The client is being admited with suicidal thoughts. Which questions should the nurse ask the client? Select all that apply.
Does your family know you are considering this?
What method are you considering?
Have you determined when you will do this?
Do you have access to means for completing your thoughts?
Do you have a plan to end your life?
Can we call a chaplain or someone to talk to you?
Correct Answer : A,B,C,D,E,F
Choice A reason: Knowing if the family is aware can help in understanding the client's support system.
Choice B reason: Understanding the method the client is considering can help assess the level of risk and immediacy.
Choice C reason: Knowing the timing can help in immediate risk assessment and prevention planning.
Choice D reason: Assessing access to means is crucial for immediate safety planning.
Choice E reason: Understanding if there is a specific plan can help gauge the seriousness and immediacy of the risk.
Choice F reason: Offering spiritual or emotional support can be an important part of the care plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Seizure precautions and monitoring vital signs are important but not comprehensive enough for a complete care plan.
Choice B reason: This is the correct choice. It encompasses a broad range of interventions that are critical for a client undergoing alcohol withdrawal, including monitoring for various symptoms, ensuring safety, and administering medications.
Choice C reason: While suicide precautions are important, they are not the only intervention needed for a client in alcohol withdrawal.
Choice D reason: Monitoring vital signs and administering medications are important but do not cover all necessary precautions such as seizure and fall precautions.
Correct Answer is C
Explanation
Choice A reason: This choice is incorrect. Requesting quiet to sleep does not necessarily support a diagnosis of a manic episode.
Choice B reason: This choice is incorrect. Feeling tired and wanting to rest is not indicative of a manic episode, which is typically characterized by increased energy and activity.
Choice C reason: This is the correct choice. The statement about the purple hat and zebra-striped pants suggests a lack of awareness of social norms and possibly grandiosity or flamboyance, which can be indicative of a manic episode.
Choice D reason: This choice is incorrect. Concern about appearance does not specifically support a diagnosis of a manic episode.
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