A client has a diagnosis of risk for suicide r/t a past attempt. Which of the following outcome should the nurse prioritize?
The client will verbalize 3 positive attributes about themselves by day 3
The client will perform personal hygiene with no prompting
The client will attend group by day 2
The client will remain free from injury for duration of their hospitalization
The Correct Answer is D
A. The client will verbalize 3 positive attributes about themselves by day 3. This is a good long-term goal but does not directly prevent self-harm.
B. The client will perform personal hygiene with no prompting. Improved self-care is beneficial but is not the primary priority in suicide prevention.
C. The client will attend group by day 2. Participation in therapy is helpful, but ensuring physical safety takes precedence.
D. The client will remain free from injury for the duration of their hospitalization. The most critical goal for a client at risk for suicide is preventing self-harm, making this the priority outcome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Circulating nurse: The circulating nurse ensures that the time-out occurs but does not mark the surgical site.
B. Patient's primary nurse: The primary nurse is responsible for preoperative care but does not mark the site.
C. Surgeon: The surgeon performing the procedure is responsible for marking the surgical site to ensure accuracy and prevent wrong-site surgery.
D. Surgical technician: Surgical technicians assist with instruments and procedures but do not mark the surgical site.
Correct Answer is D
Explanation
A. Educate the patient about the time period before new medications become effective. Education is important but not the priority in a crisis situation. Immediate safety is the top concern.
B. Have the client verbalize their plans for discharge. This is a future-oriented intervention, but the priority is ensuring the client's safety now.
C. Encouraging the client to participate in group therapy. Group therapy is beneficial but does not take precedence over ensuring immediate safety.
D. Monitor the client closely but at random intervals. Patients with suicidal ideation require close monitoring to prevent self-harm. Observing at random intervals reduces the chance of the patient anticipating when they are not being watched.
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