Suicide Risk Assessment - 2026 Safety Planning

1. What is the primary goal of a suicide risk assessment? A. To identify the level of risk and guide intervention B. To diagnose a psychiatric disorder C. To prescribe medication D. To discharge the patient quickly Correct Answer: A. To identify the level of risk and guide intervention Rationale: The primary purpose is to evaluate current risk and determine appropriate safety interventions. 2. Which validated tool is commonly used for suicide screening in EDs? A. Glasgow Coma Scale B. Columbia-Suicide Severity Rating Scale (C-SSRS) C. Braden Scale D. Norton Scale Correct Answer: B. Columbia-Suicide Severity Rating Scale (C-SSRS) Rationale: The C-SSRS is an evidence-based tool widely used for identifying suicide risk. 3. What is the first step in safety planning intervention? A. Calling emergency services B. Recognizing personal warning signs C. Restricting access to lethal means D. Scheduling a follow-up appointment Correct Answer: B. Recognizing personal warning signs Rationale: The Stanley-Brown model begins with identifying individual warning signs. 4. Which of the following is a modifiable risk factor for suicide? A. Family history of suicide B. Age C. Access to firearms D. Gender Correct Answer: C. Access to firearms Rationale: Restricting access to lethal means especially firearms is a key modifiable risk factor. 5. What does means restriction refer to in suicide prevention? A. Limiting financial resources B. Reducing access to methods used for self-harm C. Restricting patient movement D. Limiting social media access Correct Answer: B. Reducing access to methods used for self-harm Rationale: Means restriction involves reducing access to lethal methods. 6. Which demographic has the highest completed suicide rate in the U.S.? A. Adolescent females B. Middle-aged and older White males C. Young Black females D. Elderly Asian females Correct Answer: B. Middle-aged and older White males Rationale: Middle-aged and older White males consistently have the highest rates. 7. A patient has a specific plan to end their life tonight. What risk level? A. Low risk B. Moderate risk C. High risk D. No risk Correct Answer: C. High risk Rationale: A specific plan with intent and timeline indicates high imminent risk. 8. Which protective factor is most associated with reduced suicide risk? A. Social isolation B. Strong social connectedness C. Substance use D. Chronic pain Correct Answer: B. Strong social connectedness Rationale: Social connectedness is a well-established protective factor. 9. What is the recommended ratio for one-to-one suicide precautions? A. 1:4 B. 1:1 C. 1:6 D. 1:8 Correct Answer: B. 1:1 Rationale: One-to-one means one staff member assigned exclusively to one patient. 10. Which neurotransmitter deficiency is most linked to suicidal behavior? A. Dopamine B. Serotonin C. Acetylcholine D. GABA Correct Answer: B. Serotonin Rationale: Low serotonin levels are consistently associated with suicidal behavior. 11. What is the purpose of a no-suicide contract? A. It is legally binding B. It guarantees safety C. It is a therapeutic tool but NOT a substitute for assessment D. It replaces observation Correct Answer: C. It is a therapeutic tool but NOT a substitute for assessment Rationale: No-suicide contracts are not evidence-based as standalone interventions. 12. Which mental health condition carries the highest lifetime suicide risk? A. Generalized anxiety disorder B. Bipolar disorder C. OCD D. Specific phobia Correct Answer: B. Bipolar disorder Rationale: Bipolar disorder carries one of the highest lifetime suicide risks. 13. A patient gave away all personal possessions. This suggests: A. Generosity B. Financial planning C. Possible preparation for suicide D. Hoarding recovery Correct Answer: C. Possible preparation for suicide Rationale: Giving away prized possessions is a recognized warning sign. 14. Which component is in the Stanley-Brown Safety Plan? A. Medication reconciliation B. Internal coping strategies C. Insurance verification D. Dietary plan Correct Answer: B. Internal coping strategies Rationale: Step 2 includes internal coping strategies. 15. What is the 988 Suicide and Crisis Lifeline? A. A billing code B. A national crisis hotline providing 24/7 support C. An insurance number D. A diagnosis code Correct Answer: B. A national crisis hotline providing 24/7 support Rationale: 988 provides free confidential 24/7 crisis support. 16. Which question is most appropriate for assessing suicidal ideation? A. You are not thinking of hurting yourself, are you? B. Are you having thoughts of ending your life? C. You seem fine, right? D. Do you want to talk about something else? Correct Answer: B. Are you having thoughts of ending your life? Rationale: Direct nonjudgmental questioning is the gold standard. 17. Which is a warning sign of imminent suicide risk? A. Improved appetite B. Sudden calmness after depression C. Increased socialization D. Interest in hobbies Correct Answer: B. Sudden calmness after depression Rationale: Sudden calm after severe depression may indicate a decision to die. 18. What is the sitter role during suicide precautions? A. Complete charting B. Maintain continuous visual observation C. Administer medications D. Conduct group therapy Correct Answer: B. Maintain continuous visual observation Rationale: The sitter provides uninterrupted visual observation. 19. How often should environmental safety rounds occur on a psychiatric unit? A. Once per shift B. Every 1-2 hours or per policy C. Once daily D. Only at admission Correct Answer: B. Every 1-2 hours or per policy Rationale: Regular rounds identify and remove potential hazards. 20. Which item should be removed from a patient room on suicide precautions? A. Pillow B. Plastic bag or cord C. Hospital gown D. Meal tray Correct Answer: B. Plastic bag or cord Rationale: Items that could be used as ligatures must be removed. 21. Patient on precautions requests bathroom alone. The nurse should: A. Allow privacy B. Maintain observation per policy C. Send another patient D. Lock the bathroom Correct Answer: B. Maintain observation per policy Rationale: Observation protocols must be maintained. 22. What is the most lethal method of suicide attempt? A. Overdose B. Cutting C. Firearm D. Drowning Correct Answer: C. Firearm Rationale: Firearms have the highest case fatality rate exceeding 85 percent. 23. Which factor most increases suicide risk after hospital discharge? A. Returning to work B. The first 7-30 days post-discharge C. Having insurance D. Attending follow-up Correct Answer: B. The first 7-30 days post-discharge Rationale: The post-discharge period is the highest-risk window. 24. Which scale specifically assesses hopelessness? A. Beck Hopelessness Scale B. Hamilton Anxiety Scale C. MMSE D. Braden Scale Correct Answer: A. Beck Hopelessness Scale Rationale: The Beck Hopelessness Scale measures negative future expectations.