(Select All That Apply): A client has expressed thoughts of suicide during a therapy session. Which therapeutic interventions should the nurse incorporate into the client's care plan? (Select three.).

Exploring the client's feelings and thoughts about suicide.

Developing a safety plan with the client.

Avoiding any discussion of suicide to prevent negative feelings.

Instructing the client to suppress their emotions.

Identifying the client's support systems and resources.

Answer and Explanation

Correct Answer : A,B,E

Choice A rationale:

Exploring the client's feelings and thoughts about suicide is crucial to understanding their perspective, emotions, and reasons behind their thoughts. Openly discussing these feelings can help the client feel understood and validated, fostering a therapeutic relationship and potentially reducing their distress.

Choice B rationale:

Developing a safety plan with the client is essential. A safety plan outlines strategies the client can use when they experience suicidal thoughts or overwhelming emotions. It includes steps to manage their emotions, reach out for support, and avoid harmful behaviors. Having a concrete plan in place empowers the client to take control of their safety.

Choice E rationale:

Identifying the client's support systems and resources is important for their recovery. Building a network of people who can offer emotional support, as well as identifying professional resources such as therapists or support groups, can enhance the client's coping mechanisms and reduce feelings of isolation.

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Correct Answer is C

Explanation

Choice A rationale:

This statement is not accurate. The Columbia-Suicide Severity Rating Scale (C-SSRS) is not focused on assessing suicide-related thoughts and behaviors in the past year. Instead, it is designed to assess the severity of suicidal ideation and behavior over a specified time frame.

Choice B rationale:

This statement is not accurate. The C-SSRS is not a self-report questionnaire for depression and suicidal ideation in the past two weeks. It is a structured interview that involves a series of questions and prompts administered by a trained clinician to assess the severity of suicidal ideation and behavior.

Choice C rationale:

This statement is accurate. The Columbia-Suicide Severity Rating Scale (C-SSRS) guides the evaluation and triage of patients with suicidal ideation or behavior based on five steps: Determining the presence of active suicidal ideation. Assessing the intensity of ideation. Examining the presence and severity of any preparatory behavior. Evaluating the level of intent to die. Determining the lethality of the suicide plan. The C-SSRS is widely used in clinical and research settings to assess suicide risk and guide appropriate interventions.

Choice D rationale:

This statement is not accurate. The C-SSRS does not measure the severity and intensity of suicidal ideation and behavior in the past month. It focuses on assessing the severity of suicidal ideation and behavior based on the steps mentioned in choice C.

A. Expressing hopelessness or worthlessness. B. Engaging in positive coping strategies. C. Increasing alcohol or drug use. D. Talking about wanting to die. E. Withdrawing or isolating oneself.

Correct Answer is ["A","C","D","E"]

Explanation

The correct answers are A. Expressing hopelessness or worthlessness, C. Increasing alcohol or drug use, D. Talking about wanting to die, and E. Withdrawing or isolating oneself.

Choice A rationale:

Expressing feelings of hopelessness or worthlessness is a significant warning sign of suicide. These feelings often indicate severe emotional distress and a lack of perceived future.

Choice B rationale:

Engaging in positive coping strategies is generally a protective factor against suicide, not a warning sign.

Choice C rationale:

Increasing alcohol or drug use can be a sign of self-medicating to cope with emotional pain, which is a common warning sign of suicidal ideation.

Choice D rationale:

Talking about wanting to die is a direct indicator of suicidal thoughts and should always be taken seriously.

Choice E rationale:

Withdrawing or isolating oneself is a common behavior in individuals contemplating suicide, as they may feel disconnected from others or believe they are a burden.

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(Select All That Apply): A client has expressed thoughts of suicide during a therapy session. Which therapeutic interventions should the nurse incorporate into the client's care plan? (Select three.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a patient's suicide risk using standardized tools. Which statement is accurate regarding the Columbia-Suicide Severity Rating Scale (C-SSRS)?

Correct Answer is C

Explanation

A client has expressed suicidal thoughts to the nurse. Select all the warning signs for suicide that the nurse should be aware of.

Correct Answer is ["A","C","D","E"]

Explanation

A nurse is working with a client who has suicidal ideation. Which intervention should the nurse implement to promote hope in the client?

A client with a history of suicide attempts is admitted to the hospital. Which statement by the client should the nurse address during the assessment phase?

(Select All That Apply): A client has expressed thoughts of suicide during a therapy session. Which therapeutic interventions should the nurse incorporate into the client's care plan? (Select three.).

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A nurse is providing care to a client with suicidal ideation. Select all the interventions that the nurse should include in the implementation phase of the client's care.

A nurse is conducting an assessment of a client who may be at risk for suicide. Which of the following are common risk factors associated with suicide and suicidal ideation? (Select All That Apply):

A nurse is developing a plan of care for a patient with suicidal ideation. Which of the following is a priority principle to consider in the planning phase for this patient's care?

A client is diagnosed with "Impaired coping." Which statement accurately describes this nursing diagnosis for a patient with suicidal ideation?