(Select all that apply): A nurse is analyzing data collected during the assessment phase for a patient at risk for suicide. Which of the following nursing diagnoses are commonly associated with suicidal ideation? Select three.
Risk for suicide.
Ineffective family coping.
Chronic low self-esteem.
Altered nutrition.
Risk for infection.
Correct Answer : A,B,C
Choice A:
Risk for suicide.
Choice B:
Ineffective family coping.
Choice C:
Chronic low self-esteem.
Choice A rationale:
This choice aligns with the primary concern of the patient being at risk for suicide, which is the focus of the assessment. Identifying this diagnosis is crucial for implementing appropriate interventions to ensure the patient's safety.
Choice B rationale:
Ineffective family coping could contribute to the patient's stressors and emotional state. It's relevant because the support system plays a significant role in a patient's mental health. However, it might not be as immediate a concern as the risk for suicide itself.
Choice C rationale:
Chronic low self-esteem is relevant to the patient's overall mental health and might contribute to their suicidal ideation. However, it might not directly address the immediate risk and urgency of the situation compared to the diagnosis of "Risk for suicide."
Choice D rationale:
Altered nutrition and risk for infection are not directly related to the primary concern of suicidal ideation and the associated nursing diagnoses. While they may be aspects of the patient's overall health, they are not the most pertinent concerns when addressing the risk of suicide.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A rationale:
Engaging in team sports is generally a positive activity and does not typically indicate suicidal ideation. While team sports can have mental health benefits, it is important to focus on the other signs that are more strongly associated with potential suicide risk.
Choice B rationale:
Expressing feelings of hopelessness is a significant warning sign of suicidal ideation. When individuals consistently express a sense of hopelessness, it could indicate that they feel trapped in their current situation and may be contemplating suicide as a way out.
Choice C rationale:
Withdrawing from social activities is a red flag for potential suicidal ideation. Social withdrawal can be indicative of a lack of interest in activities once enjoyed, a desire to isolate oneself, and an increased sense of loneliness and isolation, all of which are concerning signs.
Choice D rationale:
Demonstrating good academic performance is generally not a strong indicator of suicidal ideation. It's important to consider other emotional and behavioral signs that are more closely related to mental distress.
Choice E rationale:
Participating in creative hobbies can be a warning sign of suicidal ideation, especially if there is a sudden loss of interest in activities that the person used to enjoy. Creative hobbies may serve as an outlet for emotions, and a decrease in engagement could signal emotional turmoil.
Correct Answer is B
Explanation
Choice A rationale:
Leaving the client alone to give them space is not a suitable intervention for someone with a history of suicide attempts and depression. Isolation can increase the risk of acting on suicidal thoughts, and the client needs close monitoring and support during this vulnerable time.
Choice B rationale:
Removing any potential means of self-harm from the client's environment is essential. This intervention helps reduce the immediate risk by limiting access to harmful items. It's a crucial step in creating a safer environment for the client and preventing impulsive acts of self-harm.
Choice C rationale:
Encouraging the client to confront their feelings of hopelessness is important, but it should be done in a supportive and therapeutic manner. Simply telling someone to confront their feelings without appropriate guidance can be overwhelming and unproductive.
Choice D rationale:
Telling the client that they should be grateful for what they have minimizes their emotional experience and does not address the complexity of depression and suicidal ideation. This statement lacks empathy and understanding of the client's struggles.
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