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"
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Mild anxiety usually presents with slight discomfort, restlessness, or irritability, and the client remains able to focus and problem-solve.
B. Severe anxiety is characterized by physical symptoms such as chest pain, headache, shortness of breath, and a preoccupation with specific concerns (e.g., personal problems) that limit the client’s ability to focus on other matters.
C. Panic involves sudden, intense terror or dread, often accompanied by inability to communicate or function, and may include distorted perceptions or irrational behavior. The client in this scenario can still verbalize concerns.
D. Moderate anxiety causes narrowing of attention and some tension or restlessness, but the physical manifestations and preoccupation in this scenario indicate a more severe level.
Correct Answer is A
Explanation
A. This occurs when the nurse projects personal feelings about someone from their own life onto the patient (e.g., comparing the patient to a grandparent and feeling sadness).
B. This refers to severe emotional outbursts in cognitively impaired patients, not nurse behavior.
C. This would involve the nurse using defense mechanisms to protect themselves from anxiety, not relating to the patient as a grandparent.
D. Transference is when the patient projects feelings onto the nurse, not the other way around.
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