A nurse is collecting data from a client who has had major depressive disorder for 5 years. Which of the following statements made by the client should the nurse identify as a covert statement regarding suicide?

"I feel that soon everything will be ok."

"I just cannot take this anymore.

"My family would be better off if i was dead."

"I do not want to be here anymore."

Answer and Explanation

The Correct Answer is A

Rationale:

A. "I feel that soon everything will be ok.": This is a covert statement because it sounds hopeful but may actually reflect a decision to end one’s life. Sudden calmness or vague optimism in someone with a history of major depressive disorder can indicate suicidal planning and should prompt immediate follow-up.

B. "I just cannot take this anymore.": This is an overt expression of emotional distress and hopelessness. While serious, it clearly communicates the client's feelings and is more direct than covert.

C. "My family would be better off if I was dead.": This is an overt suicidal statement suggesting that the client believes their death would benefit others. It requires immediate attention and suicide risk assessment.

D. "I do not want to be here anymore.": This is another overt expression that directly indicates a desire to no longer live or be present. It reflects suicidal ideation and needs urgent intervention but is not considered covert.

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Correct Answer is C

Explanation

Rationale:

A. "I'm going to contact your partner for you now.": While involving loved ones can be supportive, taking action without first addressing the client’s emotional state or asking their preference may feel dismissive or intrusive during a vulnerable moment.

B. "Let's talk about the treatment options you were given.": Shifting the focus to treatment too quickly can invalidate the client's immediate emotional response. Emotional support should take precedence over information processing in the early moments of distress.

C. "I'll stay with you for a little while if that's okay.": Offering presence and emotional support communicates compassion and allows the client space to express grief. This response fosters trust and demonstrates empathy without pressuring the client to talk or act.

D. "Your provider will take good care of you.": Though intended to reassure, this response deflects the client’s emotional pain and may come off as impersonal or minimizing. It does not address the need for immediate emotional support.

A. Examine the client's nail beds. B. Place the client in the supine position. C. Encourage client to perform deep breathing exercises. D. Prepare to administer oxygen via Venturi face mask. E. Add a humidifier to the oxygen device.

Correct Answer is ["A","C","D"]

Explanation

Rationale:

• Examine the client's nail beds: Assessing nail beds for cyanosis provides visual clues of hypoxia. This is a noninvasive, rapid method to evaluate tissue perfusion and oxygenation. The client's saturations are borderline low despite increasing oxygen.

• Place the client in the supine position: The supine position can reduce lung expansion and worsen hypoxia, especially after sedation. Elevating the head of the bed promotes lung expansion and better diaphragmatic movement.

• Encourage client to perform deep breathing exercises: Deep breathing helps expand alveoli and improves oxygen exchange. It may reduce the need for higher oxygen delivery if the hypoxia is due to shallow respirations after sedation.

• Prepare to administer oxygen via Venturi face mask: The client's O₂ saturation is dropping despite nasal cannula at 5 L/min. A Venturi mask delivers a more precise and consistent oxygen concentration, making it appropriate here.

• Add a humidifier to the oxygen device: Humidification is generally needed for oxygen above 4 L/min over long durations. This client has only been on oxygen for a short time post-procedure, so humidification is not urgently required.

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A nurse is collecting data from a client who has had major depressive disorder for 5 years. Which of the following statements made by the client should the nurse identify as a covert statement regarding suicide?

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