1.

After assessing Sue using the mhGap intervention guide, the following are your findings: There
are no underlying MNS condition, chronic pain, but verbalizes conflict with parents? Based on your
findings, what management interventions could be used to manage the case of Sue? Identify at
least five interventions. *
5 points

Your answer

 Assess barriers/stressors that impact family functioning (e.g., meeting client care needs)
 Assess family dynamics to determine plan of care (e.g., structure, bonding, communication, boundaries,
coping mechanisms)
 Assess parental techniques related to discipline
 Encourage the client's participation in group/family therapy
 Evaluate resources available to assist family functioning

2. Since one of the management for self- harm is to provide psychoeducation, cite five possible
questions that may help elicit the client’s protective/ coping mechanisms to manage her present
situation. *
5 points

 What things in your life make you want to go on living?

 What things would lead you to feel more (or less) hopeful about the future?
 Have you tried sharing your thoughts with other people or seeking help with regards to the emotional
distress that you are feeling?
 Have you tried asking yourself what is making you feel the way you do and eventually come up with a
few strategies to change or resolve the situation?
 Has your view of things changed, or is anything different for you since the attempt?

3. While caring for Sue, you notice her parents sitting in the waiting area. Both appear so worried;
her mother is crying. You endorse Sue to another nurse and you approach her parents. When the
mother saw you she cried and said, “I love my daughter so much, I would not like her to hurt herself
or kill herself. What should we do?” You are aware that in situations like this, carers would also
need support and guidance. What health teachings can you tell the parents who are caring for their
daughter with a high risk of self-harm? *
  Inform carers and family members that asking about suicide will often help the person feel relieved,
less anxious, and better understood.
 Carers and family members of people at risk of self-harm often experience severe stress. Provide
emotional support to them if they need it.
 Inform carers that even though they may feel frustrated with the person, they should avoid hostility
and severe criticism towards the vulnerable person at risk of self-harm/suicide.
 Mobilize family, friends, concerned individuals and other available resources to ensure close
monitoring of the person as long as the risk of self-harm/suicide persists.
 Advise the person and carers to restrict access to means of self-harm/suicide (e.g. pesticides/toxic
substances, prescription medications, firearms, etc.) when the person has thoughts or plans of self-
harm/suicide.

Scenario
The client came for her weekly follow-up visit and upon initial observation Sue is now stable and calm. Base on the manual,
assessing thoughts of self- harm and suicide must be done on a regular basis.

4. One week after the discharge, Sue came for follow-up, accompanied by her mother and father.
She appears calm. What will be your interventions?
3 points

 Assess for improvement

 Routinely assess for thoughts and plans of self-harm/suicide

5. During the nurse patient interaction, Sue verbalizes. “I still feel that my family does not
understand. They would be better without me.” What will be your appropriate response? Give
rationale for your answer. (2 points for the response and 3 points for the correct rationale) *
5 points

Response: ”That seems to be very upsetting. What have led you to think of this way?”
Rationale: Validation of how the patient feels about her family will lead to understanding the patient’s situation.
And asking the patient what could have been the reason why she feels that way may extract the reality of her
condition. This way the patient will be able to share her thoughts, allowing the nurse to gain more information
about the patient’s state.

6. What specific questions will you ask Sue to assess the client’s thoughts of self-harm. List at least
5. *
5 points

Your answer
  When did you first notice such thoughts?
 How close have you come to acting on those thoughts?
 Have you made a specific plan to harm or kill yourself? (If so, what does the plan include?)
 What things in your life would lead you to want to escape from life or be dead?
 How does the future look to you?

7. Sue’s mother asks, “How often is Sue supposed to have a follow up check-up?” Based on the
mhGAP, what will be your appropriate reply? *
3 points

”We maintain regular contact more frequently initially (e.g. daily, weekly) for the first 2 months.”