A nurse in an acute care mental health facility is assessing a client who has bipolar disorder. Which of the following findings indicates the client is at risk for suicide?

The client has begun playing basketball with several other clients during the past month.

The client identifies with problems expressed by other clients.

The client's behavior has become impulsive in the past few weeks.

The client states she wants to go home to be with her children and partner.

Answer and Explanation

The Correct Answer is C

A. The client has begun playing basketball with several other clients during the past month.

Engaging in activities and social interactions can actually be a positive sign, as it suggests involvement and connection with others, which can be protective against suicide.

B. The client identifies with problems expressed by other clients.

Identifying with others' problems may indicate empathy, but it is not necessarily indicative of suicide risk on its own.

C. The client's behavior has become impulsive in the past few weeks.

Explanation: Impulsivity can be a significant risk factor for suicide. A sudden increase in impulsive behavior might indicate that the client is not thinking clearly and is acting without considering the potential consequences. Impulsivity can lead to actions that are harmful or dangerous, including suicidal behaviors.

D. The client states she wants to go home to be with her children and partner.

Expressing a desire to be with loved ones is generally not an indicator of suicide risk. In fact, having a strong support system can be protective against suicidal thoughts.

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Correct Answer is D

Explanation

A. "Using nontraditional treatments is not a good idea. I'd rather you avoid that route."

This response is directive and dismissive of the client's choice. It does not promote open communication or respect for the client's autonomy and beliefs.

B. "Your provider is very knowledgeable. If he prescribes chemotherapy, it's the best treatment for you."

While healthcare providers have expertise, this response doesn't address the client's concerns or give them an opportunity to express their feelings. It may come across as authoritarian and not respecting the client's wishes.

C. "A lot of people think nontraditional treatments will work, and they find out too late that they made the wrong choice."

This response uses scare tactics and doesn't address the client's individual needs or concerns. It does not foster a trusting and respectful nurse-client relationship.

D. "Tell me more about your concerns about taking chemotherapy."

This is the most appropriate response. It demonstrates active listening, empathy, and a willingness to understand the client's perspective. By asking the client to share more about their concerns, the nurse can engage in a meaningful conversation and provide information and support based on the client's needs.

A. He will monitor your lithium levels closely while you are taking this medication." B. This medication is addictive, so you will need to discontinue it in six months." C. "Weight gain should be reported to your provider as an indication of lithium toxicity." D. "Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Correct Answer is A

Explanation

Lithium is a commonly used medication for treating bipolar disorder, and therapeutic drug monitoring is crucial to ensure its effectiveness and prevent potential toxicity. Monitoring the client's lithium levels in the blood is important because lithium has a narrow therapeutic range, meaning that levels that are too low might not provide the desired therapeutic effect, while levels that are too high can lead to toxicity.

B) "This medication is addictive, so you will need to discontinue it in six months."

Lithium is not considered addictive. It's important to provide accurate information about the nature of the medication to avoid unnecessary concerns.

C) "Weight gain should be reported to your provider as an indication of lithium toxicity."

While weight gain can be a side effect of some medications, it's not a specific indicator of lithium toxicity. Lithium toxicity is characterized by a range of symptoms including tremors, confusion, nausea, vomiting, and excessive thirst, among others.

D) "Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Diuretics are generally not recommended with lithium because they can increase the risk of lithium toxicity. Lithium can affect kidney function, and using diuretics may exacerbate this effect. The client should be advised not to use diuretics without consulting their healthcare provider.

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A nurse in an acute care mental health facility is assessing a client who has bipolar disorder. Which of the following findings indicates the client is at risk for suicide?

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