A nurse assesses a patient who reports a 3-week history of depression and periods of uncontrolled crying. The patient says. "My business is bankrupt and was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a covert suicidal message?

"My family will be better off without me."

"Life is not worth living."

"I wish I were dead."

"I have a plan that will fix everything"

Answer and Explanation

The Correct Answer is A

A. "My family will be better off without me" is an indirect or covert suicidal statement (passive ideation) that suggests the patient believes others would be better off if they were gone. Such remarks require immediate assessment of suicide risk (ask directly about thoughts, intent, plan, access to means) and appropriate safety interventions.
B. "Life is not worth living" is an explicit expression of hopelessness and indicates suicidal ideation, but it is more overt than covert. It still warrants urgent assessment, but the question asked specifically for the covert message.
C. "I wish I were dead" is a direct statement of suicidal desire (overt) rather than a covert hint.
D. "I have a plan that will fix everything" is the most concerning because it indicates a specific plan (high lethality risk), but it is overt rather than covert.

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Correct Answer is D

Explanation

A. A busy family may experience stress, but this alone is not the greatest risk factor for abuse.
B. Multiple caregivers can sometimes create inconsistency in care, but it is not the primary factor.
C. Rural living may limit access to resources, but dementia itself poses a greater risk.
D. Dementia (especially Alzheimer’s disease) significantly increases vulnerability to abuse because of impaired memory, communication, and judgment, which limit the ability to report or stop mistreatment.

A. is able to describe the difference between "as if" and "for real." B. reports a consistently sad, discouraged, and hopeless mood. C. reports occasional sleeplessness and anxiety. D. perceives difficulty making a decision about whether to change jobs.

Correct Answer is B

Explanation

A. Distinguishing between reality and fantasy shows intact cognition, not mental illness.
B. A persistent sad, hopeless mood suggests depression, a hallmark of mental illness when symptoms are severe and ongoing.
C. Occasional anxiety and insomnia can be normal stress responses, not necessarily mental illness.
D. Difficulty making a decision about work is a common life stressor, not a clear sign of mental illness.

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A nurse assesses a patient who reports a 3-week history of depression and periods of uncontrolled crying. The patient says. "My business is bankrupt and was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a covert suicidal message?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older adult diagnosed with dementia lives with family in a rural area. During the week, this adult attends a day care center while the family is at work. In the evenings, members of the family provide care. Which factor makes this adult most vulnerable to abuse?

Correct Answer is D

Explanation

Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The patient

Correct Answer is B

Explanation

Select an example of a tort.

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