A nurse is assessing a psychiatricmental health client who has ...

[tatyanajohnson]

A nurse is assessing a psychiatricmental health client who has presented with altered thought processes.
 
  The client's medical record notes a history of suicide attempts. When assessing the client's current suicide risk, what principle should guide the nurse's line of questioning?
  A) The nurse should use clinical judgment when deciding to ask about suicide due to the risk of presenting it as a plausible option.
  B) The nurse should address the issue of suicide indirectly, using open-ended questions.
  C) The nurse should ask about the client's current thoughts around suicide in a direct manner.
  D) The nurse should ask the client to describe how he felt prior to his earlier suicide attempts.

Question 2

A man has been brought to the emergency department for an emergency psychiatric assessment following a physical altercation with a bus driver that appeared to be unprovoked.
 
  How should this individual's risk to others in the context of this altercation be assessed?
  A) Why did you attack the bus driver?
  B) What do you think could have happened to that bus driver if you'd had a weapon?
  C) Do you think that you injured the bus driver?
  D) Did you hit or strike the bus driver?

[Beatricemm]

Answer to Question 1

Ans: C
Feedback:
Many myths about suicide and suicidal behavior contribute to apprehension when approaching this topic with clients. One is the fear of planting the idea of suicide in a client's mind simply by discussing it. In fact, it is critical for nurses to ask direct questions to protect the safety of clients. Use of closed-ended questions is particularly beneficial during this inquiry because they require specific responses.

Answer to Question 2

Ans: D
Feedback:
Formulating questions around danger to others that focus on facts rather than client interpretations is also an important skill. For example, asking Did you hurt anyone? allows clients to interpret and possibly to minimize the seriousness of their violent behavior. A better alternative is Did you physically hit anyone? which attempts to solicit a factual response.