A severely depressed patient who has been on suicide precautions ...

[Metfan725]

A severely depressed patient who has been on suicide precautions tells the nurse, I am feeling a lot better, so you can stop watching me. I have taken too much of your time already.. The best response for the nurse to make would be:
 
  a. I wonder what this sudden change is all about. Care to elaborate?
  b. I am glad you are feeling better. The team will consider what you have said..
  c. You should not try to direct your plan for care. Leave that to the team..
  d. Because we are concerned about your safety, we will continue with our plan..

Question 2

A suspicious, socially isolated patient lives alone, eats one meal a day at a local soup kitchen, and spends the remaining daily food allowance on cigarettes. Select a community psychiatric nurse's best initial action.
 
  a. Explore ways to stop smoking with the patient.
  b. Report the situation to the manager of the soup kitchen.
  c. Assess the patient's weight; determine foods and amounts eaten.
  d. Arrange hospitalization for the patient while a new treatment plan is formulated.

[ally]

Answer to Question 1

D
When a patient seeks to have precautions lifted by professing to feel better, the patient may be seeking greater freedom in which to attempt suicide. Changing the treatment plan requires careful evaluation of outcome indicators by staff. Asking the patient to elaborate could yield further evaluation data but would not reliably address suicide risk. Taking the patient's comment at face value neglects the fact that people can seek to conceal their plans in order to increase their chances of success. Asking the patient to leave that to the team conveys a parental attitude that would discourage the patient from participating in his treatment.

Answer to Question 2

C
Assessment of biopsychosocial needs and general ability to live in the community is called for before any other action is taken. Both nutritional status and income adequacy are critical assessment parameters. A patient may be able to maintain adequate nutrition while eating only one meal a day. The rule is to assess before taking action. Hospitalization may not be necessary.