32. Which behaviors observed by the nurse
Answer D
might lead to the suspicion that a depressed
female adolescent client may be suicidal?
a. The client becomes angry while speaking
on the telephone and slams the receiver
down on the hook
b. The client runs out of the therapy group
swearing at the group leader and runs to
her room
c. The clients gets angry with her roommate
when the room mate borrows the client’s
clothes without asking
d. The client gives away a prized CD and a
cherished autograph picture of the
performer
33. The police arrive at the emergency room with
a client who has seriously lacerated both
wrists. The initial nursing action is to:
a. Examine and treat the wound site
b. Secure and record a detailed history
c. Encourage and assist the client to
ventilate feelings
d. Administer an antianxiety agent
34. A nurse receives a telephone call from a
male client who states that he wants to kill
himself and has a bottle of sleeping pills in
front of him. The best nursing action is to:
a. Insist that the client give you his name
and address so that you can get the
police there immediately
b. Keep the client talking and allow the client
to ventilate feelings
c. Use therapeutic communications,
especially the reflection of feeling
d. Keep the client talking, signal to another
staff member to trace the call so that
appropriate help can be sent
35. The activity that would be the least
therapeutic for severely depressed clients
would be:
a. Specific, simple instructions to be allowed
b. Simple, easily completed, short term
projects
c. Monotonous, repetitive projects and
activities
d. Allowing the clients to plan their own
activities
St. Louis Review Center, Inc-Davao Tel. no. (082) 224-2515 or 222-8732
32.
A depressed suicidal client often “gives”
away that which is of value as a way of
saying “goodbye” and wanting to be
remembered. Options A, B and C identify
acting out behaviors.
33. Answer A
The initial nursing action is to examine
and treat the self inflicted injuries. Injuries
from the lacerated wrist can lead to a life
threatening situation. Other interventions
may follow after the client has been
treated medically.
34. Answer D
In a crisis, the nurse must take an
authoitative,active role to promote the
client’s safety. A bottle of sleeping pills in
front of the client who verbalizes he wants
to kill himself is a crisis. The client safety
is of prime concern. Keeping the client on
the phone and getting help to the client is
the best intervention. The word “insist”
may anger the client anf he may hang up.
Option B lacks the authoritative action
stance of securing the client’s safety.
Usingtherapeutic communication is
important, but overuse of “reflection” may
sound uncaring or superficial and is
lacking direction/solutions to the
immediate problem of the clients safety.
35. Answer D
Severely depressed clients are not
motivated to take action or to plan ahead.
They are unable to direct their energy on
the environment.
A. This would be helpful to a severely
depressed client, whose attention
span is limited.
B. This would be helpful to a severely
depressed client because it requires
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