which risk factor for suicide is considered the most lethal

NCLEX-RN

Psychosocial Integrity NCLEX PN Questions

1. Which risk factor for suicide is considered the most lethal?

A. History of alcohol and drug abuse
B. Previous high-lethality suicide attempts
C. Recent withdrawal from friends
D. Disturbance of family dynamics

Correct answer: B

Rationale: The correct answer is 'Previous high-lethality suicide attempts.' This is the most lethal risk factor as it indicates that the individual has previously attempted suicide in a manner that could lead to death. This history increases the likelihood of future attempts. While substance abuse, like alcohol and drug use, is a significant risk factor for suicide, it is not considered the most lethal. Withdrawal from friends or social isolation can contribute to suicide risk but is not as directly deadly as high-lethality attempts. Disturbance of family dynamics can also be a stressor but does not represent the immediate lethality associated with a history of high-lethality suicide attempts.

2. Which basic principle of Alcoholics Anonymous (AA) should a client with alcohol use disorder follow?

A. Spouses should attend Al-Anon meetings.
B. It is a commitment to focus on long-term goals.
C. Amends must be made to each person who has been harmed.
D. People have the power to overcome alcoholism if they truly want to stop drinking.

Correct answer: C

Rationale: The correct answer is that amends must be made to each person who has been harmed. This principle is reflected in the eighth step of the 12 steps of AA, which involves making a list of all persons harmed and being willing to make amends to them. It is a fundamental principle of AA to address past harms and seek to rectify them. Choice A is incorrect because spouses attending Al-Anon meetings is not a basic principle of AA; it is a support group for family members of individuals with alcohol use disorder. Choice B is incorrect because while focusing on long-term goals can be beneficial, AA emphasizes taking one day at a time rather than committing to long-term goals. Choice D is incorrect because AA teaches that individuals struggling with alcoholism are powerless over their addiction and need to rely on a higher power rather than solely their willpower to overcome it.

3. Under what patient conditions or situations are restraints sometimes used?

A. As punishment when the patient is uncontrollable
B. To prevent the patient from pulling their IV out
C. When a patient is a danger to self and others
D. Both B and C

Correct answer: D

Rationale: Restraints are sometimes used to prevent a patient from pulling out their IV or another life-saving tube and when the person poses a serious danger to themselves and/or others. Restraints are never used as a form of punishment. Choice A is incorrect because restraints are not utilized for punishment but for patient safety and care. Choice B and C are correct because they reflect the appropriate and necessary situations where restraints may be used in healthcare settings.

4. The client admitted for uncontrolled diabetes is worried about how to pay bills for the family while hospitalized. Which statement by the nurse is therapeutic?

A. "You are worried about paying your bills?"
B. "Don't worry; your bills will get paid eventually."
C. "When was the last time you were admitted for hyperglycemia?"
D. "You really shouldn't be drinking alcohol because of your diagnosis of diabetes."

Correct answer: A

Rationale: The therapeutic communication technique used in this scenario is reflection. By repeating the client's concern, the nurse acknowledges the client's feelings and encourages further exploration of the topic. Choice A is correct as it reflects the client's worry without offering false assurance, advice, or using professional jargon. Choice B dismisses the client's concerns with false reassurance. Choice C introduces professional jargon, which may hinder effective communication. Choice D provides advice, which can limit the client's expression of feelings and concerns.

5. When bathing an uncircumcised boy older than 3 years, which action should the nurse take?

A. Remind the child to clean his genital area.
B. Defer perineal care because of the child's age.
C. Retract the foreskin gently to cleanse the penis
D. Ask the parents why the child is not circumcised

Correct answer: C

Rationale: When bathing an uncircumcised boy older than 3 years, it is essential to gently retract the foreskin to cleanse the penis. This helps in preventing the buildup of bacteria and maintaining good hygiene. Reminding the child to clean his genital area (Option A) may not be effective due to the child's cognitive development level. Perineal care should not be deferred (Option B) as it is necessary for maintaining hygiene at any age. Asking the parents why the child is not circumcised (Option D) is not relevant to the immediate care required during bathing.