Chapter 21: Variables Affecting the Therapeutic Environment: Violence and Suicide

Chapter 21: Variables Affecting the Therapeutic Environment: Violence and Suicide

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A student tells the school nurse, “My friend threatened to take an overdose of pills.” The nurse talks to the friend who verbalized the suicidal threat. Select the most critical question for the nurse to ask.

ANS:  B

The nurse must assess the patient’s access to a means to carry out the plan and, if there is access, alert the parents to remove the medications from the home. The information in the other questions is important to ask, but it is not the most critical.

DIF:    Cognitive level: Analyzing              REF:   p. 227

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

2. A tearful patient at the mental health center says, “I should be dead.” What is the most important first task for the nurse in assessing this patient?

ANS:  B

Establishing rapport will allow the nurse to obtain relevant assessment data such as the presence of a suicide plan, lethality of plan, and presence of risk factors for suicide.

DIF:    Cognitive level: Analyzing              REF:   p. 227

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

3. A patient being treated at the mental health center says, “I am having thoughts about suicide.” Select the nurse’s most therapeutic response.

ANS:  B

This response gives the patient reinforcement and validation for making a positive response rather than acting out a suicidal impulse. It gives neither advice nor false reassurance, and it does not imply stereotypes such as “You have a lot to live for.” It uses the patient’s ambivalence and sets the stage for more realistic problem solving.

DIF:    Cognitive level: Applying                REF:   p. 227

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

4. Select the most appropriate comment by the nurse when a depressed patient says, “What’s the use in going on?”

ANS:  A

The possibility of suicide must be openly addressed. The patient often feels relieved to be able to talk about suicidal ideation. The subject must be addressed directly.

DIF:    Cognitive level: Applying                REF:   p. 227

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity