A nurse is providing care to a client who is displaying warning signs of suicidal ideation. Which interventions should the nurse prioritize to ensure the client's safety? (Select all that apply.).
Monitoring the client's access to lethal means.
Encouraging the client to isolate themselves for self-reflection.
Providing the client with a detailed plan for coping.
Collaborating with the client's family and friends.
Administering sedative medications to keep the client calm.
Correct Answer : A,C,D
The correct answer is A. Monitoring the client’s access to lethal means, C. Providing the client with a detailed plan for coping, and D. Collaborating with the client’s family and friends.
Choice A rationale:
Monitoring the client’s access to lethal means is crucial to prevent any immediate risk of self-harm. This includes removing or securing items that could be used for suicide, such as medications, sharp objects, or firearms.
Choice B rationale:
Encouraging the client to isolate themselves for self-reflection is not advisable. Isolation can increase feelings of loneliness and hopelessness, which may exacerbate suicidal ideation.
Choice C rationale:
Providing the client with a detailed plan for coping helps them manage their thoughts and emotions more effectively. This plan can include strategies for dealing with stress, identifying triggers, and knowing when and how to seek help.
Choice D rationale:
Collaborating with the client’s family and friends is essential for creating a support network. Involving loved ones can provide the client with emotional support and help monitor their well-being.
Choice E rationale:
Administering sedative medications to keep the client calm is not a primary intervention for suicidal ideation. While medication may be part of a broader treatment plan, it should not be the sole strategy for ensuring safety.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Active listening. Active listening is an important communication skill that involves attentively hearing and interpreting what the patient is saying. However, it doesn't specifically address the aspect of acknowledging the patient's feelings and thoughts as real and understandable without agreeing or disagreeing.
Choice B rationale:
Empowerment. Empowerment refers to the process of enabling and supporting patients to take control of their own health and make informed decisions. While this is an essential aspect of patient care, it doesn't directly address the skill of acknowledging the patient's feelings and thoughts without expressing agreement or disagreement.
Choice C rationale:
Validation. Validation involves recognizing and accepting the patient's feelings and thoughts as valid, even if you don't share the same perspective. It shows empathy and understanding without passing judgment. In the context of a patient with suicidal ideation, validation is crucial as it helps build trust and rapport, creating an environment where the patient feels heard and supported.
Choice D rationale:
Open-ended questions. Open-ended questions are inquiries that can't be answered with a simple "yes" or "no" and encourage patients to provide more detailed responses. While they are valuable for eliciting information, they don't specifically address the act of acknowledging the patient's feelings and thoughts as real and understandable without taking a stance.
Correct Answer is C
Explanation
Choice C rationale:
Collaborating with the client to develop a comprehensive aftercare plan is a priority nursing goal for a client who has recently attempted suicide and is now stabilized. Aftercare planning involves creating a structured plan that addresses the client's ongoing psychological, emotional, and social needs. This includes arranging follow-up therapy sessions, connecting with appropriate community resources, and involving the client in decisions regarding their care. Developing an aftercare plan aims to prevent further episodes of suicidal ideation and support the client's overall well-being. Isolating the client from friends and family, as mentioned in choice A, would be counterproductive. Isolation can exacerbate feelings of loneliness and hopelessness, potentially increasing the risk of further emotional distress. Encouraging the client to keep their feelings and experiences private, as suggested in choice B, is not in line with therapeutic practice. Open communication and sharing emotions with appropriate support systems are crucial for the client's healing process. Discharging the client home as soon as possible, as mentioned in choice D, without addressing the underlying issues and providing a comprehensive aftercare plan, could lead to a recurrence of suicidal thoughts and behaviors. It is essential to ensure the client's safety and well-being before considering discharge.
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