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.
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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Naxlex Comprehensive Predictor Exams
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No explanation
Correct Answer is A
Explanation
A. Determining if the client has psychotic thinking.
Explanation: The highest priority assessment in this situation is to determine if the client has psychotic thinking. Psychotic thinking can indicate a severe mental health condition that requires immediate attention and intervention. If the client is experiencing psychotic symptoms, they might be at risk of harming themselves or others. Identifying and addressing psychotic thinking is crucial to ensure the safety and well-being of the client and those around them.
B. Asking the client to identify the cause of the crisis.
While understanding the cause of the crisis is important for providing appropriate care, it is not the highest priority. Psychotic thinking or risk of harm takes precedence over understanding the cause.
C. Identifying the client's coping skills.
Coping skills are important for managing the crisis and promoting the client's well-being, but assessing for psychotic thinking and immediate safety concerns comes before evaluating coping skills.
D. Identifying the client's support systems.
Support systems are valuable for the client's overall recovery, but they are not as time-sensitive as assessing for psychotic thinking or imminent safety risks. Identifying support systems can come after addressing the immediate concerns.
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