Question on a test for employment

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I feel really stupid asking this question but I am recently employed by a home health agency and they are wanting the answer to this question on a quiz they are giving me. I think any of the answers could be correct in certain situations. It is a vague question in my opinion. What do you all think?

Mr. Coop has been depressed and threatened to commit suicide, he now states he feels much better The nurse should:

a. Encourage him to evaluate the reason for the improvement.

b. Observe the patient closely as he may have settled on method for suicide.

c. Begin plans for follow-up care after he is discharged.

d. Both b and c

Thanks in advance for any input.

Sue

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Specializes in CTICU.

If he's in hospital, D. If he's already at home, B.

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The answer is B. This is a standard "suicide" question that focuses on the fact that depressed people who are successful at suicide often show a marked improvement just before they complete the act. Their "improvement" coincides with their decision to go through with suicide. You will see variations of this question often.

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Specializes in ortho, hospice volunteer, psych,.

"b" because you don't know what he may be thinking about or what he may be hearing inside his head, or what plan he may have cooked up.

as an afterthought, when i was about to take a standardized exam for a state nursing job, i called home for moral support and my mom sad that if it were anything like the social worker exam she took once,

"run like ...." should have been a choice for most questions. she was right!:D

sharpeimom:paw::paw:

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Specializes in ICU, School Nurse, Med/Surg, Psych.

As a home health nurse who works with chronically mentally ill I pick A- I want him to talk about it with me. I want to have a therapeutic communication and gather more information so that I figure out what actions will help him most.

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Specializes in ortho, hospice volunteer, psych,.

mr. coop has been depressed and threatened to commit suicide, he now states he feels much better

often when a person/patient says he "feels much better now" that's another way of saying he's made a decision to kill himself soon. ditto, if mr. coop beginning to give away even cherished possessions and/or pets.

kathy

sharpei mom:paw::paw:

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Specializes in Psych ICU, addictions.

I'd say all of the above:

a. Find out why he's feeling better because it could be he's resolved his

issues and is getting past the depression...or he has decided when/how he's going to kill himself. Assessing him could help you learn more about what's going on.

b. Exactly what Sharpeimom said--she explained it perfectly. So you need to keep an eye on this patient.

c. One of the danger periods for suicides is about a month after a patient starts antidepressants--the reason being that the patient is starting to feel better and has more energy and motivation...enough of it to carry out a suicide plan. So unless you're going to keep the patient in a facility for several weeks, you need to plan his follow-up care.

If I have to pick one answer though, it'd be D.

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Safety first--I'd go for frequent observation. If he has decided on a plan, and successfully implements it, any discharge planning will be pointless. A caution with anti-depression meds--when they work, the depressed person can get energized enough to carry out a suicide attempt that they were previously too depressed to attempt.

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Specializes in Psychiatric.

Agree totally with the person right above mine!! :D

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