Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations?

Monitor the client at close, but irregular, intervals.

Encourage the client to participate in group therapy.

Enlist friends and family to assist the client to remain safe after discharge.

Remind the client that it takes 4 to 6 weeks for antidepressants to be fully effective.

Answer and Explanation

The Correct Answer is A

Suicidal ideation involves thoughts of self-harm or death and may be passive or active. Active ideation includes a plan or intent and requires immediate intervention. The most critical priority is ensuring safety, preventing access to lethal means, and initiating continuous observation. Risk increases with prior attempts, psychiatric comorbidities, and recent losses. Monitoring must be direct and unpredictable to prevent manipulation or concealment of intent.

Rationale for correct answer

1. Close monitoring is essential to prevent self-harm during the acute phase. Irregular intervals reduce predictability, making it harder for the client to plan an attempt.

Rationale for incorrect answers

2. Group therapy is contraindicated in acute suicidal states due to risk of triggering, lack of insight, and inability to engage safely.

3. Discharge planning is secondary. Immediate safety during admission takes precedence before involving external support systems.

4. Antidepressant education is important but not urgent. Delayed onset of action does not address immediate risk of self-harm.

Take Home Points

Active suicidal ideation requires immediate safety interventions including unpredictable monitoring.
Group therapy is inappropriate during acute suicidal crises due to emotional instability and risk of contagion.
Discharge planning is important but secondary to inpatient safety stabilization.
Antidepressants take weeks to work; acute suicidal risk must be managed before pharmacologic effects are expected.

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Free Nursing Study Resources

Correct Answer is ["A","B","C"]

Explanation

Electroconvulsive therapy (ECT) is a controlled procedure used to treat severe depression, catatonia, and treatment-resistant psychiatric conditions. It involves inducing a brief generalized seizure under anesthesia. Pre-ECT medications are administered to reduce secretions, induce anesthesia, and prevent musculoskeletal injury. The goal is to optimize safety and minimize complications such as aspiration, prolonged seizures, or cardiovascular instability. Agents used must not interfere with seizure threshold or therapeutic efficacy.

Rationale for correct answers

1. Anticholinergic agents like glycopyrrolate reduce salivary and bronchial secretions, lowering aspiration risk and preventing bradycardia during ECT.

2. Anesthetic induction is achieved with thiopental, a short-acting barbiturate that provides rapid unconsciousness without significantly altering seizure threshold.

3. Muscle relaxation is critical to prevent injury during seizure. Succinylcholine, a depolarizing neuromuscular blocker, minimizes convulsive movements while preserving seizure activity.

Rationale for incorrect answers

4. Benzodiazepines like lorazepam raise seizure threshold and may blunt ECT efficacy. They are avoided unless treating status epilepticus or severe agitation.

5. Anticonvulsants such as divalproex suppress seizure activity and counteract ECT’s therapeutic mechanism. They are contraindicated unless treating comorbid epilepsy.

Take Home Points

Pre-ECT medications include anticholinergics, anesthetics, and muscle relaxants to ensure safety and efficacy.
Benzodiazepines and anticonvulsants interfere with seizure induction and are avoided before ECT.
Glycopyrrolate prevents bradycardia and aspiration by reducing secretions.
Succinylcholine minimizes physical injury during seizure without suppressing therapeutic activity.

A. “Your daughter will become very tired and may experience depression.” B. “It’s hard to say because she may not have any problems except mild nausea.” C. “Sometimes it can cause people to become agitated and act aggressively toward others.” D. “There’s a high risk of seizures and other neurological problems.”

Correct Answer is A

Explanation

Amphetamine withdrawal occurs when chronic use of stimulant drugs like amphetamine or methamphetamine is abruptly discontinued. The body, having adapted to elevated dopamine and norepinephrine levels, experiences a neurochemical crash. This leads to symptoms such as fatigue, hypersomnia, depression, and anhedonia. The withdrawal process is largely psychological, with physical symptoms being mild. While cravings and mood instability are common, seizures and severe neurological complications are rare unless there is co-occurring substance use or underlying pathology.

Rationale for correct answer

1. Fatigue and depression are hallmark symptoms of amphetamine withdrawal. The sudden drop in stimulant-induced neurotransmitter activity leads to lethargy, hypersomnia, and low mood. These symptoms reflect the body’s attempt to recalibrate after prolonged stimulation and are expected in most cases of withdrawal.

Rationale for incorrect answers

2. Mild nausea is not a defining feature of amphetamine withdrawal. This response minimizes the psychological impact and may mislead the client into underestimating the seriousness of mood-related symptoms like depression and anhedonia.

3. While agitation can occur, it is not the most common or defining symptom. Aggression is more typical during intoxication or in cases of polysubstance withdrawal. This response may unnecessarily alarm the client and misrepresent the usual withdrawal profile.

4. Seizures are not a high-risk feature of amphetamine withdrawal. Unlike alcohol or benzodiazepines, stimulants do not typically cause withdrawal seizures unless there is concurrent use of other substances or predisposing neurological conditions.

Take Home Points

Amphetamine withdrawal commonly causes fatigue, hypersomnia, and depressed mood due to neurotransmitter depletion.
Severe neurological symptoms like seizures are rare unless other substances are involved.
Agitation may occur but is less common than emotional and energy-related symptoms.
Accurate education helps families anticipate and support withdrawal safely and effectively.

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Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following medications may be administered before electroconvulsive therapy? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

A depressed client states that her daughter uses amphetamines, then asks the nurse, “What will happen when my daughter can’t get them and goes into withdrawal from them?” Which response by the nurse would be helpful information for the client?

Correct Answer is A

Explanation

A nursing student is studying major depressive disorder. Which student statement indicates that learning has occurred?

Which symptom is an example of an affective alteration exhibited by clients diagnosed with severe depression?

Which client statement is evidence of the etiology of major depressive disorder from a genetic perspective?

A client recently diagnosed with depression tells a nurse that she is 2 months pregnant and is reluctant to take an antidepressant medication. The client asks what other treatment options are available. Which type of therapy should a nurse recommend as an alternate treatment for depression?

Which of the following conditions is considered to be the only absolute contraindication for ECT?

A client diagnosed with major depressive disorder has an outcome that states, “The client will verbalize a measure of hope about the future by day 3.” Which client statement indicates this outcome was successful?

A client admitted with major depressive disorder has a nursing diagnosis of ineffective sleep pattern related to aches and pains. Which is an appropriate short-term outcome for this client?