Chapter 25: Suicide and Non-Suicidal Self-Injury

Chapter 25: Suicide and Non-Suicidal Self-Injury

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. An adult outpatient diagnosed with major depression 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 (Elavil), a sedating tricyclic medication
b.	Fluoxetine (Prozac), a selective serotonin reuptake inhibitor
c.	Desipramine (Norpramin), a stimulating tricyclic medication
d.	Tranylcypromine sulfate (Parnate), a monoamine oxidase inhibitor

 

 

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 case she takes an overdose of her prescribed medication.

 

PTS:   1                    DIF:    Cognitive Level: Analyze (Analysis)

REF:   Page 492        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:   Page 486-487                                  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:   Page 487-488                                  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	c.	Acetylcholine excess
b.	Serotonin deficiency	d.	Gamma-aminobutyric acid deficiency

 

 

ANS:  B

Research suggests that low levels of serotonin may play a role in the decision to commit suicide. The other neurotransmitter alterations have not been implicated in suicidality.

 

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 484-485                                  TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity

 

5. A college student who failed two tests cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate and asked to be left alone for a few hours. Which behavior provides the strongest clue of an impending suicide attempt?

a.	Calling parents	c.	Giving away sweaters
b.	Excessive crying	d.	Staying alone in dorm room

 

 

ANS:  C

Giving away prized possessions may signal that the individual thinks he or she will have no further need for the item, such as when a suicide plan has been formulated. Calling parents, remaining in a dorm, and crying do not provide direct clues to suicide.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 486-487                                  TOP:   Nursing Process: Assessment

MSC:   Client Needs: Psychosocial Integrity