The nurse should frequently assess a client with a depressive disorder for lethality risk related to suicidal ideation. Which questions should the nurse include? (Select all that apply.)
"Where do you keep your gun?"
"Are you thinking about hurting yourself or someone else?"
"Have you thought about how you would hurt yourself?"
"Can you tell me your feelings about dying?"
"Have you told your psychiatrist you feel like dying?"
Correct Answer : A,B,C,D
Choice A reason: While it’s important to assess access to lethal means, this question is too specific and assumes the client owns a gun. A more appropriate question might be, “Do you have access to any means to harm yourself?”
Choice B reason: Inquiring about thoughts of self-harm or harming others is a direct question that assesses suicidal ideation and intent, which is essential for determining immediate risk.
Choice C reason: Understanding if the client has specific plans for self-harm can help gauge the immediacy and seriousness of the suicide risk.
Choice D reason: Discussing feelings about dying can provide insight into the client's emotional state and potential risk for suicide.
Choice E reason: This question is important but it should not replace direct questions about the client’s current thoughts and feelings. It’s possible for a client to deny feelings of suicidality to their psychiatrist while still experiencing them.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This response is dismissive of the client's concerns and does not address her discomfort with a male nurse.
Choice B reason: This response is respectful of the client's wishes and offers a solution that could make her more comfortable.
Choice C reason: This response does not acknowledge the client's specific discomfort with a male nurse and does not offer an alternative.
Choice D reason: While this offers an alternative, it may not fully address the client's discomfort with having a male nurse responsible for her overall care.
Correct Answer is ["A","C","E"]
Explanation
Choice A reason: Ongoing communication with team members is essential in managing care for clients with personality disorders, as it ensures consistency and support among caregivers.
Choice B reason: Solving clients' problems is a goal, but it is not a technique to manage the nurse's frustration.
Choice C reason: Recognizing that behavior changes can occur quickly allows the nurse to adjust care plans promptly and may reduce frustration.
Choice D reason: It is not advisable to consider clients as personal friends, as this can blur professional boundaries and potentially lead to frustration.
Choice E reason: Discussing feelings of anger or frustration with colleagues can provide a support system for the nurse, helping to manage stress and prevent burnout.
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