A home health nurse is assessing a client with AIDS.
Which of the following responses by the client indicates a risk for suicide?
"I don't want to lose control of my ability to make decisions.".
"I know that everything will be better soon.".
"I am relying more and more on my partner for support.".
"I am afraid of experiencing pain near the end.".
The Correct Answer is D
People living with HIV/AIDS have a much higher risk of suicide than the general population1. Some of the risk factors for suicidal ideation, suicide attempts and suicide deaths in this group are depression, advanced disease, neurological changes, stigma, poor social support, negative life events, physical pain and fear of rejection.
Based on these risk factors, the response by the client that indicates a higher risk for suicide is d. “I am afraid of experiencing pain near the end.” This response suggests that the client has a low perception of their physical health, a fear of losing control and a pessimistic outlook on their future. These are signs of hopelessness, which is a strong predictor of suicide.
The other responses do not necessarily indicate a high risk for suicide, although they may reflect some challenges that the client is facing. For example, response a. may indicate a desire for autonomy and dignity, response b. may indicate a coping strategy or denial, and response c. may indicate a source of emotional support or dependency. However, these responses do not imply that the client is thinking about harming themselves or ending their life.
Therefore, the home health nurse should assess the client’s level of hopelessness, suicidal ideation and suicide plan, and provide appropriate interventions and referrals to prevent a possible suicide attempt. The nurse should also monitor the client’s mood, pain, medication adherence and social support, and offer education, counseling and resources to improve the client’s quality of life.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Before planning and implementing a program about healthy eating, it is important for the nurse to first determine the students’ motivation to learn about healthy food choices. This will help the nurse tailor the program to meet the needs and interests of the students.
Choice A is not the answer because providing students with resources about making wise choices independently is an action that can be taken after determining their motivation to learn about healthy food choices.
Choice B is not the answer because helping students recognize the value of making healthy food choices is an action that can be taken after determining their motivation to learn about healthy food choices.
Choice C is not the answer because giving positive feedback to students who make appropriate choices is an action that can be taken after determining their motivation to learn about healthy food choices.
Correct Answer is A
Explanation
The first step a nurse should take when caring for a client who is homeless is to assess their understanding of their living situation. This will help the nurse to understand the client’s perspective and needs, and to tailor their care accordingly.
Choice B, assisting the client to develop goals for obtaining shelter, is important but should come after the initial assessment.
Choice C, discussing the risks of being homeless with the client, is also important but should come after the initial assessment.
Choice D, developing client teaching using a variety of strategies, is also important but should come after the initial assessment and after determining the client’s needs and goals.
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