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."
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Removing an NG tube: Removing a nasogastric tube is a task that can be safely delegated to a licensed practical nurse (LPN) under appropriate supervision, as it is considered a stable, routine procedure that does not require complex assessment.
B. Administering a subcutaneous insulin injection: LPNs are trained and authorized to administer subcutaneous injections, including insulin, as long as the client's condition is stable and the dose is clearly prescribed.
C. Providing discharge teaching about home IV medication therapy: Discharge education involving IV therapy requires comprehensive teaching, clinical judgment, and evaluation of understanding, which falls within the scope of practice of a registered nurse (RN).
D. Collecting a sputum culture: Collecting a sputum specimen is a basic nursing task that can be performed by an LPN or even by trained assistive personnel, depending on facility policy. It does not require the expertise of an RN.
Correct Answer is D
Explanation
Rationale:
A. Ask the client's partner to sign as next of kin: The partner cannot legally provide informed consent on behalf of the client unless they have legal power of attorney. Consent must come from the client unless they are incapacitated.
B. Document the client's refusal in their medical record: While documentation is important, it should only occur after ensuring the client fully understands the procedure. Without effective communication, refusal may not be informed.
C. Check to see if the client has an advance directive: Advance directives guide care if the client is incapacitated but may not apply if the client is alert and able to make decisions about the current procedure.
D. Ask the provider to explain the procedure through an interpreter: Using a professional interpreter ensures clear communication so the client can make an informed decision about the cesarean birth, respecting autonomy and reducing misunderstanding.
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