AIIMS Delhi NO- 2019
Mental Health Nursing
Hard
A patient has tried to commit suicide with drug overdose. Which of the situation depicts that the patient has high risk of suicide?
Appeared in: AIIMS Delhi NO- 2019
Explanation
- Acute alcohol intake is a significant risk factor for both attempted and completed suicide, even in individuals without a history of alcoholism.
- Alcohol acts as a disinhibitor, which means it impairs judgment, lowers self-control, and increases impulsivity, making a person more likely to act on suicidal thoughts.
- Research indicates that alcohol use prior to an attempt can increase the lethality of the act, as it may lead to the choice of more violent methods or a diminished capacity to reconsider.
- Substance intoxication, including alcohol, is considered a key dynamic risk factor in psychiatric assessments for suicide.
Why Other Options Were Wrong
- Option A: Writing a suicide note is a sign of premeditation and suicidal intent, but it is not considered as high a risk factor for immediate completion as acute intoxication. Many individuals who write notes do not complete suicide.
- Option B: Informing a relative is an ambiguous action. It could be a cry for help and an opportunity for intervention, or it could be a final goodbye. It is not a reliable indicator of high risk.
- Option C: While impulsivity is a personality trait linked to increased suicide risk, an impulsive attempt may be less planned and therefore less lethal. In contrast, alcohol use actively impairs judgment and increases impulsivity in the moment, which is a more acute and higher-risk situation.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Suicide Risk Assessment to guide bedside assessment, documentation, and the next nursing action.
- Nurses performing a suicide risk assessment must always screen for recent alcohol or drug use, as this is a critical factor in determining the immediate level of risk and the necessary safety precautions.
- A patient who has attempted suicide while under the influence of alcohol requires immediate medical stabilization for the overdose and intoxication, followed by intensive psychiatric monitoring due to the high risk of another attempt.
- What if? If the patient had a history of multiple, highly lethal prior suicide attempts but no alcohol intake this time, the history of prior attempts would be considered the strongest predictor of high risk. A history of a previous suicide attempt is the single most important risk factor for future attempts.
How to Approach the Question
- First, identify the core of the question, which is to find the factor that indicates the highest risk of suicide among the given options.
- Evaluate each option based on established psychiatric nursing principles for suicide risk assessment.
- Recall that risk factors can be static (e.g., history) or dynamic (e.g., current state). Dynamic factors that acutely impair judgment are particularly dangerous.
- Compare the relative danger of each option. While all may be relevant to a suicidal patient, consider which one most directly increases the likelihood of a fatal outcome.
- Recognize that substance use, especially alcohol, is a potent disinhibitor that impairs judgment and increases impulsivity, making it a high-risk factor for completing suicide.
Concept Tested & Keywords
- Concept Tested: Suicide Risk Assessment
- Stem keywords: commit suicide, drug overdose, high risk
- Lead-in keywords: Which of the situation depicts
- Negative lead-in flag: false
Question ID
QsWn0x7gTYstpSHY21UpEh
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 5498-5500, 12432-12434
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 307-309
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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