It has been 5 days since a suicidal patient was hospitalized and prescribed an antidepressant medication. The patient is now more talkative and shows increased energy. Select the highest priority nursing intervention.
Consider discontinuation of suicide precautions.
Supervise the patient 24 hours a day.
Begin discharge planning for the patient.
Refer the patient to art and music therapists
The Correct Answer is B
A. Suicide precautions should never be discontinued at this time; in fact, suicide risk is highest when energy improves before mood fully stabilizes.
B. Increased energy after starting antidepressants raises suicide risk, as the patient may now have the ability to act on suicidal thoughts. Continuous supervision is the priority for safety.
C. Discharge planning is premature at this stage; safety comes first.
D. Art and music therapy may be beneficial long-term but do not address the immediate suicide risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Buspirone – This anxiolytic does not typically cause significant anticholinergic effects.
B. Lithium – Common side effects include tremor, polyuria, and mild gastrointestinal upset, not prominent anticholinergic effects.
C. Imipramine, a tricyclic antidepressant, has strong anticholinergic properties, leading to dry mouth, blurred vision, mydriasis, constipation, and urinary retention.
D. Risperidone – An atypical antipsychotic; anticholinergic effects are minimal compared to tricyclic antidepressants.
Correct Answer is C
Explanation
A. Singing carols is calm, unlikely to trigger combat-related flashbacks.
B. A seashore outing is generally peaceful and not typically a PTSD trigger.
C. Fireworks mimic gunfire and explosions, which can easily trigger flashbacks, hypervigilance, and distress in combat veterans with PTSD.
D. Halloween can be stimulating, but not as direct a combat reminder as fireworks.
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