A patient who is a policewoman tells the nurse she is depressed ...

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A patient who is a policewoman tells the nurse she is depressed and can no longer deal with the stress of her job. She mentions that employee assistance counseling failed to change her hopeless attitude.
 
  She states that she will use her police revolver to shoot herself in the head during the day when no one is at home and the home is locked. Which formulation by the triage nurse is correct?
  a. Plan explicit. Imminence high. Method highly lethal and accessible. Rescue po-tential low.
  b. Plan vague. Imminence moderate. Method somewhat lethal and accessible. Res-cue potential moderate.
  c. Plan complete. Imminence low. Method low lethality but accessible. Rescue po-tential high.
  d. Plan nebulous. Imminence low. Method low lethality but accessible. Rescue po-tential high.

Question 2

A patient was admitted and prescribed antidepressants for severe depression with feel-ings of hopelessness, helplessness, and suicidal ideation. When would the patient be at greatest risk for suicide during hospitalization?
 
  a. Within the first hour after admission and when family leaves
  b. At night after visitors leave and patients are allow in their room
  c. Within the first 24 hours after admission and as discharge approaches
  d. Within 48 hours of first expressing suicidal ideation and as therapy progresses

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Answer to Question 1

ANS: A
The correct option identifies that the plan is well thought out; the imminence is high because the patient is ready to act; the gun is a highly lethal method, and she has the weapon; and the rescue potential is low because a gun is the chosen method. The remaining options do not show the proper assessment of these criteria.

Answer to Question 2

ANS: C
Statistics show that the most dangerous times for a hospitalized patient who has the potential for self-harm is within the first 24 hours after admission and as the associated stress of dis-charge nears.

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