Chapter 25: Suicide and Nonsuicidal Self-Injury |Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. An adult outpatient diagnosed with major depressive disorder has a history of several suicide attempts by overdose. Given this patient‘s history and diagnosis, which antidepressant medication would the nurse expect to be prescribed? a. Amitriptyline b. Fluoxetine c. Desipramine d. Tranylcypromine sulfate ANS: B Selective serotonin reuptake inhibitor antidepressants are very safe in overdosage situations, which is not true of the other medications listed. Given this patient‘s history of overdosing, it is important that the medication be as safe as possible in the event of another overdose of prescribed medication. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 25-25, 26 TOP: Nursing Process: Planning MSC: Client Needs: Physiological Integrity 2. Four individuals have given information about their suicide plans. Which plan evidences the highest suicide risk? a. Turning on the oven and letting gas escape into the apartment during the night b. Cutting the wrists in the bathroom while the spouse reads in the next room c. Overdosing on aspirin with codeine while the spouse is out with friends d. Jumping from a railroad bridge located in a deserted area late at night ANS: D This is a highly lethal method with little opportunity for rescue. The other options are lower lethality methods with higher rescue potential. See relationship to audience response question. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 25-15, 16 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 3. Which measure would be considered a form of primary prevention for suicide? a. Psychiatric hospitalization of a suicidal patient b. Referral of a formerly suicidal patient to a support group c. Suicide precautions for 24 hours for newly admitted patients d. Helping school children learn to manage stress and be resilient ANS: D This measure promotes effective coping and reduces the likelihood that such children will become suicidal later in life. Admissions and suicide precautions are secondary prevention measures. Support group referral is a tertiary prevention measure. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 25-17, 18, 54 (Box 25-3) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 4. Which change in the brain‘s biochemical function is most associated with suicidal behavior? a. Dopamine excess b. Serotonin deficiency c. Acetylcholine excess d. γ-aminobutyric acid deficiency