d. Suicide is an impulsive act. Antidepressant medication does not alter impulsivity. ANS: A
Antidepressant medication has the objective of relieving depression. Risk for suicide is greater as the depression lifts, primarily because the patient has more physical energy at a time when he or she may still have suicidal ideation. The other options have little to do with nursing interventions relating to antidepressant medication therapy.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 25-14 TOP: Nursing Process: Planning MSC: Client Needs: Safe, Effective Care Environment 17. A nurse assesses a patient who reports a 3-week history of depression and periods of
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uncontrolled crying. The patient says, “My business is bankrupt, and I was served with divorce papers.” Which subsequent statement by the patient alerts the nurse to a concealed suicidal message? a. “I wish I were dead.” b. “Life is not worth living.” c. “I have a plan that will fix everything.” d. “My family will be better off without me.” ANS: C
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Verbal clues to suicide may be overt or covert. The incorrect options are overt references to suicide. The correct option is more veiled. It alludes to the patient’s suicide as being a way to “fix everything” but does not say it outright.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 25-12, 13, 47 (Table 25-2) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 18. A depressed patient says, “Nothing matters anymore.” What is the most appropriate response
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ANS: A
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by the nurse? a. “Are you having thoughts of suicide?” b. “I am not sure I understand what you are trying to say.” c. “Try to stay hopeful. Things have a way of working out.” d. “Tell me more about what interested you before you became depressed.”
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The nurse must make overt what is covert; that is, the possibility of suicide must be openly addressed. The patient often feels relieved to be able to talk about suicidal ideation.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 25-12, 13, 18 (Case Study and Nursing Care Plan), 47 (Table 25-2) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment
19. A nurse counsels a patient with recent suicidal ideation. Which is the nurse’s most therapeutic
comment? 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.”
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