Question 1

A college student who failed two tests cried for hours and then tried to telephone a parent but got no answer.The student then gave several expensive sweaters to a roommate and asked to be left alone for a few hours.Which behavior provides the strongest clue of an impending suicide attempt?

Accepted Answer

A)   Calling parents
B)   Excessive crying
C)   Giving away sweaters
D)   Staying alone in dorm room C

Question 2

The feeling experienced by a patient that should be assessed by the nurse as most predictive of elevated suicide risk is

Accepted Answer

A)   hopelessness.
B)   sadness.
C)   elation.
D)   anger. A

Question 3

Four individuals have given information about their suicide plans.Which plan evidences the highest suicide risk?

Accepted Answer

A)   Turning on the oven and letting gas escape into the apartment during the night
B)   Cutting the wrists in the bathroom while the spouse reads in the next room
C)   Overdosing on aspirin with codeine while the spouse is out with friends
D)   Jumping from a railroad bridge located in a deserted area late at night D

Question 4

A person intentionally overdosed on antidepressants.Which nursing diagnosis has the highest priority?

Accepted Answer

A)   Powerlessness
B)   Social isolation
C)   Risk for suicide
D)   Compromised family coping

Question 5

Which intervention will the nurse recommend for the distressed family and friends of someone who has committed suicide?

Accepted Answer

A)   Participating in reminiscence therapy
B)   Psychological postmortem assessment
C)   Attending a self-help group for survivors
D)   Contracting for at least two sessions of group therapy

Question 6

A college student is extremely upset after failing two examinations.The student said,"No one understands how this will hurt my chances of getting into medical school." The student then suspends access to his social networking website and turns off his cell phone.Which suicide risk factors are evident? Select all that apply.

Accepted Answer

A)   Shame
B)   Panic attack
C)   Humiliation
D)   Self-imposed isolation
E)   Recent stressful life event

Question 7

A tearful,anxious patient at the outpatient clinic reports,"I should be dead." The initial task of the nurse conducting the assessment interview is to:

Accepted Answer

A)   assess lethality of suicide plan.
B)   encourage expression of anger.
C)   establish rapport with the patient.
D)   determine risk factors for suicide.

Question 8

A nurse and patient construct a no-suicide contract.Select the preferable wording.

Accepted Answer

A)   "I will not try to harm myself during the next 24 hours."
B)   "I will not make a suicide attempt while I am hospitalized."
C)   "For the next 24 hours, I will not in any way attempt to harm or kill myself."
D)   "I will not kill myself until I call my primary nurse or a member of the staff."

Question 9

Which statement provides the best rationale for closely monitoring a severely depressed patient during antidepressant medication therapy?

Accepted Answer

A)   As depression lifts, physical energy becomes available to carry out suicide.
B)   Patients who previously had suicidal thoughts need to discuss their feelings.
C)   For most patients, antidepressant medication results in increased suicidal thinking.
D)   Suicide is an impulsive act. Antidepressant medication does not alter impulsivity.

Question 10

After one of their identical twin daughters commits suicide,the parents express concern that the other twin may also have suicidal tendencies.Which reply should the nurse provide?

Accepted Answer

A)   "Genetics are associated with suicide risk. Monitoring and support are important."
B)   "Apathy underlies suicide. Instilling motivation is the key to health maintenance."
C)   "Your child is unlikely to act out suicide when identifying with a suicide victim."
D)   "Fraternal twins are at higher risk for suicide than identical twins."

Question 11

Select the most critical question for the nurse to ask an adolescent who has threatened to take an overdose of pills.

Accepted Answer

A)   "Why do you want to kill yourself?"
B)   "Do you have access to medications?"
C)   "Have you been taking drugs and alcohol?"
D)   "Did something happen with your parents?"

Question 12

An adult outpatient diagnosed with major depression has a history of several suicide attempts by overdose.Given this patient's history and diagnosis,which antidepressant medication would the nurse expect to be prescribed?

Accepted Answer

A)   Amitriptyline (Elavil) , a sedating tricyclic medication
B)   Fluoxetine (Prozac) , a selective serotonin reuptake inhibitor
C)   Desipramine (Norpramin) , a stimulating tricyclic medication
D)   Tranylcypromine sulfate (Parnate) , a monoamine oxidase inhibitor

Question 13

Which individual in the emergency department should be considered at highest risk for completing suicide?

Accepted Answer

A)   An adolescent Asian American girl with superior athletic and academic skills who has asthma
B)   A 38-year-old single, African American female church member with fibrocystic breast disease
C)   A 60-year-old married Hispanic man with twelve grandchildren who has type 2 diabetes
D)   A 79-year-old single, white male diagnosed recently with terminal cancer of the prostate

Question 14

It has been 5 days since a suicidal patient was hospitalized and prescribed an antidepressant medication.The patient is now more talkative and shows increased energy.Select the highest priority nursing intervention.

Accepted Answer

A)   Supervise the patient 24 hours a day.
B)   Begin discharge planning for the patient.
C)   Refer the patient to art and music therapists.
D)   Consider discontinuation of suicide precautions.

Question 15

Which measure would be considered a form of primary prevention for suicide?

Accepted Answer

A)   Psychiatric hospitalization of a suicidal patient
B)   Referral of a formerly suicidal patient to a support group
C)   Suicide precautions for 24 hours for newly admitted patients
D)   Helping school children learn to manage stress and be resilient

Question 16

A nurse counsels a patient with recent suicidal ideation.Which is the nurse's most therapeutic comment?

Accepted Answer

A)   "Let's make a list of all your problems and think of solutions for each one."
B)   "I'm happy you're taking control of your problems and trying to find solutions."
C)   "When you have bad feelings, try to focus on positive experiences from your life."
D)   "Let's consider which problems are very important and which are less important."

Question 17

Which nursing interventions will be implemented for a patient who is actively suicidal? Select all that apply.

Accepted Answer

A)   Maintain arm's-length, one-on-one direct observation at all times.
B)   Check all items brought by visitors and remove risk items.
C)   Use plastic eating utensils; count utensils upon collection.
D)   Remove the patient's eyeglasses to prevent self-injury.
E)   Interact with the patient every 15 minutes.

Question 18

A college student who attempted suicide by overdose was hospitalized.When the parents were contacted,they responded,"We should have seen this coming.We did not do enough." The parents' reaction reflects:

Accepted Answer

A)   guilt.
B)   denial.
C)   shame.
D)   rescue feelings.

Question 19

A patient hospitalized for 2 weeks committed suicide during the night.Which initial nursing measure will be most important regarding this event?

Accepted Answer

A)   Ask the information technology manager to verify the hospital information system is secure.
B)   Hold a staff meeting to express feelings and plan care for the other patients.
C)   Ask the patient's roommate not to discuss the event with other patients.
D)   Prepare a report of a sentinel event.

Question 20

A person who attempted suicide by overdose was treated in the emergency department and then hospitalized.The initial outcome is that the patient will:

Accepted Answer

A)   verbalize a will to live by the end of the second hospital day.
B)   describe two new coping mechanisms by the end of the third hospital day.
C)   accurately delineate personal strengths by the end of first week of hospitalization.
D)   exercise suicide self-restraint by refraining from attempts to harm self for 24 hours.

Exam 25: Suicide and Non-Suicidal Self-Injury