MH 709 EXAM QUESTIONS WITH 100%
CORRECT ANSWERS
What is the difference between PMHNPs screening of versus assessment of suicide? -
ANSWER Screening will identify if there is an issue that needs further assessment,
whereas assessment helps to determine the actual level of risk.
Which is the MOST important in the PMHNP assessment of suicide risk factors? -
ANSWER Clinical judgement.
How are chronic suicidal risk factors different than acute suicide risk factors? -
ANSWER Chronic factors are unchangeable and non-modifiable.
What are five examples of chronic suicide risk factors? - ANSWER History of psychiatric
illness; Substance abuse (etoh=10x greater risk, IV drug use=14x greater risk); Age;
Gender (men =4x greater risk); Chronic medical condition or pain; Single/unmarried;
Family history of suicide; History of psychiatric hospitalizations; History of child abuse.
Which is the MOST potent chronic risk factor for suicide? - ANSWER Previous suicide
attempt. The more lethal the past attempt, the greater the risk.
What are five examples of suicide mitigating factors? - ANSWER No recent history of
suicide attempts; Good social supports/married; No substance abuse; No weapons in
the home; Willing & motivated to engaged in treatment; Non-psychotic; Able to state
reasons for living; Employment; Faith beliefs against suicide.
Should the PMHNP quantify risk of suicide through the use of assessment tools alone? -
ANSWER No. Assessment tools can be used as one measure in addition to clinical
judgment. Suicide risk is difficult to quantify and suicides are difficult to predict with
accuracy.
What are the two areas of focus for the PMHNP to determine level of suicide risk? -
ANSWER SDI: Suicidal Desire and Ideation (reasons for living, lack of deterrents to
attempt), and RPP: Resolved Plans and Preparation (availability of means, specificity of
plans).
A patient with a history of multiple suicide attempts would be considered what level of
risk? - ANSWER Chronic high risk.
What are three factors that create an "acute" risk of suicide? - ANSWER Presence of a
crisis; Significant life stressors; Increased symptomatology.
What steps would the PMHNP take next if a patient has been determined to have a
severe suicide risk? - ANSWER Immediate hospitalization, involve family and possibly
law enforcement.
, How often should the PMHNP assess suicide risk? - ANSWER Every visit.
What steps could the PMHNP take if a patient has been determined to have a moderate
suicide risk? - ANSWER Increased frequency of visits; Create a crisis plan; Provide 24
hour crisis service availability.
How effective are "no harm contracts" in reducing suicide? - ANSWER Not effective.
What are three facets of a suicide crisis response plan? - ANSWER Concrete & specific;
Collaborative; Documented.
Which factor is important in the assessment of homicide risk? - ANSWER Is the patient's
judgement impaired by the presence of psychiatric illness (knowing the difference
between right and wrong) versus poor coping (law enforcement issue).
Why is the PMHNP required to alert the authorities when her patient has made a
credible threat to the safety of another? - ANSWER Tarasoff Act, "Duty to Warn."
Describe the two ends of the suicidal ideation continuum. - ANSWER From fleeting and
vague thoughts, to persistent and highly specific plans.
Describe the two ends of the suicidal risk continuum. - ANSWER From vague and
unrealistic thoughts, to specific and feasible plans.
Do signs of suicidal preparation, such as giving away possessions or hoarding pills,
truly increase risk of suicide? - ANSWER Yes.
What are the two major elements of suicide attempts? - ANSWER The subjective level of
the patient's intent to die; and the objective lethality of the act (as determined by
clinician).
What are three examples of suicide direct warning signs? - ANSWER Suicidal
communication, seeking access to means/methods, and making preparations.
What does the acronym "ISPATHWARM" stand for? - ANSWER Ideation; Substance
abuse; Purposelessness; Anxiety; Trapped; Hopeless; Withdrawal; Anger;
Recklessness; Mood changes.
Does NSSI increase one's risk for future suicide? - ANSWER Yes.
What are three recommended therapies for NSSI? - ANSWER CBT, DBT, and MI.
Which medications are FDA approved for NSSI? - ANSWER None.
Which is the first line treatment for NSSI? - ANSWER SSRI's
When is a patient most at risk for suicide in relation to a psychiatric hospitalization? -
ANSWER The first three months after discharge.
Provide three examples of "re-experiencing" symptoms that occur in PTSD. - ANSWER
CORRECT ANSWERS
What is the difference between PMHNPs screening of versus assessment of suicide? -
ANSWER Screening will identify if there is an issue that needs further assessment,
whereas assessment helps to determine the actual level of risk.
Which is the MOST important in the PMHNP assessment of suicide risk factors? -
ANSWER Clinical judgement.
How are chronic suicidal risk factors different than acute suicide risk factors? -
ANSWER Chronic factors are unchangeable and non-modifiable.
What are five examples of chronic suicide risk factors? - ANSWER History of psychiatric
illness; Substance abuse (etoh=10x greater risk, IV drug use=14x greater risk); Age;
Gender (men =4x greater risk); Chronic medical condition or pain; Single/unmarried;
Family history of suicide; History of psychiatric hospitalizations; History of child abuse.
Which is the MOST potent chronic risk factor for suicide? - ANSWER Previous suicide
attempt. The more lethal the past attempt, the greater the risk.
What are five examples of suicide mitigating factors? - ANSWER No recent history of
suicide attempts; Good social supports/married; No substance abuse; No weapons in
the home; Willing & motivated to engaged in treatment; Non-psychotic; Able to state
reasons for living; Employment; Faith beliefs against suicide.
Should the PMHNP quantify risk of suicide through the use of assessment tools alone? -
ANSWER No. Assessment tools can be used as one measure in addition to clinical
judgment. Suicide risk is difficult to quantify and suicides are difficult to predict with
accuracy.
What are the two areas of focus for the PMHNP to determine level of suicide risk? -
ANSWER SDI: Suicidal Desire and Ideation (reasons for living, lack of deterrents to
attempt), and RPP: Resolved Plans and Preparation (availability of means, specificity of
plans).
A patient with a history of multiple suicide attempts would be considered what level of
risk? - ANSWER Chronic high risk.
What are three factors that create an "acute" risk of suicide? - ANSWER Presence of a
crisis; Significant life stressors; Increased symptomatology.
What steps would the PMHNP take next if a patient has been determined to have a
severe suicide risk? - ANSWER Immediate hospitalization, involve family and possibly
law enforcement.
, How often should the PMHNP assess suicide risk? - ANSWER Every visit.
What steps could the PMHNP take if a patient has been determined to have a moderate
suicide risk? - ANSWER Increased frequency of visits; Create a crisis plan; Provide 24
hour crisis service availability.
How effective are "no harm contracts" in reducing suicide? - ANSWER Not effective.
What are three facets of a suicide crisis response plan? - ANSWER Concrete & specific;
Collaborative; Documented.
Which factor is important in the assessment of homicide risk? - ANSWER Is the patient's
judgement impaired by the presence of psychiatric illness (knowing the difference
between right and wrong) versus poor coping (law enforcement issue).
Why is the PMHNP required to alert the authorities when her patient has made a
credible threat to the safety of another? - ANSWER Tarasoff Act, "Duty to Warn."
Describe the two ends of the suicidal ideation continuum. - ANSWER From fleeting and
vague thoughts, to persistent and highly specific plans.
Describe the two ends of the suicidal risk continuum. - ANSWER From vague and
unrealistic thoughts, to specific and feasible plans.
Do signs of suicidal preparation, such as giving away possessions or hoarding pills,
truly increase risk of suicide? - ANSWER Yes.
What are the two major elements of suicide attempts? - ANSWER The subjective level of
the patient's intent to die; and the objective lethality of the act (as determined by
clinician).
What are three examples of suicide direct warning signs? - ANSWER Suicidal
communication, seeking access to means/methods, and making preparations.
What does the acronym "ISPATHWARM" stand for? - ANSWER Ideation; Substance
abuse; Purposelessness; Anxiety; Trapped; Hopeless; Withdrawal; Anger;
Recklessness; Mood changes.
Does NSSI increase one's risk for future suicide? - ANSWER Yes.
What are three recommended therapies for NSSI? - ANSWER CBT, DBT, and MI.
Which medications are FDA approved for NSSI? - ANSWER None.
Which is the first line treatment for NSSI? - ANSWER SSRI's
When is a patient most at risk for suicide in relation to a psychiatric hospitalization? -
ANSWER The first three months after discharge.
Provide three examples of "re-experiencing" symptoms that occur in PTSD. - ANSWER
