The client's priority nursing diagnosis has been established as risk for self-directed violence: suicide related to multiple losses.
What is the priority outcome for this client?
Be placed on suicide precautions.
Refrain from attempting suicide.
State absence of feelings of powerlessness.
Attend a self-help group daily.
The Correct Answer is B
Choice A rationale
Placing a client on suicide precautions is an intervention (a safety measure) designed to prevent an attempt, not the priority outcome. The outcome is the measurable change in the client's status or behavior that demonstrates goal achievement. While precautions are essential for safety, the ultimate goal is the cessation of the life-threatening behavior itself.
Choice B rationale
Refrain from attempting suicide is the most direct and life-preserving priority outcome for a client with a nursing diagnosis of risk for self-directed violence: suicide. The immediate goal in this high-risk situation is the client's physical safety and survival, which is measurably achieved by the absence of suicidal behavior or gestures. All other goals are secondary to this primary safety objective.
Choice C rationale
Stating absence of feelings of powerlessness is a valuable intermediate or long-term outcome, as powerlessness is a contributing factor to suicidal ideation. However, it addresses the underlying etiology (related to) of the risk, not the life-threatening risk itself. Physical safety must take precedence over emotional or cognitive shifts in the immediate timeframe.
Choice D rationale
Attending a self-help group daily is a therapeutic intervention aimed at long-term coping and recovery, not the immediate priority outcome. While social support and engagement are crucial for preventing recurrence, they do not represent the primary, measurable, and immediate objective of protecting the client's life from imminent self-harm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Quaternary prevention is a relatively newer concept focused on protecting patients from medical interventions that are likely to cause harm. It involves identifying patients at risk of overmedicalization or unnecessary diagnostic or therapeutic procedures. This level of prevention is not directly applicable to the intervention stage for active suicidal tendencies.
Choice B rationale
Secondary prevention focuses on early detection and prompt treatment of a condition to limit disability and prevent severe progression. For a patient with major depression and active suicidal tendencies, the intervention (hospitalization, crisis intervention, initiation of pharmacotherapy) represents a critical effort to rapidly treat the acute phase of the illness, thus preventing suicide, which is a severe outcome.
Choice C rationale
Tertiary prevention aims to reduce the long-term consequences or disability of a chronic or already established disease. For major depression, tertiary prevention would include rehabilitation, ongoing support groups, and maintenance medication to prevent relapse and maximize functioning after the acute crisis has been resolved.
Choice D rationale
Primary prevention aims to prevent disease or injury before it ever occurs. This would include universal mental health education, stress management programs, or screenings for at-risk populations before they develop major depression or suicidal ideation. It is not appropriate for an actively suicidal patient.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
The Patient Protection and Affordable Care Act (PPACA) of 2010 strengthened mental health and substance use disorder parity requirements by integrating them into the Essential Health Benefits (EHBs). This legislation effectively mandated that most individual and small-group health plans cover mental health and substance use disorder services with benefits and cost-sharing equivalent to those for medical and surgical care.
Choice B rationale
The Health Care and Education Reconciliation Act (HCERA) of 2010 was an amendment to the PPACA. Although its primary focus was on student loans and Medicare, it is integral to the overall structure of the PPACA and contributes to the legislative foundation that mandates parity for mental health benefits within the expanded health coverage system.
Choice C rationale
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 primarily addresses the continuation of health insurance coverage, simplification of administrative processes, and the establishment of standards for the electronic transmission and security of health information (patient privacy rules). It does not specifically address or mandate parity in benefit levels between mental health and medical/surgical services.
Choice D rationale
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 significantly strengthened previous parity laws. It required group health plans that offer mental health or substance use disorder benefits to provide benefits that are no more restrictive than those for medical and surgical benefits, particularly concerning financial requirements and treatment limitations.
Choice E rationale
The Mental Health Parity Act (MHPA) of 1996 was the precursor to MHPAEA. It initially required parity for annual and lifetime dollar limits for mental health benefits compared to medical/surgical benefits. Although limited in scope, it was the first federal law to require some level of equality in mental health coverage.
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