Chapter 23 My Nursing Test Banks


Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 23

Question 1

Type: MCMA

While taking care of a client at the mental health clinic, the student nurse notices scars and healing lacerations on the clients arms. The client states, I did all of that. The student nurse knows this type of behavior is:

Standard Text: Select all that apply.

1. Self-destructive.

2. A prank.

3. A maladaptive measure.

4. A coping mechanism.

5. A waste of time.

Correct Answer: 1,3,4

Rationale 1: Self-destructive. Self-destructive behaviors are sometimes used to restore inner equilibrium when a mentally ill client feels overwhelmed.

Rationale 2: A prank. A prank is a silly or mean act done for fun.

Rationale 3: A maladaptive measure. Self-harming behaviors are maladaptive ways some clients use to cope with lifes stressors.

Rationale 4: A coping mechanism. Harming oneself is a coping mechanism employed by some mentally ill clients in an effort to take away unbearable emotional pain.

Rationale 5: A waste of time. Self-destructive, maladaptive coping mechanisms are not a waste of time to the clients experiencing these behaviors.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify the social, demographic, and clinical variables that influence suicidal or self-destructive behavior.

Question 2

Type: MCSA

When teaching students about suicide, the nursing instructor knows to include facts such as:

1. Over 31,000 people kill themselves each year, and suicide is the primary reason for their deaths.

2. Suicide is the fourth leading cause of death among African-American teenagers and the ninth leading cause of Caucasian teen deaths.

3. Suicide is the 11th leading cause of self-inflicted injuries, accounting for over 325,000 people each year going to the emergency department.

4. Suicide is the leading cause of death among mentally ill clients, and over three million people kill themselves each year according to the CDC.

5. Suicide is the 11th leading cause of death among Americans, and as many as 44% of psychiatric emergency clients are at increased risk for suicide.

Correct Answer: 5

Rationale 1: Suicide, the willful act of ending ones own life, is the 11th leading cause of death among Americans. Over 34,000 people kill themselves each year (CDC, 2009), and as many as 44% of psychiatric emergency clients are at increased risk for suicide (Pompili, et al., 2009).

Rationale 2: Suicide, the willful act of ending ones own life, is the 11th leading cause of death among Americans. Over 34,000 people kill themselves each year (CDC, 2009), and as many as 44% of psychiatric emergency clients are at increased risk for suicide (Pompili, et al., 2009).

Rationale 3: Suicide, the willful act of ending ones own life, is the 11th leading cause of death among Americans. Over 34,000 people kill themselves each year (CDC, 2009), and as many as 44% of psychiatric emergency clients are at increased risk for suicide (Pompili, et al., 2009).

Rationale 4: Suicide, the willful act of ending ones own life, is the 11th leading cause of death among Americans. Over 34,000 people kill themselves each year (CDC, 2009), and as many as 44% of psychiatric emergency clients are at increased risk for suicide (Pompili, et al., 2009).

Rationale 5: Suicide, the willful act of ending ones own life, is the 11th leading cause of death among Americans. Over 34,000 people kill themselves each year (CDC, 2009), and as many as 44% of psychiatric emergency clients are at increased risk for suicide (Pompili, et al., 2009).

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Identify the social, demographic, and clinical variables that influence suicidal or self-destructive behavior.

Question 3

Type: MCSA

The student nurse realizes that individuals who self-mutilate may:

1. Process feeling verbally if someone listens.

2. Never learn how to control their urges.

3. Cut for attention only.

4. Have difficulty processing feelings.

Correct Answer: 4

Rationale 1: Many self-destructive people have lifelong difficulties communicating their needs to others. Some people cannot express their needs or feelings; or, when they do, they do not obtain the results they hoped for. For them, self-mutilation or suicide becomes a clear and direct, if violent, form of communication. Many of these individuals use self-mutilationsuch as cutting themselves, burning themselves with cigarettes, burning themselves on a stove, pulling out their hair, biting their fingernails into the cuticlesto deal with anxiety and distress.

Rationale 2: Many self-destructive people have lifelong difficulties communicating their needs to others. Some people cannot express their needs or feelings; or, when they do, they do not obtain the results they hoped for. For them, self-mutilation or suicide becomes a clear and direct, if violent, form of communication. Many of these individuals use self-mutilationsuch as cutting themselves, burning themselves with cigarettes, burning themselves on a stove, pulling out their hair, biting their fingernails into the cuticlesto deal with anxiety and distress.

Rationale 3: Many self-destructive people have lifelong difficulties communicating their needs to others. Some people cannot express their needs or feelings; or, when they do, they do not obtain the results they hoped for. For them, self-mutilation or suicide becomes a clear and direct, if violent, form of communication. Many of these individuals use self-mutilationsuch as cutting themselves, burning themselves with cigarettes, burning themselves on a stove, pulling out their hair, biting their fingernails into the cuticlesto deal with anxiety and distress.

Rationale 4: Many self-destructive people have lifelong difficulties communicating their needs to others. Some people cannot express their needs or feelings; or, when they do, they do not obtain the results they hoped for. For them, self-mutilation or suicide becomes a clear and direct, if violent, form of communication. Many of these individuals use self-mutilationsuch as cutting themselves, burning themselves with cigarettes, burning themselves on a stove, pulling out their hair, biting their fingernails into the cuticlesto deal with anxiety and distress.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify the social, demographic, and clinical variables that influence suicidal or self-destructive behavior.

Question 4

Type: MCSA

A recent study about suicide risk based on the cultural worldview of African-American and European-Americans shows that:

1. Resilience gives individuals more reasons to live.

2. Difficulty communicating and the ability to integrate new and old information is the reason for suicidal behavior.

3. Constriction of thought, a dyadic event, and/or increased communication skills give individuals more reasons to live.

4. High parental conflict is the reason for suicidal behavior.

Correct Answer: 1

Rationale 1: African-American and European-American participants were studied by Walker and associates (2010) for suicide risk based on cultural worldview. The results showed that resilience within ethnic groups, regardless of their worldview, gave individuals more reasons to live.

Rationale 2: African-American and European-American participants were studied by Walker and associates (2010) for suicide risk based on cultural worldview. The results showed that resilience within ethnic groups, regardless of their worldview, gave individuals more reasons to live.

Rationale 3: African-American and European-American participants were studied by Walker and associates (2010) for suicide risk based on cultural worldview. The results showed that resilience within ethnic groups, regardless of their worldview, gave individuals more reasons to live.

Rationale 4: African-American and European-American participants were studied by Walker and associates (2010) for suicide risk based on cultural worldview. The results showed that resilience within ethnic groups, regardless of their worldview, gave individuals more reasons to live.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the similarities and differences in suicide rates among various demographic groups.

Question 5

Type: MCSA

A high school nurse is sharing the results of a national survey with school faculty and staff. The nurse states that, if the students in their school are similar to those surveyed, close to one out of five have seriously considered suicide in the:

1. Springtime.

2. Winter months.

3. Past year.

4. 3 months preceding the survey.

Correct Answer: 3

Rationale 1: A nationwide survey of youth in grades 9 through 12 in public and private schools in the United States found that 15% of students reported seriously considering suicide and 7% reported trying to take their own life in the 12 months preceding the survey.

Rationale 2: A nationwide survey of youth in grades 9 through 12 in public and private schools in the United States found that 15% of students reported seriously considering suicide and 7% reported trying to take their own life in the 12 months preceding the survey.

Rationale 3: A nationwide survey of youth in grades 9 through 12 in public and private schools in the United States found that 15% of students reported seriously considering suicide and 7% reported trying to take their own life in the 12 months preceding the survey.

Rationale 4: A nationwide survey of youth in grades 9 through 12 in public and private schools in the United States found that 15% of students reported seriously considering suicide and 7% reported trying to take their own life in the 12 months preceding the survey.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the similarities and differences in suicide rates among various demographic groups.

Question 6

Type: MCSA

A suicidal client tells his psychiatric nurse practitioner, My death will benefit my family; Im 83-years-old and have outlived my usefulness. The nurse practitioner knows this is an example of:

1. Suicide theory.

2. Sociocultural theory.

3. Interpersonal theory.

4. Biologic theory.

Correct Answer: 2

Rationale 1: Sociocultural theories about suicide propose that the social and cultural contexts in which the individual lives influence the expression of suicidality. The client believes he is not useful to his family because of his age.

Rationale 2: Sociocultural theories about suicide propose that the social and cultural contexts in which the individual lives influence the expression of suicidality. The client believes he is not useful to his family because of his age.

Rationale 3: Sociocultural theories about suicide propose that the social and cultural contexts in which the individual lives influence the expression of suicidality. The client believes he is not useful to his family because of his age.

Rationale 4: Sociocultural theories about suicide propose that the social and cultural contexts in which the individual lives influence the expression of suicidality. The client believes he is not useful to his family because of his age.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the sociocultural, interpersonal, and biologic theories that enhance our understanding of self-destructive behavior.

Question 7

Type: MCSA

A 22-year-old suicidal client acknowledges being molested by her stepfather since she was eight-years-old. The nurse knows this clients self-destructive behavior is best explained by:

1. Interpersonal theory.

2. Sociocultural theory.

3. Biologic theory.

4. Self-destructive behavior.

Correct Answer: 1

Rationale 1: Suicide can be better understood if viewed in the context of the interpersonal relationship between two people: the suicidal person and the significant other. Broadly defined, the significant other can be a spouse, child, boss, landlord, friend, nurse, or other health care worker. The clients negative interpersonal relationship with her stepfather influenced her suicidal behavior.

Rationale 2: Suicide can be better understood if viewed in the context of the interpersonal relationship between two people: the suicidal person and the significant other. Broadly defined, the significant other can be a spouse, child, boss, landlord, friend, nurse, or other health care worker. The clients negative interpersonal relationship with her stepfather influenced her suicidal behavior.

Rationale 3: Suicide can be better understood if viewed in the context of the interpersonal relationship between two people: the suicidal person and the significant other. Broadly defined, the significant other can be a spouse, child, boss, landlord, friend, nurse, or other health care worker. The clients negative interpersonal relationship with her stepfather influenced her suicidal behavior.

Rationale 4: Suicide can be better understood if viewed in the context of the interpersonal relationship between two people: the suicidal person and the significant other. Broadly defined, the significant other can be a spouse, child, boss, landlord, friend, nurse, or other health care worker. The clients negative interpersonal relationship with her stepfather influenced her suicidal behavior.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the sociocultural, interpersonal, and biologic theories that enhance our understanding of self-destructive behavior.

Question 8

Type: MCSA

According to biologic theory, there is considerable evidence that what system, partly under genetic control, may influence the risk for suicidal behavior?

1. HPA-axis system

2. Serotonergic system

3. Neurotransmitter system

4. System of PET

Correct Answer: 2

Rationale 1: There is considerable evidence that the serotonergic system is partly under genetic control and that as yet unknown genetic factors influence the risk for suicidal behavior. These genetic factors are thought to be independent of the factors responsible for the heritability of major psychiatric conditions associated with suicide.

Rationale 2: There is considerable evidence that the serotonergic system is partly under genetic control and that as yet unknown genetic factors influence the risk for suicidal behavior. These genetic factors are thought to be independent of the factors responsible for the heritability of major psychiatric conditions associated with suicide.

Rationale 3: There is considerable evidence that the serotonergic system is partly under genetic control and that as yet unknown genetic factors influence the risk for suicidal behavior. These genetic factors are thought to be independent of the factors responsible for the heritability of major psychiatric conditions associated with suicide.

Rationale 4: There is considerable evidence that the serotonergic system is partly under genetic control and that as yet unknown genetic factors influence the risk for suicidal behavior. These genetic factors are thought to be independent of the factors responsible for the heritability of major psychiatric conditions associated with suicide.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the sociocultural, interpersonal, and biologic theories that enhance our understanding of self-destructive behavior.

Question 9

Type: MCMA

The nurse knows that when performing a lethality assessment, asking the client, Have you ever thought of taking your own life? may:

Standard Text: Select all that apply.

1. Cause the client to think about suicide.

2. Alleviate the clients anxiety about considering suicide.

3. Be direct enough to promote effective communication.

4. Give the client an idea about suicide methods.

5. Cause the client to open up about other attempts.

Correct Answer: 2,3,5

Rationale 1: Cause the client to think about suicide. It is not possible to cause a persons suicide by assessing feelings and thoughts.

Rationale 2: Alleviate the clients anxiety about considering suicide. Inquiring about suicidal thoughts may alleviate a persons anxiety about considering suicide.

Rationale 3: Be direct enough to promote effective communication. Direct and clear communication helps clients open up about their feelings.

Rationale 4: Give the client an idea about suicide methods. Assessment of feelings and thoughts helps to ease the clients anxiety about suicide, not give the client an idea.

Rationale 5: Cause the client to open up about other attempts. Open communication allows the client to open up about feelings and thoughts about other possible attempts.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Formulate a lethality assessment.

Question 10

Type: MCSA

When teaching students about suicide, the nursing instructor knows that basic suicide precautions include:

1. Beginning measures with an order from the psychiatrist.

2. Checking the clients whereabouts and safety every 15 minutes.

3. Maintaining one-to-one supervision during visits.

4. Providing one-to-one nursing supervision at all times.

Correct Answer: 2

Rationale 1: The clients whereabouts and safety are checked and documented every 15 minutes. Basic suicide precautions may be started without a psychiatrists order, but a psychiatric consultation must be obtained as soon as possible. The client may remain in the room with the door open unless accompanied by staff or a family member.

Rationale 2: The clients whereabouts and safety are checked and documented every 15 minutes. Basic suicide precautions may be started without a psychiatrists order, but a psychiatric consultation must be obtained as soon as possible. The client may remain in the room with the door open unless accompanied by staff or a family member.

Rationale 3: The clients whereabouts and safety are checked and documented every 15 minutes. Basic suicide precautions may be started without a psychiatrists order, but a psychiatric consultation must be obtained as soon as possible. The client may remain in the room with the door open unless accompanied by staff or a family member.

Rationale 4: The clients whereabouts and safety are checked and documented every 15 minutes. Basic suicide precautions may be started without a psychiatrists order, but a psychiatric consultation must be obtained as soon as possible. The client may remain in the room with the door open unless accompanied by staff or a family member.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Distinguish between the crucial components of basic suicide precautions and maximum suicide precautions.

Question 11

Type: MCSA

The nurse on a psychiatric unit looks through a suicidal clients belongings, removing craft materials and mirrors. This is an example of:

1. Common precautions.

2. An invasion of privacy.

3. A crime in progress.

4. Maximum suicide precautions.

Correct Answer: 4

Rationale 1: Look through the clients belongings in the clients presence, and remove any potentially harmful objects, such as pills, matches, belts, shoelaces, pantyhose, brassieres, razors, tweezers, mirrors or other glass objects (such as light bulbs), wire, and craft materials. If suicide precautions are initiated after the client has been on the unit for any length of time, make a complete search of the room. As this helps the client and staff remain safe, it is not considered an invasion of privacy. Searching through a suicidal clients belongings is not a common precaution and is not considered a crime in progress.

Rationale 2: Look through the clients belongings in the clients presence, and remove any potentially harmful objects, such as pills, matches, belts, shoelaces, pantyhose, brassieres, razors, tweezers, mirrors or other glass objects (such as light bulbs), wire, and craft materials. If suicide precautions are initiated after the client has been on the unit for any length of time, make a complete search of the room. As this helps the client and staff remain safe, it is not considered an invasion of privacy. Searching through a suicidal clients belongings is not a common precaution and is not considered a crime in progress.

Rationale 3: Look through the clients belongings in the clients presence, and remove any potentially harmful objects, such as pills, matches, belts, shoelaces, pantyhose, brassieres, razors, tweezers, mirrors or other glass objects (such as light bulbs), wire, and craft materials. If suicide precautions are initiated after the client has been on the unit for any length of time, make a complete search of the room. As this helps the client and staff remain safe, it is not considered an invasion of privacy. Searching through a suicidal clients belongings is not a common precaution and is not considered a crime in progress.

Rationale 4: Look through the clients belongings in the clients presence, and remove any potentially harmful objects, such as pills, matches, belts, shoelaces, pantyhose, brassieres, razors, tweezers, mirrors or other glass objects (such as light bulbs), wire, and craft materials. If suicide precautions are initiated after the client has been on the unit for any length of time, make a complete search of the room. As this helps the client and staff remain safe, it is not considered an invasion of privacy. Searching through a suicidal clients belongings is not a common precaution and is not considered a crime in progress.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Distinguish between the crucial components of basic suicide precautions and maximum suicide precautions.

Question 12

Type: MCSA

The nurse knows that basic suicide precautions may be started without a physicians order and maximum suicide precautions (or restrictions):

1. Need a physicians order and a psychiatric consult.

2. May be started on the recommendation of the psychiatric nurse.

3. Can be instituted without a physicians order only under emergency conditions.

4. Cannot be instituted without the clients consent.

Correct Answer: 3

Rationale 1: Most psychiatric inpatient units have developed a set of protocols or guidelines for observing and monitoring client behavior, often referred to as suicide precautions. Systems of observation may have three to six levels. Restrictions may require a physicians order but can and should be implemented on an emergency basis by nurses or other clinical staff. The clients consent is not required in an emergency.

Rationale 2: Most psychiatric inpatient units have developed a set of protocols or guidelines for observing and monitoring client behavior, often referred to as suicide precautions. Systems of observation may have three to six levels. Restrictions may require a physicians order but can and should be implemented on an emergency basis by nurses or other clinical staff. The clients consent is not required in an emergency.

Rationale 3: Most psychiatric inpatient units have developed a set of protocols or guidelines for observing and monitoring client behavior, often referred to as suicide precautions. Systems of observation may have three to six levels. Restrictions may require a physicians order but can and should be implemented on an emergency basis by nurses or other clinical staff. The clients consent is not required in an emergency.

Rationale 4: Most psychiatric inpatient units have developed a set of protocols or guidelines for observing and monitoring client behavior, often referred to as suicide precautions. Systems of observation may have three to six levels. Restrictions may require a physicians order but can and should be implemented on an emergency basis by nurses or other clinical staff. The clients consent is not required in an emergency.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Distinguish between the crucial components of basic suicide precautions and maximum suicide precautions.

Question 13

Type: MCSA

In an effort to prevent suicide, an important advocacy strategy for all nurses to implement is to:

1. Increase nurses pay.

2. Increase cultural and spiritual diversity.

3. Reduce barriers to health care.

4. Reduce financial burden for all patients through charities.

Correct Answer: 3

Rationale 1: Reducing barriers to health care is an important advocacy strategy for all nurses. Fewer barriers may encourage clients to access mental health care. Barriers may be insurance-related, financial, structural, cultural, spiritual, language-related, or related to concerns about confidentiality, discrimination, or stigma. Increasing nurses pay is not an advocacy strategy for suicide prevention.

Rationale 2: Reducing barriers to health care is an important advocacy strategy for all nurses. Fewer barriers may encourage clients to access mental health care. Barriers may be insurance-related, financial, structural, cultural, spiritual, language-related, or related to concerns about confidentiality, discrimination, or stigma. Increasing nurses pay is not an advocacy strategy for suicide prevention.

Rationale 3: Reducing barriers to health care is an important advocacy strategy for all nurses. Fewer barriers may encourage clients to access mental health care. Barriers may be insurance-related, financial, structural, cultural, spiritual, language-related, or related to concerns about confidentiality, discrimination, or stigma. Increasing nurses pay is not an advocacy strategy for suicide prevention.

Rationale 4: Reducing barriers to health care is an important advocacy strategy for all nurses. Fewer barriers may encourage clients to access mental health care. Barriers may be insurance-related, financial, structural, cultural, spiritual, language-related, or related to concerns about confidentiality, discrimination, or stigma. Increasing nurses pay is not an advocacy strategy for suicide prevention.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Develop nursing intervention strategies to prevent suicide that can and should be implemented in any health care setting.

Question 14

Type: MCSA

Suicide prevention hotline callers had a significant decrease in suicidality during the course of the telephone session when crisis hotline workers demonstrated:

1. Faith, respect, and trepidation.

2. Hope, support, and happiness.

3. Empathy, support, and hopelessness.

4. Empathy, respect, and support.

Correct Answer: 4

Rationale 1: For people contemplating suicide or families concerned about loved ones, the National Suicide Prevention Lifeline 1800213TALK circumvents the barriers described earlier and provides immediate assistance around the clock. This lifeline consists of a network of more than 120 crisis centers in communities around the country that are committed to suicide prevention. Standards for the assessment of suicide risk to effectively guide crisis hotline workers in assessing callers have been developed. Having empathy, respect, a supportive approach, good contact, and collaborative problem solving are helper behaviors and intervention styles that are significantly related to positive outcomes in telephone suicide intervention.

Rationale 2: For people contemplating suicide or families concerned about loved ones, the National Suicide Prevention Lifeline 1800213TALK circumvents the barriers described earlier and provides immediate assistance around the clock. This lifeline consists of a network of more than 120 crisis centers in communities around the country that are committed to suicide prevention. Standards for the assessment of suicide risk to effectively guide crisis hotline workers in assessing callers have been developed. Having empathy, respect, a supportive approach, good contact, and collaborative problem solving are helper behaviors and intervention styles that are significantly related to positive outcomes in telephone suicide intervention.

Rationale 3: For people contemplating suicide or families concerned about loved ones, the National Suicide Prevention Lifeline 1800213TALK circumvents the barriers described earlier and provides immediate assistance around the clock. This lifeline consists of a network of more than 120 crisis centers in communities around the country that are committed to suicide prevention. Standards for the assessment of suicide risk to effectively guide crisis hotline workers in assessing callers have been developed. Having empathy, respect, a supportive approach, good contact, and collaborative problem solving are helper behaviors and intervention styles that are significantly related to positive outcomes in telephone suicide intervention.

Rationale 4: For people contemplating suicide or families concerned about loved ones, the National Suicide Prevention Lifeline 1800213TALK circumvents the barriers described earlier and provides immediate assistance around the clock. This lifeline consists of a network of more than 120 crisis centers in communities around the country that are committed to suicide prevention. Standards for the assessment of suicide risk to effectively guide crisis hotline workers in assessing callers have been developed. Having empathy, respect, a supportive approach, good contact, and collaborative problem solving are helper behaviors and intervention styles that are significantly related to positive outcomes in telephone suicide intervention.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Develop nursing intervention strategies to prevent suicide that can and should be implemented in any health care setting.

Question 15

Type: MCSA

When working with suicidal clients, the nurse must be compassionate enough to:

1. Be able to form an effective link with suicidal clients without being overwhelmed by the clients pain.

2. Communicate effectively to solve the clients problems.

3. Avoid asking the client difficult questions in order to prevent an escalation in symptoms.

4. Ask the right questions in order to stop the client from getting angry.

Correct Answer: 1

Rationale 1: The suicidal client presents a unique challenge and will call on all of the nurses resources. The nurse must be able to ask the right questions and make the right decisions as well as manage personal fears and anxieties. Helping a person who may not want your assistance but wants deliberately to harm or kill himself is a very complicated process. The nurse must be compassionate enough to be able to form an effective link with a suicidal client. The goal is to encourage the client to see the nurse as an ally, yet maintain enough detachment to avoid being overwhelmed by the clients pain.

Rationale 2: The suicidal client presents a unique challenge and will call on all of the nurses resources. The nurse must be able to ask the right questions and make the right decisions as well as manage personal fears and anxieties. Helping a person who may not want your assistance but wants deliberately to harm or kill himself is a very complicated process. The nurse must be compassionate enough to be able to form an effective link with a suicidal client. The goal is to encourage the client to see the nurse as an ally, yet maintain enough detachment to avoid being overwhelmed by the clients pain.

Rationale 3: The suicidal client presents a unique challenge and will call on all of the nurses resources. The nurse must be able to ask the right questions and make the right decisions as well as manage personal fears and anxieties. Helping a person who may not want your assistance but wants deliberately to harm or kill himself is a very complicated process. The nurse must be compassionate enough to be able to form an effective link with a suicidal client. The goal is to encourage the client to see the nurse as an ally, yet maintain enough detachment to avoid being overwhelmed by the clients pain.

Rationale 4: The suicidal client presents a unique challenge and will call on all of the nurses resources. The nurse must be able to ask the right questions and make the right decisions as well as manage personal fears and anxieties. Helping a person who may not want your assistance but wants deliberately to harm or kill himself is a very complicated process. The nurse must be compassionate enough to be able to form an effective link with a suicidal client. The goal is to encourage the client to see the nurse as an ally, yet maintain enough detachment to avoid being overwhelmed by the clients pain.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Develop nursing intervention strategies to prevent suicide that can and should be implemented in any health care setting.

Question 16

Type: MCMA

The nurse knows that including family members in the plan of care for a suicidal client is extremely important. Two important strategies that families need to know are:

Standard Text: Select all that apply.

1. How to help loved ones avoid acting on suicidal thoughts.

2. How to work with other families.

3. How to prevent suicide.

4. How to communicate with hospital staff.

5. How to communicate with one another.

Correct Answer: 1,3

Rationale 1: How to help loved ones avoid acting on suicidal thoughts. Including family members in the plan of care for the client is extremely important. Knowing how to help their loved one avoid acting on suicidal thoughts when they occur is one of the most important strategies that families need to know.

Rationale 2: How to work with other families. Working with other families may be helpful, but it is not one of the most important strategies.

Rationale 3: How to prevent suicide. Including family members in the plan of care for the client is extremely important. Knowing how to prevent suicide will help empower and educate individuals to assist keeping their loved one safe.

Rationale 4: How to communicate with hospital staff. Hospitalizations for suicidal ideation or a suicide attempt may be brief and may be terminated before antidepressant medication has had a chance to work.

Rationale 5: How to communicate with one another. Good communication among family members is helpful, but it is not one of the most important strategies.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Integrate family members into the plan of care for the suicidal client.

Question 17

Type: MCSA

The nurse is presenting information to a gatekeeper training class about the people in a suicide victims life, including the most commonly recognized risk factors for suicidal behavior, symptoms of mental illness, and barriers to mental health treatment. The nurse teaches that both parents and friends were equally able to recognize many risk factors, but friends were better than parents at recognizing risk factors for:

1. Suicide.

2. Mania.

3. Substance abuse.

4. Depression.

Correct Answer: 3

Rationale 1: Parents and friends can be instrumental in preventing suicide. Parents and friends universally recognized most symptoms, although friends were better able to recognize symptoms of substance abuse.

Rationale 2: Parents and friends can be instrumental in preventing suicide. Parents and friends universally recognized most symptoms, although friends were better able to recognize symptoms of substance abuse.

Rationale 3: Parents and friends can be instrumental in preventing suicide. Parents and friends universally recognized most symptoms, although friends were better able to recognize symptoms of substance abuse.

Rationale 4: Parents and friends can be instrumental in preventing suicide. Parents and friends universally recognized most symptoms, although friends were better able to recognize symptoms of substance abuse.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Integrate family members into the plan of care for the suicidal client.

Question 18

Type: MCMA

A client was admitted to the psychiatric unit on a suicide watch. In an effort to include family members in the clients care, the nurse must:

Standard Text: Select all that apply.

1. Be prepared to deal with family members who may be confused, angry, or uninterested. Strive to remain neutral, and do not make assumptions about the familys behavior.

2. Involve the family in a bereavement support group.

3. Involve the family in psychoeducational and family network services.

4. Take the bereaved on a family outing.

5. Decide with the client which family members and friends are to be contacted and by whom.

Correct Answer: 1,5

Rationale 1: Be prepared to deal with family members who may be confused, angry, or uninterested. Strive to remain neutral, and do not make assumptions about the familys behavior. This helps family members come to terms with the clients behavior and their role in the clients behavior.

Rationale 2: Involve the family in a bereavement support group. This helps families come to terms with the client who has successfully committed suicide.

Rationale 3: Involve the family in psychoeducational and family network services. These activities are intended more for survivor families of clients who have committed suicide.

Rationale 4: Take the bereaved on a family outing. When dealing with family members of a deceased client, a family outing with the health care professional helps the family come to terms with the clients suicide.

Rationale 5: Decide with the client which family members and friends are to be contacted and by whom. Deciding with the client which family members and friends are to be contacted and by whom helps the client come to terms with what they did, and helps the family consider other positive alternatives.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Integrate family members into the plan of care for the suicidal client.

Question 19

Type: MCSA

The nurse knows that family members of suicide victims rarely seek assistance from mental health care professionals. One way to help survivors may be to:

1. Get families involved with the American Association of Suicidology.

2. Teach families how to bear the burden alone.

3. Talk to the physician about their case.

4. Assure the family they will soon feel better.

Correct Answer: 1

Rationale 1: Survivors rarely seek assistance from mental health care professionals. They may be angry and believe mental health care professionals should have prevented this. Those who work with survivors, including nurses, must be prepared for this reaction. The American Association of Suicidology maintains a website for professionals and survivors of suicide at www.suicidology.org. Family members should not be encouraged to bear the burden alone or be assured that they will soon feel better. Talking to the physician may be beneficial if the physician encourages the family to pursue appropriate mental health resources.

Rationale 2: Survivors rarely seek assistance from mental health care professionals. They may be angry and believe mental health care professionals should have prevented this. Those who work with survivors, including nurses, must be prepared for this reaction. The American Association of Suicidology maintains a website for professionals and survivors of suicide at www.suicidology.org. Family members should not be encouraged to bear the burden alone or be assured that they will soon feel better. Talking to the physician may be beneficial if the physician encourages the family to pursue appropriate mental health resources.

Rationale 3: Survivors rarely seek assistance from mental health care professionals. They may be angry and believe mental health care professionals should have prevented this. Those who work with survivors, including nurses, must be prepared for this reaction. The American Association of Suicidology maintains a website for professionals and survivors of suicide at www.suicidology.org. Family members should not be encouraged to bear the burden alone or be assured that they will soon feel better. Talking to the physician may be beneficial if the physician encourages the family to pursue appropriate mental health resources.

Rationale 4: Survivors rarely seek assistance from mental health care professionals. They may be angry and believe mental health care professionals should have prevented this. Those who work with survivors, including nurses, must be prepared for this reaction. The American Association of Suicidology maintains a website for professionals and survivors of suicide at www.suicidology.org. Family members should not be encouraged to bear the burden alone or be assured that they will soon feel better. Talking to the physician may be beneficial if the physician encourages the family to pursue appropriate mental health resources.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Develop nursing intervention strategies that may be helpful to survivors of suicide.

Question 20

Type: MCSA

A child or adolescent who experiences a parents or friends suicide are at greater risk for suicide and should be:

1. Screened for possible drug overdose.

2. Evaluated for depression.

3. Observed for suicidal attempts.

4. Immediately hospitalized.

Correct Answer: 2

Rationale 1: Children who experience a loss as the result of a parental suicide or adolescents exposed to the suicide of a friend require urgent intervention to deal with the trauma. Both are at greater risk for suicide and depression and should be carefully screened, observed, and treated for depressive symptoms if present, but immediate hospitalization is not usually warranted.

Rationale 2: Children who experience a loss as the result of a parental suicide or adolescents exposed to the suicide of a friend require urgent intervention to deal with the trauma. Both are at greater risk for suicide and depression and should be carefully screened, observed, and treated for depressive symptoms if present, but immediate hospitalization is not usually warranted.

Rationale 3: Children who experience a loss as the result of a parental suicide or adolescents exposed to the suicide of a friend require urgent intervention to deal with the trauma. Both are at greater risk for suicide and depression and should be carefully screened, observed, and treated for depressive symptoms if present, but immediate hospitalization is not usually warranted.

Rationale 4: Children who experience a loss as the result of a parental suicide or adolescents exposed to the suicide of a friend require urgent intervention to deal with the trauma. Both are at greater risk for suicide and depression and should be carefully screened, observed, and treated for depressive symptoms if present, but immediate hospitalization is not usually warranted.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Develop nursing intervention strategies that may be helpful to survivors of suicide.

Question 21

Type: MCMA

The psychiatric nurse knows that maladaptive grief reactions and perceptions of blame are reduced in nurse-led counseling programs. Nursing students should be taught to include the following outreach services for families and significant others who survive suicide:

Standard Text: Select all that apply.

1. Take the bereaved on family outings for a year.

2. Arrange for staff or a representative to attend any funeral services.

3. Involve families in psychoeducational and family network services.

4. Make frequent telephone calls to the family immediately after the suicide and periodically until the first anniversary of the death.

5. Involve the family in a bereavement support group.

Correct Answer: 2,3,4,5

Rationale 1: Take the bereaved on family outings for a year. Planned outreach services would not include taking the family on outings for a year.

Rationale 2: Arrange for staff or a representative to attend any funeral services. Planned outreach services might include arranging for staff or a staff representative to attend services, if appropriate.

Rationale 3: Involve families in psychoeducational and family network services. Psychoeducational services and family network intervention have also been found to be helpful (Jordan, 2001). Support from family and friends have been found to be the strongest protective factor (Callahan, 2000).

Rationale 4: Make frequent telephone calls to the family immediately after the suicide and periodically until the first anniversary of the death. Planned outreach services might include telephoning the family immediately after the suicide and periodically until the first anniversary of the death.

Rationale 5: Involve the family in a bereavement support group. Planned outreach services might include considering involving the family in a bereavement support group.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Develop nursing intervention strategies that may be helpful to survivors of suicide.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

Leave a Reply