Answer to Question 1
A
Most persons who later attempt suicide have given some indication of being at risk, of having ideation or intent related to suicide. The suicide rate among physicians and nurses is higher than in the general population; their special knowledge of pharmacology and physiology can make attempts more likely to be lethal. Most people who complete suicide have made at least one previous attempt, and a history of prior attempts is one of the strongest predictors of future risk. Some attempts may appear unlikely to have succeeded from the outset, because the means was one of low lethality (e.g., choking oneself with socks wrapped around the neck) or because circumstances would have led to their being rescued before harm resulted (e.g., an attempt initiated in front of witnesses). Many tend to interpret such unlikely-to-succeed attempts as meaning that the person wasn't really serious about suicide, that it was a (so-called) suicide gesture. In fact, often a depressed or psychotic person simply is too cognitively impaired to plan well to succeed at suicide. Further, identifying a serious attempt as a gesture (not serious) can increase the risk of suicide if it is perceived as a challenge or if the person feels they or their attempt are being ridiculed or not taken seriously. The person may respond by intensifying efforts and may succeed in a subsequent attempt.
Answer to Question 2
C
Because lithium should be taken at the same time each day and the therapeutic range is narrow, 5 hours after the first dose was missed would be too close to take the second dose. The client should not to try to make up the first missed dose. Altering the schedule for one missed dose could cause more problems with future doses.