Download NSG 503 WEEK 4 (CH 11 LEC) QUESTIONS AND 100% CORRECT ANSWERS!! and more Exams Advanced Education in PDF only on Docsity!
NSG 503 WEEK 4 (CH 1 1 LEC) QUESTIONS AND 100%
CORRECT ANSWERS!!
Which of the following individuals is at highest risk for a suicide attempt?
a. John, who reports he is in deep emotional pain, feels hopeless, and says "No one is there for me." b. Kelly, who has been seeing a doctor for chronic, intractable pain and is taking pain medication. c. Jim, an American Indian who just graduated from high school with honors. d. Mike, a physician who reports feeling 'burnt out" and is considering retirement. a. John, who reports he is in deep emotional pain, feels hopeless, and says "No one is there for me."
We have an expert-written solution to this problem! The nurse in the emergency department encounters a patient, Niko, who is expressing suicide ideation. The nurse recognizes that which of the following considerations are important to good suicide risk assessment? (Select all that apply.)
a. Collaborating with the patient b. Asking specific questions about leisure activities c. Establishing trust and open communication with the patient d. Asking the patient specific questions about the strength of his intention to die e. Identifying whether the patient has thought about a plan for trying to kill himself a. Collaborating with the patient c. Establishing trust and open communication with the patient
d. Asking the patient specific questions about the strength of his intention to die e. Identifying whether the patient has thought about a plan for trying to kill himself
Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for six years. I love him so much. I know I'll never get over him." Which is the best response by the nurse?
a. "You'll get over him in time, Theresa." b. "Forget him. There are other fish in the sea." c. "You must be feeling sad about your loss." d. "Why do you think he broke up with you, Theresa?" c. "You must be feeling sad about your loss."
The nurse identifies the primary nursing diagnosis for Theresa as Risk for suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would be most appropriate for this diagnosis?"
a. The client has experienced no physical harm to herself. b. The client sets realistic goals for herself. c. The client expresses some optimism and hope for the future. d. The client has reached a stage of acceptance in the loss of the relationship with her boyfriend. a. The client has experienced no physical harm to herself.
Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend.
c. Imminent risk d. Unable to be determined b. High risk
Theresa, who has been hospitalized following a suicide attempt is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions are most appropriate in this instance? (Select all that apply.)
a. Restrict access to any item that might be harmful by placing the client in a seclusion room. b. Check on Theresa every 15 minutes at irregular intervals, or assign a staff person to stay with her on a one-to-one basis. c. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas. d. Do not allow Theresa to participate in any unit activities while she is on suicide precautions. e. Ask Theresa specific questions about her thoughts, plans, and intentions related to suicide. b. Check on Theresa every 15 minutes at irregular intervals, or assign a staff person to stay with her on a one-to-one basis. e. Ask Theresa specific questions about her thoughts, plans, and intentions related to suicide.
Which of the following interventions are appropriate for a client on suicide precautions? (Select all that apply.)
a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities.
c. Reassess intensity of suicidal thoughts and urges on a regular basis. d. Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions. a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Reassess intensity of suicidal thoughts and urges on a regular basis.
We have an expert-written solution to this problem! Success of long-term psychotherapy with Theresa (who attempted suicide following a break-up with her boyfriend) could be measured by which of the following behaviors?
a. Theresa has a new boyfriend. b. Theresa has an increased sense of self-worth. c. Theresa does not take antidepressants anymore. d. Theresa told her old boyfriend how angry she was with him for breaking up with her. b. Theresa has an increased sense of self-worth.
A nurse discovers a clients 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? A. Administering lorazepam (Ativan) prn, because the client is angry about the discovery of the note B. Establishing room restrictions, because the clients 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 clients threat must be addressed
C. Increase frequency of client observation. D. Request that the psychiatrist reevaluate the current medication protocol. C. Increase frequency of client observation.
- 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 clients safety upon discharge? 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. B. Provide a 1-week supply of Elavil with refills contingent on follow-up appointments.
We have an expert-written solution to this problem!
- 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
- The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the teams decision?
A. No previous admissions for major depressive disorder B. Vital signs stable; no psychosis noted C. Able to comply with medication regimen; able to problem-solve life issues D. Able to participate in a plan for safety; family agrees to constant observation D. Able to participate in a plan for safety; family agrees to constant observation
We have an expert-written solution to this problem!
- 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? 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. D. Be available to actively listen, support, and accept feelings.
- A stockbroker commits suicide after being convicted of insider trading. In speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information? A. Your grieving will subside within 1 year; until then I recommend antidepressants. B. Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area. C. 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. D. Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone B. Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area.
D. After a brief assessment, the nurse should avoid the topic of suicide. A. The more specific the plan is, the more likely the client will attempt suicide.
- A suicidal client says to a nurse, Theres nothing to live for anymore. Which is the most appropriate nursing reply? A. Why dont you consider doing volunteer work in a homeless shelter? B. Lets discuss the negative aspects of your life. C. Things will look better in the morning. D. It sounds like you are feeling pretty hopeless. D. It sounds like you are feeling pretty hopeless.
- A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse managers best reply? A. Suicide is a DSM-5 diagnosis. B. Suicide is a mental disorder. C. Suicide is a behavior. D. Suicide is an antisocial affliction. C. Suicide is a behavior.
- A nursing student is developing a plan of care for a suicidal client. Which documented intervention should the student implement first? A. Communicate therapeutically. B. Observe the client. C. Provide a hazard-free environment. D. Assess suicide risk.
D. Assess suicide risk.
We have an expert-written solution to this problem!
- 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? A. The client will not physically harm self. B. The client will express three positive self-attributes by day 4. C. The client will reveal a suicide plan. D. The client will establish a trusting relationship. B. The client will express three positive self-attributes by day 4.
We have an expert-written solution to this problem!
- A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? 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. Fifty to eighty percent of all people who kill themselves have a history of a previous attempt. D. Fifty to eighty percent of all people who kill themselves have a history of a previous attempt.
- A nurse is caring for four clients diagnosed with major depressive disorder. When considering each clients belief system, the nurse should conclude which client would potentially be at highest risk for suicide?
C. Disclosing a plan for suicide to staff D. Expressing feelings of hopelessness to nurse C. Disclosing a plan for suicide to staff
We have an expert-written solution to this problem!
- 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? A. I must observe you continually for 1 hour in order to keep you safe. B. Lets confer with the treatment team about the resources that you may need after discharge. C. You must have been very upset to do what you did today. D. Are you currently thinking about harming yourself? B. Lets confer with the treatment team about the resources that you may need after discharge.
- A client is newly admitted to an inpatient psychiatric unit. Which of the following is most critical to assess when determining risk for suicide? A. Family history of depression B. The clients orientation to reality C. The clients history of suicide attempts D. Family support systems C. The clients history of suicide attempts
- 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?
A. Assessing the clients 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 A. Assessing the clients pulse oximetry and vital signs
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- 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 grief responses should a nurse anticipate? Select all that apply. A. I cant believe this is happening. B. If only I had been more understanding. C. How dare he do this to me! D. I'm just going to have to accept that he was gay. E. Well, that was a selfish thing to do. A. I cant believe this is happening. B. If only I had been more understanding. C. How dare he do this to me!
- 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. A. In the Middle Ages, suicide was viewed as a selfish and criminal act. B. During the Roman Empire, suicide was followed by incineration of the body. C. Suicide was an offense in ancient Greece, and a common-site burial was denied. D. During the Renaissance, suicide was discussed and viewed more philosophically. E. Old Norse traditionally set a person who committed suicide adrift in the North Sea.
c)Observe the client continuously to prevent self-harm. d)Assist the client to develop more effective coping mechanisms. d)Assist the client to develop more effective coping mechanisms.
- The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the teams decision?
A. No previous admissions for major depressive disorder
B. Vital signs stable; no psychosis noted
C. Able to comply with medication regimen; able to problem-solve life issues
D. Able to participate in a plan for safety; family agrees to constant observation D. Able to participate in a plan for safety; family agrees to constant observation
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- Which changes in brain biochemical function is most associated with suicidal behavior? a. Dopamine excess b. Serotonin deficiency c. Acetylcholine excess d. Gamma-aminobutyric acid deficiency b. Serotonin deficiency
- A college student failed two tests. Afterward, the student cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate. Which behavior provides the strongest clue of an impending suicide attempt? a. Calling parents b. Excessive crying c. Giving away sweaters d. Staying alone in a dorm room c. Giving away sweaters
- A nurse uses the SAD PERSONS scale to interview a patient. This tool provides data relevant to: a. current stress level. b. mood disturbance. c. suicide potential. d. level of anxiety. c. suicide potential.
The SAD PERSONS tool evaluates 10 major risk factors in suicide potential: sex, age, depression, previous attempt, ethanol use, rational thinking loss, social supports lacking, organized plan, no spouse, and sickness. The tool does not have appropriate categories to provide information on the other options listed.
- A person intentionally overdoses on antidepressant drugs. Which nursing diagnosis has the highest priority? a. Powerlessness b. Social isolation
The parents' statements indicate denial. Denial or minimization of suicidal ideation or attempts is a defense against uncomfortable feelings. Family members are often unable to acknowledge suicidal ideation in someone close to them. The feelings suggested in the distractors are not clearly described in the scenario.
- An adolescent tells the school nurse, "My friend threatened to take an overdose of pills." The nurse talks to the friend who verbalized the suicide threat. The most critical question for the nurse to ask would be: 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?" b. "Do you have access to medications?"
The nurse must assess the patient's access to the means to carry out the plan and, if there is access, alert the parents to remove them from the home. The other questions may be important to ask but are not the most critical.
- An adult attempts suicide after declaring bankruptcy. The patient is hospitalized and takes an antidepressant medication for five days. The patient is now more talkative and shows increased energy. Select the highest priority nursing intervention. 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 the discontinuation of suicide precautions. a. Supervise the patient 24 hours a day.
The patient now has more energy and may have decided on suicide, especially
considering the history of the prior suicide attempt. The patient is still a suicide risk; therefore, continuous supervision is indicated.
- A nurse and patient construct a no-suicide contract. Select the preferable wording for the contract. 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 kill or harm myself in any way." d. "I will not kill myself until I call my primary nurse or a member of the staff." c. "For the next 24 hours, I will not kill or harm myself in any way."
The correct answer leaves no loopholes. The wording about not harming oneself and not making an attempt leaves loopholes or can be ignored by the patient who thinks, "I am not going to harm myself, I am going to kill myself," or "I am not going to attempt suicide, I am going to commit suicide." A patient may call a therapist and leave the telephone to carry out the suicidal plan.
We have an expert-written solution to this problem!
- 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: a. assess the lethality of a suicide plan. b. encourage expression of anger. c. establish a rapport with the patient. d. determine risk factors for suicide. c. establish a rapport with the patient.
Establishing rapport will allow the nurse to obtain relevant assessment data such as the presence of a suicide plan, the lethality of a suicide plan, and the presence of risk factors for suicide.
