Susan, the nurse is caring for a client who states "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority?
Lethality of the method and availability of means
Client's educational and economic background
Client's insight into the reasons for the decision.
Quality of the client's social support
The Correct Answer is A
A. Lethality of the method and availability of means. Assessing the method and means helps determine the immediacy and seriousness of the threat. Knowing the lethality of the method and whether the means are readily available informs the level of intervention needed to keep the client safe.
B. Client's educational and economic background: While socioeconomic factors can influence mental health, they are not immediate priorities in a suicidal crisis.
C. Client's insight into the reasons for the decision: Insight is important for understanding motivations but is secondary to immediate safety concerns.
D. Quality of the client's social support: Social support is crucial but is secondary to assessing imminent risk of harm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Confusion: Not typically associated with iron deficiency anemia.
B. Fatigue. Fatigue is a hallmark symptom due to decreased oxygen-carrying capacity of the blood. Iron is essential for hemoglobin, and without sufficient iron, oxygen delivery to tissues is impaired, leading to fatigue.
C. Pain: Pain is not a typical symptom of iron deficiency anemia.
D. Slurred speech: Neurological symptoms like slurred speech are not typically seen in iron deficiency anemia unless severe.
Correct Answer is D
Explanation
A. Mood swings and irritability: These can be symptoms of PTSD, but they are also common in other mental health conditions.
B. Difficulty falling asleep or staying asleep: Sleep disturbances are frequent in PTSD, but not specific to it.
C. Excessive worry and anxiety: Anxiety is a hallmark symptom of PTSD, but it doesn't differentiate PTSD from other anxiety disorders.
D. Flashbacks and intrusive memories are a defining characteristic of PTSD. They involve reliving the traumatic event in a very vivid and distressing way, often involuntarily. This makes them a strong indicator of PTSD.
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