A nurse in a hospital is caring for a client who has agoraphobia.
Which of the following statements by the client indicates understanding of the goals of treatment?

Choice B rationale:

Male gender is a significant risk factor for suicide. Men are more likely to die by suicide than women, with rates being approximately 3.5 times higher in men than women in the United States.

Several factors contribute to this increased risk:

Men are less likely to seek help for mental health issues. This may be due to societal expectations of masculinity, which often discourage men from expressing emotions or seeking help for emotional distress.

Men are more likely to use more lethal means of suicide. For example, men are more likely to use firearms, which have a higher fatality rate than other methods such as poisoning or cutting.

Men may be more likely to experience social isolation and loneliness. These factors can increase the risk of suicide, as they can lead to feelings of hopelessness and despair.

Men may be more likely to experience substance abuse problems. Substance abuse can increase the risk of suicide, as it can impair judgment and impulse control, and can also lead to feelings of hopelessness and despair.

Choice C rationale:

Recent marriage is not a risk factor for suicide. In fact, some studies have shown that marriage may have a protective effect against suicide.

However, it's important to note that relationship problems, including separation, divorce, or domestic violence, can be significant risk factors for suicide.

Choice D rationale:

Age greater than 55 is a risk factor for suicide. Suicide rates are highest among older adults, particularly among men aged 85 and older.

Several factors contribute to this increased risk:

Older adults are more likely to experience chronic health conditions and pain. These conditions can lead to feelings of hopelessness and despair, and can also make it more difficult to cope with stress.

Older adults are more likely to experience social isolation and loneliness. These factors can increase the risk of suicide, as they can lead to feelings of hopelessness and despair.

Older adults are more likely to experience bereavement and loss. The loss of a spouse, family members, or friends can be a major stressor, and can increase the risk of suicide.

Choice E rationale:

Diagnosis of schizophrenia is a significant risk factor for suicide.

People with schizophrenia are approximately 10 times more likely to die by suicide than the general population. Several factors contribute to this increased risk:

Schizophrenia is a severe mental illness that can cause significant distress and impairment.

People with schizophrenia may experience hallucinations, delusions, and disorganized thinking. These symptoms can be very distressing and can lead to feelings of hopelessness and despair.

People with schizophrenia may also experience social isolation and stigma. These factors can further increase the risk of suicide.

Choice A rationale:

Coercion to take necessary prescribed medications is not an appropriate indication for the use of mechanical restraints. It violates the client's right to autonomy and informed consent.

Forcing a client to take medication against their will can lead to psychological trauma, distrust of healthcare providers, and even legal action.

Alternative interventions, such as patient education, negotiation, and behavioral strategies, should be explored first to encourage medication compliance.

If a client is refusing medication due to a lack of understanding, providing clear and concise information about the medication's purpose, benefits, and potential side effects can help facilitate informed decision-making.

Negotiation strategies can involve exploring the client's concerns and preferences, and working collaboratively to find a solution that addresses those concerns.

Behavioral strategies may include positive reinforcement for medication adherence, or the use of techniques such as distraction or relaxation to reduce anxiety associated with medication administration.

Choice B rationale:

Punishment for verbally abusing other clients is also not an appropriate indication for mechanical restraints.

Restraints should never be used as a form of punishment, as this can be considered abuse and can worsen the client's behavior.

Verbal abuse is often a symptom of underlying mental health issues, and it's important to address the root cause of the behavior rather than simply trying to suppress it through restraints.

Alternative interventions for verbal abuse might include de-escalation techniques, conflict resolution strategies, and individual or group therapy to address underlying emotional or behavioral issues.

Choice C rationale:

Discipline for throwing objects at staff in the nursing station is not an appropriate indication for mechanical restraints. Restraints should only be used as a last resort to protect the client or others from imminent harm.

Throwing objects may be a sign of agitation, frustration, or anger, and it's important to address the underlying cause of these behaviors.

Alternative interventions could include de-escalation techniques, providing a safe space for the client to calm down, medication to manage agitation, or behavioral therapy to teach coping skills.

Choice D rationale:

Self-destructive behavior after all previous alternative interventions have been unsuccessful is the only appropriate indication for mechanical restraints among the choices provided.

When a client is at risk of seriously harming themselves, and other interventions have failed to protect them, restraints may be necessary to prevent injury or death.

However, it's crucial to use restraints only as a temporary measure and to continuously monitor the client's condition and behavior.

As soon as the client is no longer at risk of self-harm, the restraints should be removed.