A nurse assesses a patient who reports a 3-week history of depression and periods of uncontrolled crying. The patient says. "My business is bankrupt and was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a covert suicidal message?
"My family will be better off without me."
"Life is not worth living."
"I wish I were dead."
"I have a plan that will fix everything"
The Correct Answer is A
A. "My family will be better off without me" is an indirect or covert suicidal statement (passive ideation) that suggests the patient believes others would be better off if they were gone. Such remarks require immediate assessment of suicide risk (ask directly about thoughts, intent, plan, access to means) and appropriate safety interventions.
B. "Life is not worth living" is an explicit expression of hopelessness and indicates suicidal ideation, but it is more overt than covert. It still warrants urgent assessment, but the question asked specifically for the covert message.
C. "I wish I were dead" is a direct statement of suicidal desire (overt) rather than a covert hint.
D. "I have a plan that will fix everything" is the most concerning because it indicates a specific plan (high lethality risk), but it is overt rather than covert.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. This is an example of insight into underlying fear, not rationalization.
B. Rationalization involves providing a justifiable-sounding reason for unacceptable behavior (blaming the victim for provocation).
C. This reflects lack of awareness, not rationalization.
D. This shows acknowledgment of poor control, not an attempt to justify behavior.
Correct Answer is C
Explanation
A. Prickly skin sensations may occur with anxiety or substance use, not psychomotor agitation.
B. Slowed verbal responses indicate psychomotor retardation, not agitation.
C. Psychomotor agitation refers to increased, purposeless movement such as pacing, hand-wringing, or fidgeting.
D. Asking to repeat instructions indicates poor concentration, not specifically psychomotor agitation.
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