Which of the following principles should the nurse apply when planning nursing care for a client who was admitted after a suicide attempt?

Clients who talk about suicide are less likely to attempt it

Clients who attempt suicide and fail will not try again

Clients who attempt suicide and fail did not really want to die

The more specific the plan, the greater the risk of suicide

Answer and Explanation

The Correct Answer is D

Choice A reason: The belief that clients who talk about suicide are less likely to attempt it is a myth. Verbalizing suicidal ideation often reflects severe distress and heightened risk, as it may indicate prefrontal cortex dysfunction and impaired impulse control. This misconception underestimates the neurobiological basis of suicidal behavior, requiring vigilant assessment.

Choice B reason: Assuming clients who fail a suicide attempt will not try again is incorrect. Previous attempts increase future risk, as suicidal behavior is linked to persistent psychological distress and serotonin dysregulation. This assumption ignores the chronicity of underlying conditions like depression, necessitating ongoing monitoring and intervention to prevent recurrence.

Choice C reason: Claiming failed suicide attempts indicate a lack of intent to die is false. Many attempts fail due to external factors, not lack of intent. Suicidal behavior reflects complex neurobiological factors, including serotonin imbalance and prefrontal cortex deficits, requiring serious intervention regardless of outcome, as intent persists in high-risk individuals.

Choice D reason: A specific suicide plan indicates high risk, as it reflects advanced ideation and intent, often linked to prefrontal cortex dysfunction and reduced impulse control. Detailed planning suggests the client has visualized the act, increasing likelihood of completion. This principle guides nursing care to prioritize safety and immediate psychiatric intervention.

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Correct Answer is A

Explanation

Choice A reason: Offering dessert to stop yelling uses bargaining, not distraction, and may reinforce agitation in Alzheimer’s, where cortical and amygdala damage impairs emotional regulation. This approach risks escalating distress by focusing on the behavior, which the client cannot control due to neurocognitive deficits, making it ineffective.

Choice B reason: Asking if the client wants to finish the meal focuses on the agitation’s context, potentially worsening distress in Alzheimer’s due to impaired reasoning from cortical degeneration. This confrontational approach does not redirect attention, failing to leverage preserved procedural memory, which distraction techniques use to calm neurobiological agitation.

Choice C reason: Suggesting to watch television is a distraction technique, redirecting attention from agitation triggers in Alzheimer’s. By engaging preserved sensory and procedural memory, it reduces amygdala-driven emotional distress without confronting cognitive deficits, aligning with neurobiological strategies to manage agitation and promote calm in dementia care.

Choice D reason: Stating misunderstanding focuses on the client’s communication deficits, likely increasing frustration in Alzheimer’s due to hippocampal and cortical damage. This does not distract from agitation triggers and may exacerbate distress, as the client cannot process or correct their behavior, making it an ineffective response compared to redirection.

A. A client who has a BUN of 18 mg/dL B. A client who has a fasting blood glucose of 80 mg/dL C. A client who has a potassium level of 3.6 mEq/L D. A client who has a sodium level of 128 mEq/L

Correct Answer is D

Explanation

Choice A reason: A BUN of 18 mg/dL is within normal range (7–20 mg/dL) and does not indicate lithium toxicity. Lithium is renally excreted, and normal renal function, as reflected by BUN, suggests adequate clearance. Toxicity arises from sodium imbalances or dehydration, not directly from normal BUN levels, making this unremarkable.

Choice B reason: A fasting blood glucose of 80 mg/dL is normal (70–100 mg/dL) and unrelated to lithium toxicity. Lithium affects sodium and water balance, not glucose metabolism. Toxicity involves neurological symptoms from elevated serum lithium due to impaired renal clearance, not glycemic changes, so this value requires no further assessment.

Choice C reason: A potassium level of 3.6 mEq/L is within normal range (3.5–5.0 mEq/L) and does not indicate lithium toxicity. Lithium primarily affects sodium reabsorption in renal tubules, not potassium. Toxicity symptoms like tremors or confusion stem from sodium imbalances or high lithium levels, not normal potassium levels.

Choice D reason: A sodium level of 128 mEq/L (normal 135–145 mEq/L) indicates hyponatremia, increasing lithium toxicity risk. Lithium is reabsorbed in renal tubules like sodium; low sodium reduces lithium excretion, elevating serum levels, causing neurological symptoms like tremors or seizures. This requires immediate assessment to prevent toxicity.

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Which of the following principles should the nurse apply when planning nursing care for a client who was admitted after a suicide attempt?

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Correct Answer is A

Explanation

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Correct Answer is D

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