HESI Exit Exam Guide: Suicide Risk
Assessment & Nursing Safety
Planning
Table of Contents
Subtopic 1: Suicide Risk Factors and Epidemiology.........................................2
Subtopic 2: Suicide Screening Tools and Nursing Assessment Strategies......11
Subtopic 3: Safety Planning and Suicide Prevention Contracts......................20
Subtopic 4: Legal, Ethical, and Documentation Aspects of Suicide Risk........29
Subtopic 5: Suicide Risk in Special Populations (Adolescents, Veterans,
Elderly, LGBTQ+)...........................................................................................38
Subtopic 6: Crisis Intervention and Emergency Suicide Care........................48
Subtopic 7: Legal and Ethical Considerations in Suicide Risk Management. .57
Subtopic 8: Cultural and Developmental Factors in Suicide Risk...................67
Subtopic 9: Family Involvement and Multidisciplinary Team Coordination in
Suicide Care...................................................................................................76
Subtopic 10: Legal, Ethical, and Documentation Issues in Suicide Risk
Management..................................................................................................86
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Subtopic 1: Suicide Risk Factors and
Epidemiology
Question 1:
A nurse is reviewing risk factors for suicide. Which of the following individuals
is at highest risk for completing suicide?
A. A 25-year-old female recently diagnosed with generalized anxiety disorder
B. A 70-year-old widower with a history of depression and firearm access
C. A 45-year-old man recently fired from work with a history of alcohol use
disorder
D. A 19-year-old college student experiencing homesickness
Correct Answer: C
Rationale: Middle-aged men with recent stressors and substance use
disorders are at high risk for suicide. This patient presents multiple
converging risk factors.
Question 2:
Which demographic group has the highest rate of suicide completion in the
United States?
A. African American adolescent females
B. Hispanic adult females
C. White males aged 45–64 years
D. Native American children under 12
Correct Answer: C
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Rationale: Statistically, white males aged 45–64 have the highest rates of
suicide completion, often due to social isolation and access to lethal means.
Question 3:
A nurse should be most concerned about suicide risk in which patient?
A. A newly married woman planning a family
B. A teenager recently released from an inpatient psychiatric facility
C. A man recovering from knee surgery with family support
D. A child with mild asthma
Correct Answer: B
Rationale: The period immediately following discharge from a psychiatric
hospital is a high-risk time for suicide, particularly in adolescents.
Question 4:
Which psychiatric condition has the strongest association with suicide?
A. Schizophrenia
B. Borderline personality disorder
C. Major depressive disorder
D. Obsessive-compulsive disorder
Correct Answer: C
Rationale: Major depressive disorder is most commonly associated with
suicide, particularly when untreated or in the presence of hopelessness.
Question 5:
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Which of the following is a modifiable suicide risk factor?
A. Age
B. Substance use
C. Family history of suicide
D. Gender
Correct Answer: B
Rationale: Substance use is a modifiable factor and a key target for suicide
prevention strategies.
Question 6:
A nurse identifies a patient with a suicide plan involving overdose. What
feature makes this plan high risk?
A. The plan is vague
B. The method is lethal and accessible
C. The patient has no history of mental illness
D. The plan is far in the future
Correct Answer: B
Rationale: A specific, lethal, and accessible plan increases the risk for suicide
and requires immediate intervention.
Question 7:
Which gender attempts suicide more frequently, and which completes
suicide more frequently?