Chapter 13: Suicide My Nursing Test Banks

Chapter 13: Suicide

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Suicide is most likely to occur:

A.

On admission to a psychiatric hospital.

B.

At the beginning of psychotherapy.

C.

As the depression begins lifting.

D.

When the depression deepens.

____ 2. Your new patient is admitted after a suicide attempt. She states, Let me die, I dont deserve to live. What is your best response?

A.

Why do you want to die?

B.

You have so much to live for.

C.

How do you think your family feels now?

D.

You must have been feeling very hopeless. Tell me about it.

____ 3. Your depressed patient has suddenly changed to being more cheerful and tells you he wants to reduce the clutter at home and give away some prized possessions to friends. What should be your response?

A.

Im glad you are feeling better.

B.

Ill tell the doctor and maybe he will reduce your dose of antidepressant.

C.

Ask the patient if he has any thoughts about suicide.

D.

Document what the patient tells you and see another patient.

____ 4. Which of the following statements is true about suicide?

A.

There is generally some warning when someone commits suicide.

B.

Victims of suicide have a genetic predisposition to it.

C.

Suicide can always be prevented.

D.

Talking about suicide means the person is not serious about it.

____ 5. A patient becomes suicidal and is transferred to the locked unit of your hospital. Because this patient is actively suicidal you should:

A.

Keep the patient in your line of vision at all times.

B.

Perform suicide assessments every half-hour.

C.

Inform the doctor that the patient is now in a locked area.

D.

Take vital signs every 15 minutes.

____ 6. Patients are most likely to commit suicide when:

A.

They are severely depressed.

B.

The depression is lifting.

C.

They are recently discharged from the hospital.

D.

They have a significant other who is supportive.

____ 7. As you perform a suicide assessment on your patient, you learn that the patient has only one person to call in times of need, has been thinking about suicide frequently in past weeks, and has attempted suicide once before. Given this information you believe this patients suicide risk is:

A.

Low.

B.

Moderate.

C.

None.

D.

Imminent.

____ 8. Which would be most important to find out next about the above patient?

A.

Does he have a suicide plan now?

B.

What is his psychiatric diagnosis?

C.

Who does he live with?

D.

What type of psychiatric therapy has he had recently?

____ 9. The best approach a nurse can use to gain information relating to a patients potential for suicide is to ask:

A.

What do you plan to be doing 5 years from now?

B.

Does your family know you are considering suicide?

C.

What have other patients told you about their suicide attempts?

D.

Are you thinking of killing yourself now?

____ 10. When planning care for a patient who is suicidal, the nurse knows:

A.

Suicide attempts are only gestures.

B.

Suicide is a crime and must be reported to the authorities.

C.

Teaching new problem-solving skills is a priority of care for suicidal patients.

D.

It is necessary to know the reasons why the patient has suicidal thoughts.

____ 11. You have been consistently caring for a patient who is suicidal who now tells you, Nurse, I finally have it all figured out. Its going to be just fine. Your best response to this patient is:

A.

Im so glad to hear that!

B.

What a relief for you!

C.

Im not sure I understand what you mean. Tell me more.

D.

You are not depressed anymore then

____ 12. Of the following patient statements, which do nurses recognize as the highest risk for a patient to commit suicide?

A.

Ive been saving my pain medications for when I really need them. Now that my spouse has left me I think I will use them right before the holidays.

B.

I told my boss if he fires me, Ill kill myself.

C.

Nobody appreciates the work I do. Theyd miss me if I just killed myself and was gone one day.

D.

I really admire people who have enough nerve to kill themselves. Im not that brave yet.

____ 13. You are caring for an adolescent patient who has swallowed all of his mothers sleeping pills and pain pills. The patient has had a gastric lavage and is able to answer questions. The best question to ask this patient is:

A.

What are your thoughts right now about hurting yourself?

B.

Why on earth did you do that?

C.

Dont you know how much your family loves you and how much they will miss you if you kill yourself?

D.

This is a very immature way to get attention.

____ 14. A suicidal patient has been transferred to your unit from the medical floor and asks you why he or she has to be watched every minute. I have a right to my privacy; Im an adult and can come and go as I please. The bestresponse to this patient is:

A.

Why do you think you are being watched?

B.

We are concerned that you might attempt to seriously hurt yourself.

C.

It shouldnt bother you if you have nothing to hide from us.

D.

This is a direct order from your doctor.

____ 15. Your 15-year-old neighbor, who knows you are a mental health nurse, informs you that he has a friend who is talking about suicide. Your best initial response to the young neighbor is:

A.

Who is it? Another neighbor?

B.

I have some time. Tell me a little about this friend.

C.

Who else knows? Has this friend told anyone else?

D.

Your friend needs help right away!

____ 16. Of the following, which response is the most important for a nurse when evaluating suicide risk in a newly admitted depressed patient?

A.

The patients plans for the immediate future after discharge

B.

How long the person has felt depressed

C.

How many personal problems the patient lists as stressors

D.

How the patient plans to handle the upcoming anniversary of his or her spouses death

____ 17. Denise is brought by ambulance to the emergency room with agitation related to an overdose of prescribed antipsychotic medication. Initially the most important piece of information the charge nurse should obtain is:

A.

How long the patient has been on the medication.

B.

The name and amount of the ingested medication.

C.

Reason for the suicide attempt.

D.

The name of the nearest relative and their phone number.

____ 18. The LPN/LVN is assisting with the data collection of a patient recently admitted to the mental health unit. During the interview, the patient makes a statement that concerns the nurse. Which of the following statements would be most likely to prompt immediate attention?

A.

When I get out of here I am going to overdose on my mothers medication.

B.

When I get discharged, I am thinking I might try suicide again.

C.

I dont feel any better since I got here.

D.

If I get the chance, I just might run away.

Chapter 13: Suicide

Answer Section

MULTIPLE CHOICE

1. ANS: C

As depression lifts, the patient may have more energy to carry out a suicide plan.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210-211

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

2. ANS: D

This answer allows the patient to acknowledge her feelings and talk about them. The other responses sound more judgmental.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

3. ANS: C

Giving away prized possessions often precedes planned suicide. Being direct and asking about suicide intent is important.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

4. ANS: A

Most people give some warning about being at risk to commit suicide. Responses B, C, and D are all incorrect information about suicide risk.

PTS: 1 REF: Chapter 13: Suicide; The Warning Signs of Suicide; page 207-208

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Suicide | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts

5. ANS: A

If the patient has been determined to be at high risk for suicide, protection of the patient requires constant supervision because the patient could have access to a method that could lead to sudden death.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts and Safe and Effective Care Environment

6. ANS: B

This is the highest risk because the patient has more energy when the depression is lifting but may still suffer from sadness and hopelessness.

PTS: 1 REF: Chapter 13: Suicide; The Warning Signs of Suicide; page 208

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

7. ANS: B

This patient has suicidal thoughts, a limited support system, and previous history, all of which indicate a moderate risk. For imminent risk the patient would need to have access to a highly lethal method at that time.

PTS: 1

REF: Chapter 13: Suicide; The Reality of Suicide; page 205; Warning Signs of Suicide; page 208

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

8. ANS: A

Asking directly about a suicide plan is the most important question to ask a person with some suicide risk. All the other choices give important information but would not be a priority given the situation.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

9. ANS: D

A direct approach is the best way to gain this information.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

10. ANS: C

Helping the person to identify new ways to address problems so he or she can see alternatives is a key intervention. The patient may not know the reason for these feelings. A past history of suicide attempts can be a predictor of future attempts.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

11. ANS: C

You would want to know the meaning of the patients words, as they could be interpreted as a decision to commit suicide rather than making assumptions about what they mean.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

12. ANS: A

This patient clearly has the means available and a specific plan along with suicidal intent.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

13. ANS: A

Response A is an open-ended question to encourage the patient to talk. The other responses are judgmental and not helpful.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

14. ANS: B

This response communicates clearly and honestly your concern. The other responses are indirect communication about the patients risk for self-injury.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

15. ANS: B

You should use open-ended statements to elicit more information rather than jump to conclusions that might close off communication.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

16. ANS: D

This upcoming anniversary could represent an imminent increased risk for suicide, so it would be the most important information to have.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

17. ANS: B

In an emergency, information relating to the patients drug history is important. In this case, the medications name and amount taken will be needed to provide effective treatment. The other responses are important but can be obtained after initial emergency care.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 209

KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Pharmacology | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Management of Care: Establishing Priorities

18. ANS: A

The patient expresses the desire to end her life and verbalizes that there is a method for ending her life. This would be the highest risk that would need immediate action because the patient has motivation and the means to commit suicide.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 94

KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Suicide | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental Health Concepts

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