A nurse in a mental health clinic is collecting data from a client to determine the client's risk for suicide.
Which of the following findings should the nurse identify as a risk factor for suicide? (Select all that apply.) .

Alcohol use disorder

Currently married.

Access to guns in the home.

Sibling history of suicide.

Terminal liver cancer.

Answer and Explanation

Correct Answer : A,C,D,E

Choice A rationale:

Alcohol use disorder is a risk factor for suicide. Alcohol can increase impulsivity and decrease inhibitions, which can lead to suicidal behaviors.

Choice B rationale:

Being currently married is generally considered a protective factor against suicide, not a risk factor.

Choice C rationale:

Access to lethal means, such as guns in the home, is a significant risk factor for suicide.

Choice D rationale:

A family history of suicide, including a sibling history of suicide, is a risk factor for suicide.

Choice E rationale:

Terminal illnesses, such as liver cancer, can increase feelings of hopelessness and despair, which are risk factors for suicide.

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Correct Answer is D

Explanation

Choice A rationale:

Alcohol can interfere with sleep patterns and should not be used as a sleep aid.

Choice B rationale:

Napping can make it harder to fall asleep at night.

Choice C rationale:

Eating just before bedtime can cause discomfort and disrupt sleep.

Choice D rationale:

Limiting caffeine intake can help improve sleep, as caffeine is a stimulant that can interfere with the ability to fall asleep.

A. Discourage visitation from the client's family B. Provide a high-stimulation environment for the client. C. Limit the client's need to make decisions. D. Keep the client's room dark at night.

Correct Answer is C

Explanation

Choice A rationale:

Discouraging visitation from the client’s family could increase feelings of isolation and confusion, which could exacerbate delirium.

Choice B rationale:

A high-stimulation environment could overstimulate the client and worsen delirium.

Choice C rationale:

Limiting the client’s need to make decisions can reduce stress and confusion, which can help manage delirium.

Choice D rationale:

Keeping the client’s room dark at night could disrupt the client’s sleep-wake cycle and potentially worsen delirium.

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A nurse in a mental health clinic is collecting data from a client to determine the client's risk for suicide.
Which of the following findings should the nurse identify as a risk factor for suicide? (Select all that apply.) .