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RN Nursing · Suicide · Practice question

A nurse is caring for aclient. The nurse is caring for the client. Which of the following actions should the nurse take? Select all that apply.

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: Monitor the client for expression of covert statements. · Assess the client's use of therapeutic coping strategies. · Express empathy when communicating with the client.

This client has been admitted following a suicide attempt and continues to exhibit grief, loneliness, and social withdrawal. Three nursing actions are appropriate. Monitoring the client for covert statements is essential because clients at risk for self-harm do not always express suicidal ideation directly; statements such as wishing to be alone or feeling that others cannot understand their pain can be indirect cues that require vigilance. Assessing the client's use of therapeutic coping strategies helps the nurse evaluate whether the client is applying healthy coping mechanisms, identify gaps in the client's coping toolkit, and guide further interventions or referrals. Expressing empathy is a foundational therapeutic communication technique that establishes trust, validates the client's emotional experience, and encourages the client to engage with treatment; it is always appropriate for a client experiencing profound grief and suicidal ideation. Discouraging the client from talking about their spouse is incorrect and therapeutically harmful — processing grief requires the client to be able to speak about their loss in a safe environment. Telling the client not to attend further group sessions contradicts recovery-oriented care; group therapy, even when the client does not actively participate at first, provides therapeutic milieu benefits and peer connection, and excluding the client would reinforce isolation. Therefore, the correct actions are monitoring for covert statements, assessing coping strategies, and expressing empathy.

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