Susan, the nurse is caring for a client who states "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority?

Lethality of the method and availability of means

Client's educational and economic background

Client's insight into the reasons for the decision.

Quality of the client's social support

Answer and Explanation

The Correct Answer is A

A. Lethality of the method and availability of means. Assessing the method and means helps determine the immediacy and seriousness of the threat. Knowing the lethality of the method and whether the means are readily available informs the level of intervention needed to keep the client safe.

B. Client's educational and economic background: While socioeconomic factors can influence mental health, they are not immediate priorities in a suicidal crisis.

C. Client's insight into the reasons for the decision: Insight is important for understanding motivations but is secondary to immediate safety concerns.

D. Quality of the client's social support: Social support is crucial but is secondary to assessing imminent risk of harm.

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Correct Answer is C

Explanation

A. Pernicious anemia: Typically involves vitamin B12 deficiency, not associated with heavy menstrual periods.

B. Folic acid deficiency anemia: Presents with similar symptoms but does not typically cause heavy menstrual bleeding.

C. Iron deficiency anemia. Iron deficiency anemia is characterized by low hemoglobin and hematocrit due to insufficient iron for red blood cell production. Symptoms of weakness, fatigue, and heavy menstrual bleeding are classic signs of iron deficiency anemia, which is confirmed by low hemoglobin and hematocrit levels.

D. Sickle cell anemia: Characterized by sickle-shaped red blood cells and is genetic in nature, not related to heavy menstrual bleeding.

A. Systemic lupus erythematosus B. Placental abruption C. Heparin therapy for deep-vein thrombosis D. Warfarin therapy for atrial fibrillation

Correct Answer is C

Explanation

A. Systemic lupus erythematosus (SLE): SLE is an autoimmune disease but is not directly linked to the pathophysiology of HIT.

B. Placental abruption: Placental abruption is a complication of pregnancy and is not a risk factor for HIT.

C. Heparin therapy for deep-vein thrombosis (DVT): Correct Answer. Heparin therapy itself, especially in the treatment of deep-vein thrombosis, is a significant risk factor for developing HIT due to the exposure to heparin.

D. Warfarin therapy for atrial fibrillation: Warfarin is not associated with the development of HIT.

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Susan, the nurse is caring for a client who states "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority?

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