Which of the following is a recommended safety intervention for a teenager admitted to the hospital for suicide ideation?
Allow the teenager to keep their personal belongings, including sharp objects, in their room.
Ensure continuous monitoring by assigning a mental health professional to check on the teenager every hour.
Implement a no-suicide contract with the teenager to guarantee they will not harm themselves.
Remove any items in the room that could be used for self-harm and provide continuous supervision.
The Correct Answer is D
Choice A rationale
Allowing a teenager with suicide ideation to keep personal belongings, especially sharp objects, presents an immediate and significant safety risk. Such items can be readily used for self-harm, undermining the primary goal of ensuring the patient's physical safety in a hospital environment. The environment must be strictly controlled to remove potential means of self-injury.
Choice B rationale
While continuous monitoring is crucial for a teenager with suicide ideation, checking on them every hour is insufficient. The inherent risk of self-harm requires constant, direct observation to intervene immediately if the teenager attempts to harm themselves. Hourly checks leave ample time for potential self-injurious behaviors to occur unsupervised.
Choice C rationale
A no-suicide contract, while sometimes used as a therapeutic tool, does not guarantee that a teenager will not harm themselves. It relies on the patient's commitment, which can be overridden by intense emotional distress or impulsive urges. This intervention should never replace stringent safety measures like continuous supervision and environmental control in an acute setting.
Choice D rationale
Removing any items that could be used for self-harm and providing continuous supervision are essential safety interventions. This creates a secure environment by eliminating immediate means of injury and ensures constant observation, allowing for immediate intervention during an emergent situation. This approach directly mitigates the risk of self-harm in a vulnerable patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A sudden drop in grades, increased absenteeism, avoidance of eye contact, and flat affect are significant behavioral and emotional changes that suggest a potential underlying mental health issue. Referring the student to a school social worker, who is trained in mental health assessments and interventions, ensures a timely and appropriate professional evaluation. Early identification and intervention are crucial for improving outcomes in adolescent mental health.
Choice B rationale
Encouraging academic breaks without addressing the root cause of the student's distress is unlikely to resolve the underlying issues. While breaks can be beneficial, they do not provide the comprehensive support needed for significant behavioral and emotional changes that suggest potential mental health concerns. This approach may delay necessary professional intervention.
Choice C rationale
Contacting the child's teacher to discuss tutoring focuses solely on the academic decline and overlooks the emotional and behavioral cues. While academic support might be needed, it does not address the possible mental health component indicated by the flat affect and avoidance of eye contact, which are often symptoms of distress.
Choice D rationale
Notifying the parent to request a medical workup is a reasonable step if a physical health issue is suspected. However, the constellation of symptoms (behavioral changes, emotional blunting, social withdrawal) more strongly points towards a mental health concern rather than a purely physical one, making a referral to a mental health professional more immediately relevant.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
A personal or family history of breast cancer is a significant contraindication for hormonal contraceptive use due to the potential for exogenous hormones to stimulate hormone-sensitive cancers. Estrogen and progesterone can influence the growth of certain breast cancer types, making a thorough assessment of this history critical before prescribing hormonal contraception.
Choice B rationale
Numerous medications can interact with hormonal contraceptives, affecting their efficacy or increasing adverse effects. For instance, certain anticonvulsants, antibiotics, and antiretrovirals can accelerate the metabolism of hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. Therefore, a comprehensive medication history is essential.
Choice C rationale
Smoking, especially in women over 35 years old, significantly increases the risk of serious cardiovascular adverse events such as myocardial infarction, stroke, and thromboembolism when combined with hormonal contraceptive use. Nicotine constricts blood vessels and promotes hypercoagulability, which is exacerbated by exogenous hormones.
Choice D rationale
Hypertension is a contraindication for many hormonal contraceptives, particularly those containing estrogen, as they can exacerbate elevated blood pressure and increase the risk of cardiovascular events. Hormonal contraceptives can affect the renin-angiotensin-aldosterone system, leading to fluid retention and increased vascular tone, thus worsening hypertension.
Choice E rationale
While excessive alcohol consumption can have various health consequences, it is not a direct contraindication to hormonal contraceptive use itself. It may, however, indirectly affect adherence to medication regimens or exacerbate other health issues. The primary concern with alcohol would be if it leads to liver impairment, which could affect hormone metabolism.
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