Suicide Practice Questions PDF

BH_E1_Suicide Answers 1. Which of the following terms best describes a situation where an individual expresses thoughts of self-harm to manipulate others, without intending to die? A. Suicide Threat B. Suicidal Ideation C. Nonsuicidal Self-Injurious Thoughts D. Suicide Attempt Answer...

BH_E1_Suicide Answers 1. Which of the following terms best describes a situation where an individual expresses thoughts of self-harm to manipulate others, without intending to die? A. Suicide Threat B. Suicidal Ideation C. Nonsuicidal Self-Injurious Thoughts D. Suicide Attempt Answer: Suicide Threat (A) A suicide threat involves verbalizing thoughts of self-harm intended to make others believe one wants to die, even without the actual intent. 2. A patient is brought to the emergency department after inflicting superficial cuts on their arm. They state they did this to relieve overwhelming anxiety and had no intention of ending their life. How should this behavior be classified? A. Suicide Attempt B. Suicide Gesture C. Nonsuicidal Self-Injury D. Suicidal Ideation with Self-Harm Answer: Nonsuicidal Self-Injury (C) Nonsuicidal self-injury involves the destruction of body tissue without the intent to die, often used as a coping mechanism for anxiety or self-punishment. 3. What percentage of individuals who commit suicide were seen by a healthcare provider within the month preceding their death? A. Approximately 95% B. Approximately 33% C. Approximately 50% D. Approximately 66% Answer: Approximately 66% (D) About two-thirds (64%) of individuals who commit suicide had seen a healthcare provider in the month before their death, highlighting the importance of recognizing warning signs in medical settings. 4. Which factor poses the HIGHEST risk for suicide attempts? A. Being lesbian, gay, or bisexual B. Being transgender C. History of adverse childhood experiences D. Being male Answer: Being transgender (B) Transgender individuals are statistically more likely to attempt suicide compared to other listed demographics. However, all options represent populations at increased risk. 5. A patient with a history of depression was recently discharged from a psychiatric hospital. Statistically, during which period is this patient at the HIGHEST risk for suicide? A. The first month post-discharge B. Four years post-discharge C. The first week post-discharge D. The first year post-discharge Answer: The first week post-discharge (C) The risk of suicide is highest in the first week after discharge from a psychiatric hospital, emphasizing the need for strong aftercare and support systems. 6. A patient’s family reports that the individual, who has been struggling with depression, has suddenly become very calm, has given away several prized possessions, and has started organizing their personal affairs. According to the information, which of the following is the MOST appropriate next step? A. Reassure the family that these actions indicate the patient is recovering and no longer at risk. B. Recommend the family increase the patient’s social media activity to combat withdrawal. C. Immediately assess the patient for intent, plan, and access to means of suicide. D. Advise the family to monitor the patient closely for any changes in diet or routine. Answer: Immediately assess the patient for intent, plan, and access to means of suicide. (C) Sudden calmness, giving away possessions, and putting affairs in order are potential warning signs of imminent suicidal behavior, necessitating an immediate and thorough assessment. 7. A 21-year-old patient presents with new-onset depressive symptoms following a recent break-up. While taking the patient's history, you notice that most of the following IS PATH WARM criteria apply. Which intervention is MOST appropriate? A. Prescribe a low-dose SSRI and schedule a follow-up appointment in 1 month. B. Inquire directly about suicidal ideation, intent, plan and access to means. C. Advise the patient to increase their social media usage to combat feelings of isolation. D. Recommend the patient focus on positive affirmations to shift their mood. Answer: Inquire directly about suicidal ideation, intent, plan and access to means. (B) Given the patient's presentation and risk factors, directly assessing for suicidal ideation, intent, plan, and access to means is the most appropriate initial step to ensure the patient's safety. 8. A patient expresses suicidal ideation but denies any intent to act on these thoughts and states they made the statement to manipulate their spouse. Which term best describes this behavior? A. Suicide gesture B. Suicide threat C. Suicidal ideation D. Suicide attempt Answer: Suicide threat (B) A suicide threat involves verbalized thoughts of self-injury intended to make others believe the individual wants to die, even if there is no actual intent. 9. Which of the following is the MOST appropriate first step when implementing the Suicide Intervention Plan (SCATT)? A. Ensure the patient is not left alone to prevent immediate harm B. Transport the patient to the nearest hospital for inpatient care C. Consult with a supervisor to discuss the case and determine the next steps D. Immediately terminate the patient's access to any potential means of self- harm Answer: Ensure the patient is not left alone to prevent immediate harm (A) The initial step in the SCATT is ensuring the patient's immediate safety by staying with them. 10. Which of the following statements is the MOST accurate regarding 'no suicide' contracts? A. They lack strong evidence of effectiveness. B. They are legally binding documents that protect providers from liability. C. They are a universally supported intervention. D. They have strong empirical evidence demonstrating a significant reduction in suicide rates. Answer: They lack strong evidence of effectiveness. (A) Despite their common use, 'no suicide' contracts have limited evidence supporting their effectiveness in reducing suicide rates. 11. A patient is brought to the emergency department by law enforcement due to expressing intent to harm themselves. According to the Baker Act, what is the maximum time frame in which a medical professional must conduct an initial medical examination? A. 72 hours B. 12 hours C. 5 days D. 24 hours Answer: 12 hours (B) According to the Baker Act, a medical examination must be conducted within 12 hours of admission for a medically stable patient. 12. A provider is treating a patient who recently lost a family member to suicide. Which of the following is the MOST appropriate recommendation to support the patient through their grief? A. Recommend limiting emotional expression to maintain composure and avoid overwhelming feelings. B. Advise the patient to make immediate major life decisions to regain a sense of control. C. Encourage the patient to avoid discussing the circumstances of the death to prevent further distress. D. Suggest the patient participate in death rituals and delay major decisions if possible. Answer: Suggest the patient participate in death rituals and delay major decisions if possible. (D) For suicide loss survivors, participating in death rituals and delaying major decisions can aid in the grieving process. 13. Which of the following is LEAST likely to be included as part of a comprehensive suicide safety plan? A. Listing specific warning signs, such as particular thoughts or images. B. A list of distracting activities, such as listening to music or exercising. C. Strategies for ensuring access to lethal means during a crisis. D. Identifying personal reasons for living. Answer: Strategies for ensuring access to lethal means during a crisis. (C) A suicide safety plan focuses on removing access to lethal means, not ensuring access to them. 14. Following up with suicidal patients post-discharge is critical. What is the recommended frequency of letters to be sent to these patients in the first year post-discharge, based on the 2017 study? A. 2 letters B. 12 letters C. 4 letters D. 8 letters Answer: 8 letters (D) Sending 8 letters in the first year post-discharge is associated with a significant reduction in suicide rates; this also continues with follow-up letters in subsequent years. 15. A pregnant patient with a history of depression presents with new-onset psychotic symptoms. How does this impact her risk of suicide? A. It poses no significant change in suicide risk compared to her baseline. B. It decreases the risk of suicide due to the protective factors associated with pregnancy. C. It increases the risk of suicide due to the added complexity of postpartum psychosis (PPP). D. It increases the risk of suicide, though this is solely due to the depression. Answer: It increases the risk of suicide due to the added complexity of postpartum psychosis (PPP). (C) PPD and psychosis each increase the risk of suicide alone, however when combined the risk of suicide is compounded. 16. A clinician is deeply affected by the suicide of a patient. To proactively mitigate the risk of secondary trauma and burnout, which of the following strategies is MOST appropriate? A. Focus on self-care practices and seek support through counseling or peer groups. B. Discontinue treating patients with suicidal ideation to prevent future emotional distress. C. Avoid discussing the event with colleagues or supervisors to maintain professional distance. D. Immediately take on a higher patient load to distract from personal feelings. Answer: Focus on self-care practices and seek support through counseling or peer groups. (A) Self-care, grief processing, and psychological support such as via a counselor are essential for providers affected by a patient's suicide. 17. A 16-year-old female is brought to the emergency department by her parents after they found cutting marks on her arm. She reports feeling overwhelmed with school and social pressures but denies any intent to end her life. Which of the following best describes her current state? A. Suicide attempt B. Socially sanctioned self-harm C. Suicidal ideation with intent D. Non-suicidal self-injurious behavior Answer: Non-suicidal self-injurious behavior (D) Non-suicidal self-injurious behavior involves self-harm without the primary intent to die. The patient's denial of suicidal intent is a key differentiating factor. 18. According to recent statistics, approximately what percentage of individuals who attempt suicide have seen a healthcare provider within the month prior to their attempt? A. 53% B. 64% C. 95% D. 38% Answer: 64% (B) Data indicates that a significant number of individuals who attempt suicide have had contact with a healthcare provider in the recent past, highlighting the importance of recognizing warning signs in clinical settings. 19. Which of the following psychiatric diagnoses carries the highest risk of death by suicide? A. Schizophrenia B. Major depressive disorder C. Eating disorders D. Borderline personality disorder Answer: Eating disorders (C) Eating disorders are associated with a particularly elevated risk of death by suicide compared to other psychiatric conditions. The complex interplay of psychological, biological, and social factors contributes to this increased risk. 20. A 55-year-old male with a history of chronic back pain and recent diagnosis of terminal cancer expresses feelings of hopelessness and despair. He has started giving away personal belongings. Which intervention is most appropriate? A. Recommending a support group for cancer patients B. Initiating an immediate psychiatric evaluation for suicidal ideation and safety assessment C. Prescribing an antidepressant medication D. Encouraging increased physical activity to improve mood Answer: Initiating an immediate psychiatric evaluation for suicidal ideation and safety assessment (B) The patient's expression of hopelessness, terminal illness and giving away belongings are high-risk factors for suicide. An immediate psychiatric evaluation is necessary to assess the risk and ensure the patient's safety. 21. A 30-year-old female with a history of bipolar disorder presents to the clinic with concerns about increased anxiety and insomnia. She reports feeling overwhelmed by her responsibilities and expresses passive suicidal ideation without a specific plan. Which of the following is the most appropriate initial step in managing her care? A. Prescribing a benzodiazepine for immediate anxiety relief B. Hospitalizing the patient for close observation C. Conducting a thorough suicide risk assessment and developing a safety plan D. Recommending a self-help book on stress management Answer: Conducting a thorough suicide risk assessment and developing a safety plan (C) A comprehensive suicide risk assessment is crucial for determining the severity of the patient's suicidal ideation, identifying triggers, and developing a personalized safety plan to mitigate immediate risk. 22. What is the most accurate conclusion based on the statistics regarding suicide and firearms? A. Firearms are rarely used in completed suicides. B. Firearms are more often used for self-defense than for suicide attempts. C. The presence of a firearm in the home increases the risk of suicide. D. Restricting access to firearms has no impact on suicide rates. Answer: The presence of a firearm in the home increases the risk of suicide. (C) The presence of a firearm in the home significantly elevates the risk of suicide. This underscores the importance of safe storage practices. 23. A researcher is studying the economic impact of suicide in the United States. Which of the following is the closest estimate of the annual cost of suicide? A. $11 million B. $94 billion C. $43,000 D. $94 million Answer: $94 billion (B) Suicide has a substantial economic impact, costing billions of dollars annually due to lost productivity, healthcare expenses, and other related costs. 24. A physician is evaluating a patient who reports experiencing non-suicidal self-injurious thoughts. Which of the following best differentiates these thoughts from suicidal ideation? A. The presence of a specific plan to end one's life B. The presence of an underlying psychiatric disorder C. The absence of any intent to die D. The involvement of socially sanctioned activities Answer: The absence of any intent to die (C) Non-suicidal self-injurious thoughts involve contemplating self-harm without the goal of causing death. This distinction is key. 25. A 24-year-old patient with a history of borderline personality disorder is admitted to the psychiatric unit after a suicide attempt involving an overdose of medication. After medical clearance, the patient expresses remorse and promises it will never happen again. Which of the following interventions is MOST critical to implement before discharge? A. Providing reassurance that the patient is now 'safe' and can manage at home B. Developing a comprehensive safety plan that includes trigger identification, coping strategies, and access to support systems C. Scheduling a follow-up appointment with a general practitioner D. Discontinuing all psychotropic medications to prevent future overdoses Answer: Developing a comprehensive safety plan that includes trigger identification, coping strategies, and access to support systems (B) While the patient expresses remorse, patients with Borderline Personality Disorder and a recent suicide attempt require a thorough discharge plan that addresses their specific triggers and symptoms. 26. A school counselor is informed that a 3rd grade (8-year-old) student has expressed suicidal ideation to a classmate. According to statistics, how should the counselor interpret this information? A. While concerning, suicide is only a leading cause of death starting in adolescence. B. Suicide is among the top 10 leading causes of death for this age group. C. It is likely a misunderstanding, as suicide is not a concern for children under 10. D. The child is likely repeating something they heard, and it should not be taken seriously. Answer: Suicide is among the top 10 leading causes of death for this age group. (B) Suicide is a major concern for children and is among the top 10 leading causes of death for this age group. Any mention of suicidal ideation in a child should be taken seriously and assessed by a mental health professional. 27. A 34-year-old male presents to the clinic expressing feelings of hopelessness after a recent job loss. Which of the following is the MOST appropriate initial step in evaluating his suicide risk? A. Initiating a direct and thorough inquiry about suicidal ideation, including frequency, intensity, and plans. B. Immediately contacting the patient's emergency contact to inform them of the situation. C. Prescribing a low-dose antidepressant to alleviate his mood symptoms while monitoring for side effects. D. Administering a comprehensive mental status exam to assess cognitive function. Answer: Initiating a direct and thorough inquiry about suicidal ideation, including frequency, intensity, and plans. (A) The initial step in evaluating suicide risk involves directly asking about suicidal ideation, plans, and intent to gauge the immediate risk level. 28. During a mental health assessment, a patient admits to having fleeting thoughts of suicide but denies any specific plan or intent. They state, 'Sometimes I just wish I wasn't here anymore.' Which of the following actions is MOST appropriate? A. Recommend over-the-counter sleep aids to improve their mood and reduce negative thoughts. B. Initiate involuntary hospitalization due to the presence of suicidal ideation. C. Complete the Ask Suicide Questions (ASQ) Screening Tool and further explore the ambivalence of their feelings. D. Reassure the patient that these feelings are normal and schedule a follow-up appointment in one month. Answer: Complete the Ask Suicide Questions (ASQ) Screening Tool and further explore the ambivalence of their feelings. (C) Even in the absence of a concrete plan, it is crucial to further assess suicidal thoughts using tools like the ASQ and explore the patient's reasons for living versus their reasons for dying to gauge the full scope of the risk. 29. A 16-year-old patient, accompanied by their parents, presents with increased irritability and withdrawal from social activities over the past few weeks. The parents deny any knowledge of suicidal thoughts or behaviors. What is the MOST important next step? A. Recommend family therapy to improve communication between the patient and their parents. B. Accept the parents' assessment and focus on addressing the patient's irritability with behavioral therapy. C. Prescribe a trial of selective serotonin reuptake inhibitors (SSRIs) to improve the patient's mood and reduce irritability. D. Interview the patient alone to directly inquire about suicidal ideation, plans, and any self-harm behaviors. Answer: Interview the patient alone to directly inquire about suicidal ideation, plans, and any self-harm behaviors. (D) When assessing youth, it is essential to interview them alone to directly assess for suicidal thoughts, plans, or behaviors, as they may be hesitant to disclose such information in front of their parents. 30. A patient being assessed for suicide risk reveals a detailed plan, including the time, location, and means, but states they are unsure if they will go through with it. They have a history of impulsivity and alcohol abuse. Which factor would MOST significantly increase the immediate risk? A. The detailed nature of the suicide plan, including specific logistics. B. The patient's voluntary presentation to the clinic for help. C. The patient's history of alcohol abuse and impulsivity. D. The patient's expression of ambivalence about carrying out the plan. Answer: The patient's history of alcohol abuse and impulsivity. (C) While all factors contribute to the overall risk assessment, a history of impulsivity combined with active substance use significantly elevates the immediate risk of acting on suicidal thoughts, even in the presence of ambivalence. 31. A patient is brought to the emergency department under the Baker Act after expressing intent to harm themselves and demonstrating disorganized thought processes. The patient refuses evaluation or treatment. According to the Baker Act, what is the maximum initial period the patient can be held for evaluation, assuming medical stabilization? A. 96 hours B. 72 hours C. 48 hours D. 24 hours Answer: 72 hours (B) Under the Baker Act (and similar involuntary commitment laws), a person can typically be held for up to 72 hours for evaluation, provided they are medically stable and meet the criteria for potential harm to self or others due to mental illness. 32. Which demographic group is statistically more likely to.....complete..... a suicide attempt? A. Men B. Transgender individuals C. Women D. LGBTQIA+ youth Answer: Men (A) Men are more likely to die by suicide than women, though they attempt suicide less often. This is often attributed to the methods used. 33. A patient being discharged from inpatient psychiatric care is at highest risk of suicide during which period? A. The first week B. 1 month C. They are no more at risk than average population D. 2-4 years Answer: The first week (A) The risk of suicide is highest in the first week after discharge from psychiatric hospitalization, approximately 300 times higher than the general population. 34. Which of the following factors represents a static (unchangeable) risk factor for suicide? A. Active substance abuse B. Relationship difficulties C. Previous suicide attempt D. Current suicidal ideation Answer: Previous suicide attempt (C) A previous suicide attempt is the most significant static risk factor. Dynamic risk factors are changeable, but the fact that a person has attempted suicide in the past cannot be changed. 35. According to the 'IS PATH WARM' mnemonic, what does the 'T' stand for? A. Trapped B. Tenseness C. Tiredness D. Terror Answer: Trapped (A) In the IS PATH WARM mnemonic, ‘T’ stands for Trapped, representing the feeling of being stuck or unable to escape a situation. 36. What is a primary concern related to the 'livestream suicide phenomenon'? A. Reduced access to support services for suicidal individuals B. Decreased feelings of isolation among at-risk individuals C. Increased awareness and prevention efforts by social media platforms D. Validation and encouragement of suicide, along with suicide contagion Answer: Validation and encouragement of suicide, along with suicide contagion (D) Livestreaming suicide can lead to validation and encouragement, attention/fame and suicide contagion - where the event normalizes or encourages similar acts in vulnerable individuals. 37. A patient with a known history of depression presents with increased energy, a detailed plan for suicide, and has given away prized possessions. Which stage is a primary care provider assessing? A. Passive thought B. Ideation C. Intent D. Execution plan/rehearsal Answer: Execution plan/rehearsal (D) Although a patient can commit suicide at any stage, a detailed plan suggests movement toward execution/rehearsal, especially with the behavioral changes. 38. In the 'I'm a PA' warning signs mnemonic, what aspect would need to be assessed when looking at 'Access'? A. Method that the patient may use, such as firearms or poisoning. B. The patient believes suicide is a viable way out C. The patient is actively seeking help D. The patient has a history of prior attempts Answer: Method that the patient may use, such as firearms or poisoning. (A) Access to means refers to the availability of methods the patient could use to complete a suicide. Identifying this allows for better, more specific interventions to reduce that risk. 39. What is the most accurate understanding regarding inquiry about suicide? A. Inquiry about suicide should only occur if the patient brings up the topic first B. Asking about suicide is only appropriate for mental health professionals C. Inquiry about suicide may increase the risk of suicidal thoughts D. Asking about suicide will not increase suicidal thoughts Answer: Asking about suicide will not increase suicidal thoughts (D) Direct inquiry about suicide does not increase the risk of suicidal thoughts and is a crucial part of assessing patient safety. 40. A 16-year-old transgender male presents to the clinic and reports social isolation, bullying and pervasive thoughts of hopelessness. He denies active suicidal ideation. Which of the following interventions is MOST appropriate? A. Connect him with community resources, LGBTQ support groups, and mental health services with experience in transgender care. B. Schedule weekly follow-up appointments to monitor for changes in mental status. C. Prescribe a low-dose SSRI to address potential underlying depression. D. Initiate an immediate inpatient psychiatric referral due to his transgender status. Answer: Connect him with community resources, LGBTQ support groups, and mental health services with experience in transgender care. (A) While all options have merit, connection with community and mental health resources is the MOST appropriate initial intervention. It directly addresses factors impacting a patient at higher risk of SI. 41. A 45-year-old male with a history of heavy alcohol use presents to the emergency department after a recent job loss. He expresses feelings of worthlessness and hopelessness, stating, "My family would be better off without me." He denies suicidal intent or plan. Which of the following is the MOST appropriate next step in managing this patient's suicide risk? A. Prescribe an antidepressant and schedule a follow-up appointment for psychiatric evaluation in 2-3 weeks. B. Contact the patient's family to alert them of his current state and rely on them to provide support and supervision at home. C. Initiate a safety plan with the patient, detailing coping strategies and emergency contacts, and arrange for a comprehensive mental health evaluation. D. Reassure the patient that things will get better and discharge him with a referral to a job counseling service. Answer: Initiate a safety plan with the patient, detailing coping strategies and emergency contacts, and arrange for a comprehensive mental health evaluation. (C) Creating a safety plan collaboratively engages patients, provides immediate coping strategies, and ensures access to professional evaluation. Addressing the patient's emotions in detail and safety is more important than providing false reassurances.