to ensure safety
C)  Placing the client on one-to-one observation while monitoring suicidal ideations
D)  Encouraging client to express feelings related to suicide

Exam 18: Intervention With a Suicidal Client