C HAPTER 25: S UICIDE AND N ON - SUICIDAL
S ELF -I NJURY
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A tearful, anxious patient at the outpatient clinic reports, I should be
dead. The initial task of the nurse conducting the assessment interview is
to:
a. assess lethalit y of suicide plan.
b. encourage expression of anger.
c. establish rapport with the patient.
d. determine risk factors for suicide.
ANS: C
This scenario presents a potential crisis. Establishing rapport
facilitates a therapeutic alliance that will allow the nurse to obtain
relevant assessment data su ch as the presence of a suicide plan,
lethalit y of plan, and presence of risk factors for suicide.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 482
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
,2. A nurse interacts with an outpatient who has a history of multiple suicide
attempts. Select the most helpful response for a nurse to make when the
patient states, I am considering committing suicide.
a. Im glad you shared this. Please do not worry. We will handle it
together.
b. I think you should admit yourself to the hospital to keep you safe.
c. Bringing up these feelings is a very positive action on your part.
d. We need to talk about the good things you have to live for.
ANS: C
The correct response gives the patient reinforcem ent, recognition, and
validation for making a positive response rather than acting out the
suicidal impulse. It gives neither advice nor false reassurance, and it
does not impl y stereot ypes such as You have a lot to live for. It uses
the patients ambivalen ce and sets the stage for more realistic problem
solving.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 478 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. Which intervention will the nurse recommend for the dis tressed famil y
and friends of someone who has committed suicide?
a. Participating in reminiscence therapy
b. Psychological postmortem assessment
c. Attending a self -help group for survivors
d. Contracting for at least two sessions of group therapy
ANS: C
, Survivors need outlets for their feelings about the loss and the
deceased person. Self-help groups provide peer support while survivors
work through feelings of loss, anger, and guilt. Psychological
postmortem assessment would not provide the support necessary to
work through feelings of loss associated with the suicide.
Reminiscence therapy is not geared to loss resolution. Contracting for
two sessions of group therapy would not provide sufficient time to
work through the issues associated with a death by suicide.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 487 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. Which statement provides the best rationale for closel y monitoring a
severel y depressed patient during antidepressa nt medication therapy?
a. As depression lifts, physical energy becomes available to carry out
suicide.
b. Patients who previousl y had suicidal thoughts need to discuss their
feelings.
c. For most patients, antidepressant medication results in increased
suicidal thinking.
d. Suicide is an impulsive act. Antidepressant medication does not
alter impulsivit y.
ANS: A
Antidepressant medication has the objective of relieving depression.
Risk for suicide is greater as the depression lifts, primaril y because the
patient has more physical energy at a time when he or she may still
S ELF -I NJURY
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A tearful, anxious patient at the outpatient clinic reports, I should be
dead. The initial task of the nurse conducting the assessment interview is
to:
a. assess lethalit y of suicide plan.
b. encourage expression of anger.
c. establish rapport with the patient.
d. determine risk factors for suicide.
ANS: C
This scenario presents a potential crisis. Establishing rapport
facilitates a therapeutic alliance that will allow the nurse to obtain
relevant assessment data su ch as the presence of a suicide plan,
lethalit y of plan, and presence of risk factors for suicide.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 482
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
,2. A nurse interacts with an outpatient who has a history of multiple suicide
attempts. Select the most helpful response for a nurse to make when the
patient states, I am considering committing suicide.
a. Im glad you shared this. Please do not worry. We will handle it
together.
b. I think you should admit yourself to the hospital to keep you safe.
c. Bringing up these feelings is a very positive action on your part.
d. We need to talk about the good things you have to live for.
ANS: C
The correct response gives the patient reinforcem ent, recognition, and
validation for making a positive response rather than acting out the
suicidal impulse. It gives neither advice nor false reassurance, and it
does not impl y stereot ypes such as You have a lot to live for. It uses
the patients ambivalen ce and sets the stage for more realistic problem
solving.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 478 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. Which intervention will the nurse recommend for the dis tressed famil y
and friends of someone who has committed suicide?
a. Participating in reminiscence therapy
b. Psychological postmortem assessment
c. Attending a self -help group for survivors
d. Contracting for at least two sessions of group therapy
ANS: C
, Survivors need outlets for their feelings about the loss and the
deceased person. Self-help groups provide peer support while survivors
work through feelings of loss, anger, and guilt. Psychological
postmortem assessment would not provide the support necessary to
work through feelings of loss associated with the suicide.
Reminiscence therapy is not geared to loss resolution. Contracting for
two sessions of group therapy would not provide sufficient time to
work through the issues associated with a death by suicide.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 487 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. Which statement provides the best rationale for closel y monitoring a
severel y depressed patient during antidepressa nt medication therapy?
a. As depression lifts, physical energy becomes available to carry out
suicide.
b. Patients who previousl y had suicidal thoughts need to discuss their
feelings.
c. For most patients, antidepressant medication results in increased
suicidal thinking.
d. Suicide is an impulsive act. Antidepressant medication does not
alter impulsivit y.
ANS: A
Antidepressant medication has the objective of relieving depression.
Risk for suicide is greater as the depression lifts, primaril y because the
patient has more physical energy at a time when he or she may still
