Which measure would be considered a form of primary prevention for suicide?

Correct Answer: D

Rationale: In the context of psychiatric emergencies, the correct answer is option D: Helping school children learn to manage stress and be resilient. This option is a form of primary prevention for suicide because it focuses on promoting mental health and well-being in a population before any suicidal ideation or behavior occurs. By teaching children coping strategies, stress management skills, and resilience-building techniques, we can potentially reduce the risk of suicide in the future. Option A, psychiatric hospitalization of a suicidal patient, is a form of tertiary prevention aimed at managing and treating individuals who are already at high risk for suicide. This is not considered primary prevention as it is addressing the issue after it has already arisen. Option B, referral of a formerly suicidal patient to a support group, falls under secondary prevention as it aims to prevent recurrence or worsening of suicidal behavior in individuals who have already exhibited such tendencies. While support groups can be beneficial for individuals at risk, they do not target the broader population for prevention purposes. Option C, suicide precautions for 24 hours for newly admitted patients, is a form of secondary prevention that focuses on closely monitoring and ensuring the safety of individuals who are currently at risk for suicide. This measure does not address preventing suicide in the general population or before suicidal behavior emerges. In an educational context, it is crucial to understand the different levels of prevention in addressing psychiatric emergencies like suicide. By emphasizing primary prevention strategies such as teaching children resilience and stress management skills, we can work towards creating a mentally healthy environment that reduces the likelihood of suicide in the future. This approach underscores the importance of early intervention and promotion of mental well-being in our communities.

Correct Answer: A

Rationale: In this scenario, the highest priority nursing intervention is option A) Supervise the patient 24 hours a day. This is crucial because the patient's increased talkativeness and energy after initiating antidepressant medication could indicate a shift from a low-energy depressive state to a more active and potentially impulsive phase. This change in behavior poses an increased risk of acting on suicidal thoughts. Supervising the patient continuously allows the healthcare team to closely monitor for any signs of worsening mental state or emergence of suicidal ideation. It also enables prompt intervention if the patient's condition deteriorates, ensuring their safety. The other options are incorrect: - B) Beginning discharge planning prematurely could overlook the immediate need for intensive monitoring and potentially place the patient at risk. - C) Referring the patient to art and music therapists is beneficial for holistic care but not the highest priority when safety is a concern. - D) Considering discontinuation of suicide precautions is inappropriate at this stage, as the patient's behavior change warrants continued vigilance. Educationally, this question highlights the importance of ongoing assessment and monitoring in psychiatric emergencies, emphasizing the need for vigilant observation even when initial signs may seem positive. It underscores the critical role of nursing interventions in ensuring patient safety and well-being in mental health care settings.

Correct Answer: C

Rationale: The correct answer is C) Attending a self-help group for survivors. This intervention is the most appropriate for the distressed family and friends of someone who has committed suicide because it provides a supportive environment where individuals can share their experiences, emotions, and coping strategies with others who have gone through a similar loss. Being part of a self-help group can help reduce feelings of isolation, provide validation of emotions, and offer practical advice on how to navigate the grieving process. Option A, participating in reminiscence therapy, is not the most appropriate intervention in this scenario as it focuses on recalling past events and experiences to promote emotional healing. While reminiscence therapy can be beneficial in other contexts, it may not address the immediate needs of individuals dealing with the shock and grief of a recent suicide. Option B, psychological postmortem assessment, is also not the most suitable intervention for the distressed family and friends as it involves a formal evaluation of the deceased individual's mental health history and circumstances leading up to the suicide. While this assessment may be valuable for understanding the factors contributing to the suicide, it does not directly address the emotional needs of the bereaved individuals. Option D, contracting for at least two sessions of group therapy, may provide therapeutic support, but it lacks the specific focus on shared experiences and support from others who have experienced a similar loss, which is a key component of self-help groups for suicide survivors. In an educational context, understanding the most appropriate interventions for individuals affected by suicide is crucial for healthcare professionals working in psychiatric emergencies. By recognizing the unique needs of those grieving a suicide and knowing how to guide them towards effective support services, nurses can play a vital role in promoting healing and resilience in the face of such a traumatic event.

Correct Answer: D

Rationale: The correct answer is D) Risk for other-directed violence. In a situation where a patient has been arrested for breaking windows, the priority nursing diagnosis is identifying the risk for other-directed violence. This is crucial for ensuring the safety of not only the patient but also others around them. It is important to assess the potential for the patient to cause harm to others, especially considering their behavior of breaking windows, which could escalate to physical harm towards individuals. Option A) Risk for injury is not the priority in this scenario because the focus is on the risk the patient poses to others rather than self-injury. Option B) Ineffective coping may be relevant, but it is secondary to the immediate concern of potential violence towards others. Option C) Impaired social interaction is not the priority at this moment because the main concern is the safety and well-being of those around the patient. Educationally, understanding the prioritization of nursing diagnoses in psychiatric emergencies is vital for providing effective and timely care. Recognizing and addressing the risk for violence is crucial in ensuring the safety of all individuals involved and preventing potential harm. By prioritizing this nursing diagnosis, nurses can implement appropriate interventions to manage and mitigate the risk of other-directed violence.

Correct Answer: B

Rationale: In psychiatric emergencies, administering medication safely and effectively is crucial in managing acute symptoms. Option B, accompanied by 3 staff, is the correct choice because it prioritizes safety for both the patient and staff. The presence of multiple staff members ensures that the medication administration process is conducted securely and reduces the risk of potential harm. Option A is incorrect as it lacks the necessary support and supervision for a potentially agitated or uncooperative patient. Option C is inappropriate as using physical restraint like a basket-hold should only be considered as a last resort in extreme cases due to the risk of escalation and harm. Option D is also incorrect as involving a guard may further escalate the situation and compromise the therapeutic relationship between the patient and healthcare provider. Educationally, this question highlights the importance of proper medication administration procedures in psychiatric settings. It emphasizes the significance of teamwork, communication, and safety measures when dealing with patients experiencing psychiatric emergencies. By choosing option B, nurses can ensure the well-being of both the patient and themselves while delivering timely and appropriate care.