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RN Nursing · Suicide · Practice question

A nurse is caring for a client. Click to highlight the findings that require follow-up by the nurse. To deselect a finding, click on the finding again.

Nurses notes

One month ago

The client was seen in a primary health care provider's office for reports of anxiety and fear of driving, and a referral was provided for a mental health care provider specializing in anxiety disorders.

Five days ago, at 09:30

The client was admitted to the behavioral health unit following a suicide attempt. The client reports losing their spouse 2 years ago in a motor vehicle accident and states they have been unable to move past the grief and loss. The client states, "I think about them all the time. I can't do anything on my own, and I'm so lonely." The client reports that prior to the suicide attempt, grief was affecting their job due to frequent crying and inability to concentrate. The client also states, "My coworkers think I am rude because I don't want to hang out after work. My kids push me to get out of the house more, and I am trying. I've been on a few dates." The client reports plan to go on vacation with their children and families this summer. The client states they do not drive except when absolutely necessary because they become very anxious. The client reports a good appetite and denies any changes in weight. The client appears well-groomed, alert, and oriented, with appropriate speech.

Answer & explanation

Correct:

When reviewing this client's clinical picture, the nurse must identify findings that require follow-up — meaning areas that represent active risk, unresolved psychiatric concerns, or care gaps that need further intervention. The admission five days ago following a suicide attempt is the most critical finding and clearly demands ongoing monitoring and follow-up regarding safety, coping, and treatment progress. The anxiety and fear of driving noted one month ago, for which a referral was provided, also requires follow-up because there is no documentation that the client actually connected with a mental health specialist before the suicide attempt; this unaddressed anxiety disorder is a contributing risk factor that remains unresolved. The narrative note from five days ago also contains several concerning elements: persistent loneliness, inability to function independently, grief impacting occupational performance, and social withdrawal — all of which reflect ongoing mental health risks requiring follow-up. The blank non-text segment should not be highlighted as it contains no clinical information. Protective factors such as going on dates, planning a vacation, good appetite, stable weight, and appropriate grooming are positive signs but do not themselves require follow-up. The key sections that contain concerns warranting nursing follow-up are the one-month-ago note about anxiety and driving, and the full five-days-ago note describing the suicide attempt context and multiple psychosocial stressors.

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