Personality and Mood Disorders Q 54
The client says to the nurse “Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:
A. Anxiety
B. Suicidal ideation
C. Major depression
D. Hopelessness
Correct Answer: B. Suicidal ideation
Determine whether the person has any thoughts of hurting him or herself. Suicidal ideation is highly linked to completed suicide. Some inexperienced clinicians have difficulty asking this question. They fear the inquiry may be too intrusive or that they may provide the person with an idea of suicide. In reality, patients appreciate the question as evidence of the clinician’s concern. A positive response requires further inquiry.
Option A: The client’s statement is a verbal cue of suicidal ideation, not anxiety. If suicidal ideation is present, the next question must be about any plans for suicidal acts. The general formula is that more specific plans indicate greater danger. Although vague threats, such as a threat to commit suicide sometime in the future, are the reason for concern, responses indicating that the person has purchased a gun, has ammunition, has made out a will, and plans to use the gun are more dangerous.
Option C: While suicide is common among clients with major depression, this occurs when their depression starts to lift. Determine what the patient believes his or her suicide would achieve. This suggests how seriously the person has been considering suicide and the reason for death. For example, some believe that their suicide would provide a way for family or friends to realize their emotional distress. Others see their death as a relief from their own psychic pain. Still others believe that their death would provide a heavenly reunion with a departed loved one. In any scenario, the clinician has another gauge of the seriousness of the planning.
Option D: Hopelessness indicates no alternatives available and may lead to suicide, the statement and nonverbal cue of the client indicate suicide. Haunted and dominated by hopelessness and helplessness. They are without hope and therefore cannot foresee things ever improving; they also view themselves as helpless in 2 ways: (1) they cannot help themselves, and all their efforts to liberate themselves from the sea of depression in which they are drowning are to no avail; and (2) no one else can help them.