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 D
Explanation
A. Foot tapping and repeatedly writing the same phrase suggest compulsive or stereotypic behavior, not hallucinations.
B. Detachment and overconfidence may indicate personality or mood disturbances, but not hallucinations.
C. Euphoric mood, hyperactivity, and distractibility are signs of mania, not auditory hallucinations.
D. Darting eyes, tilted head, and mumbling to self are classic behaviors seen when a patient is responding to internal stimuli such as auditory hallucinations.
Correct Answer is D
Explanation
A. Neuroleptic malignant syndrome is a rare, life-threatening reaction associated with antipsychotic medications, not stimulants like methylphenidate.
B. Dystonia, akinesia, and extrapyramidal symptoms are primarily seen with antipsychotic use, not with ADHD stimulant medications.
C. Bradycardia and hypotensive episodes – Stimulants more commonly cause tachycardia and hypertension, not bradycardia or hypotension.
D. Sleep disturbances and weight loss are common side effects of methylphenidate due to its stimulant properties. Monitoring sleep patterns, appetite, and growth is a priority in children taking this medication.
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