Suicide Risk Assessment: Exam 1 - Questions with Correct
Answers
100 questions
1. The Papageno effect describes:
A. An increase in suicides after media reports
B. A type of suicide note
C. A protective effect when media stories focus on people coping with crises and finding help
D. A genetic risk factor
Correct Answer: C. A protective effect when media stories focus on people coping with crises
and finding help
Rationale: Stories of hope and recovery may reduce suicidal behavior, contrasting with the Werther
effect, in which sensational reporting increases imitation. Responsible reporting includes resources such
as the 988 Lifeline. It is not a genetic factor or a note type.
2. Which statement about suicide attempts by sex is accurate?
A. Males have more attempts and more deaths
B. Females have more attempts and more deaths
C. Females report more suicide attempts, while males have more suicide deaths
D. There are no sex differences
Correct Answer: C. Females report more suicide attempts, while males have more suicide
deaths
Rationale: This gender paradox is explained partly by differences in methods used, help-seeking and
lethality of means. Nonfatal attempts are still serious and predict future risk. Assessment must not dismiss
risk in women because their attempts are less often fatal.
3. A suicide death that is misclassified as accidental or undetermined is important to recognize
because:
A. It makes rates appear higher than reality
B. It has no effect on statistics
C. Only homicides are misclassified
D. Suicide rates are likely underestimated in official data
Correct Answer: D. Suicide rates are likely underestimated in official data
Rationale: Some overdoses and single-vehicle crashes may be suicides, so official counts likely
undercount the true burden. Accurate death investigation improves prevention planning. Misclassification
lowers, not raises, reported numbers.
,4. Suicidal ideation is best defined as:
A. A completed suicide
B. Self-injury without intent to die
C. A plan to harm another person
D. Thoughts of engaging in behavior intended to end one's life
Correct Answer: D. Thoughts of engaging in behavior intended to end one's life
Rationale: Ideation ranges from passive wishes to be dead to active thoughts with intent and plan, and its
frequency, intensity and duration help gauge risk. A suicide death is the outcome, not the thought.
Self-injury without intent to die is nonsuicidal self-injury, and thoughts of harming others are homicidal
ideation.
5. Research on prediction shows that suicide risk assessment:
A. Can predict every suicide accurately
B. Is unnecessary
C. Cannot predict precisely who will die by suicide, so its purpose is to identify risk and guide safety
interventions
D. Only works with blood tests
Correct Answer: C. Cannot predict precisely who will die by suicide, so its purpose is to
identify risk and guide safety interventions
Rationale: Suicide is a low base rate event, so even good tools produce many false positives; risk
assessment is used to understand the person, address modifiable risks and plan care. Treating all
elevated risk with appropriate intervention is more useful than trying to predict exact outcomes. No blood
test predicts suicide.
6. Passive suicidal ideation differs from active suicidal ideation in that passive ideation involves:
A. A specific plan and intent to act
B. Preparing the means for an attempt
C. A wish to be dead or not wake up without thoughts of acting to cause death
D. Rehearsing an attempt
Correct Answer: C. A wish to be dead or not wake up without thoughts of acting to cause
death
Rationale: Statements such as wishing not to wake up reflect passive ideation, which still warrants
follow-up questions because it can progress to active thinking. Active ideation includes thoughts of killing
oneself, and planning, preparation or rehearsal indicate higher risk. Passive ideation should never be
dismissed.
,7. The belief that a person who is suicidal will always be suicidal is a myth because:
A. Suicidal crises are often time-limited, and most people who survive an attempt do not later die by
suicide
B. Suicide risk never changes
C. Once a person attempts, they always attempt again within a week
D. Treatment never helps
Correct Answer: A. Suicidal crises are often time-limited, and most people who survive an
attempt do not later die by suicide
Rationale: Acute risk often rises and falls, and with support and treatment many people recover; follow-up
studies show that most attempt survivors do not go on to die by suicide. Prior attempts still raise long-term
risk, so ongoing care matters. Treatment is effective.
8. The statement that only people with mental illness die by suicide is a myth because:
A. Many people who die by suicide have stressors and no diagnosed mental health condition
B. No one with mental illness dies by suicide
C. Mental illness protects against suicide
D. Suicide is never linked to mental health
Correct Answer: A. Many people who die by suicide have stressors and no diagnosed mental
health condition
Rationale: CDC data show that many decedents had no known mental health condition at the time of
death, though undiagnosed conditions are common, while relationship, financial, legal and health
problems often contributed. Mental illness is an important risk factor but not the only one.
9. Command auditory hallucinations telling a patient to harm themselves:
A. Require careful assessment of the patient's response and urgent safety measures
B. Are harmless because voices are not real
C. Should be ignored if the patient denies plans
D. Only occur in dementia
Correct Answer: A. Require careful assessment of the patient's response and urgent safety
measures
Rationale: Command hallucinations, especially with distress, belief in the voice's power or previous
compliance, increase risk of self-harm. Patients should be asked how they respond to the voices. These
symptoms occur in psychotic and mood disorders, not mainly in dementia.
, 10. Emotional dysregulation contributes to suicide risk by:
A. Making emotions easier to tolerate
B. Preventing self-harm
C. Only affecting physical health
D. Making intense emotions feel unmanageable, leading to impulsive self-harm to escape them
Correct Answer: D. Making intense emotions feel unmanageable, leading to impulsive
self-harm to escape them
Rationale: Difficulty tolerating and modulating emotions is a core feature of borderline personality
disorder and is linked to self-harm and suicidal behavior; DBT targets these skills. It increases, rather than
prevents, self-harm risk.
11. Cognitive rigidity increases suicide risk because it:
A. Limits the ability to generate alternative solutions to problems
B. Increases flexibility
C. Improves coping
D. Prevents hopelessness
Correct Answer: A. Limits the ability to generate alternative solutions to problems
Rationale: People in suicidal crises often show tunnel vision and difficulty seeing options, which
problem-solving and cognitive therapies target. Rigidity worsens rather than improves coping.
Recognizing it helps clinicians guide collaborative safety planning.
12. Feeling trapped, with no way out of an unbearable situation, is called:
A. Resilience
B. Protective factor
C. Psychosis
D. Entrapment, a key component of the integrated motivational-volitional model
Correct Answer: D. Entrapment, a key component of the integrated motivational-volitional
model
Rationale: Defeat and entrapment drive the development of suicidal ideation in the IMV model. Helping
the person see alternatives through problem solving and safety planning can reduce entrapment. It is not
a protective factor.
Answers
100 questions
1. The Papageno effect describes:
A. An increase in suicides after media reports
B. A type of suicide note
C. A protective effect when media stories focus on people coping with crises and finding help
D. A genetic risk factor
Correct Answer: C. A protective effect when media stories focus on people coping with crises
and finding help
Rationale: Stories of hope and recovery may reduce suicidal behavior, contrasting with the Werther
effect, in which sensational reporting increases imitation. Responsible reporting includes resources such
as the 988 Lifeline. It is not a genetic factor or a note type.
2. Which statement about suicide attempts by sex is accurate?
A. Males have more attempts and more deaths
B. Females have more attempts and more deaths
C. Females report more suicide attempts, while males have more suicide deaths
D. There are no sex differences
Correct Answer: C. Females report more suicide attempts, while males have more suicide
deaths
Rationale: This gender paradox is explained partly by differences in methods used, help-seeking and
lethality of means. Nonfatal attempts are still serious and predict future risk. Assessment must not dismiss
risk in women because their attempts are less often fatal.
3. A suicide death that is misclassified as accidental or undetermined is important to recognize
because:
A. It makes rates appear higher than reality
B. It has no effect on statistics
C. Only homicides are misclassified
D. Suicide rates are likely underestimated in official data
Correct Answer: D. Suicide rates are likely underestimated in official data
Rationale: Some overdoses and single-vehicle crashes may be suicides, so official counts likely
undercount the true burden. Accurate death investigation improves prevention planning. Misclassification
lowers, not raises, reported numbers.
,4. Suicidal ideation is best defined as:
A. A completed suicide
B. Self-injury without intent to die
C. A plan to harm another person
D. Thoughts of engaging in behavior intended to end one's life
Correct Answer: D. Thoughts of engaging in behavior intended to end one's life
Rationale: Ideation ranges from passive wishes to be dead to active thoughts with intent and plan, and its
frequency, intensity and duration help gauge risk. A suicide death is the outcome, not the thought.
Self-injury without intent to die is nonsuicidal self-injury, and thoughts of harming others are homicidal
ideation.
5. Research on prediction shows that suicide risk assessment:
A. Can predict every suicide accurately
B. Is unnecessary
C. Cannot predict precisely who will die by suicide, so its purpose is to identify risk and guide safety
interventions
D. Only works with blood tests
Correct Answer: C. Cannot predict precisely who will die by suicide, so its purpose is to
identify risk and guide safety interventions
Rationale: Suicide is a low base rate event, so even good tools produce many false positives; risk
assessment is used to understand the person, address modifiable risks and plan care. Treating all
elevated risk with appropriate intervention is more useful than trying to predict exact outcomes. No blood
test predicts suicide.
6. Passive suicidal ideation differs from active suicidal ideation in that passive ideation involves:
A. A specific plan and intent to act
B. Preparing the means for an attempt
C. A wish to be dead or not wake up without thoughts of acting to cause death
D. Rehearsing an attempt
Correct Answer: C. A wish to be dead or not wake up without thoughts of acting to cause
death
Rationale: Statements such as wishing not to wake up reflect passive ideation, which still warrants
follow-up questions because it can progress to active thinking. Active ideation includes thoughts of killing
oneself, and planning, preparation or rehearsal indicate higher risk. Passive ideation should never be
dismissed.
,7. The belief that a person who is suicidal will always be suicidal is a myth because:
A. Suicidal crises are often time-limited, and most people who survive an attempt do not later die by
suicide
B. Suicide risk never changes
C. Once a person attempts, they always attempt again within a week
D. Treatment never helps
Correct Answer: A. Suicidal crises are often time-limited, and most people who survive an
attempt do not later die by suicide
Rationale: Acute risk often rises and falls, and with support and treatment many people recover; follow-up
studies show that most attempt survivors do not go on to die by suicide. Prior attempts still raise long-term
risk, so ongoing care matters. Treatment is effective.
8. The statement that only people with mental illness die by suicide is a myth because:
A. Many people who die by suicide have stressors and no diagnosed mental health condition
B. No one with mental illness dies by suicide
C. Mental illness protects against suicide
D. Suicide is never linked to mental health
Correct Answer: A. Many people who die by suicide have stressors and no diagnosed mental
health condition
Rationale: CDC data show that many decedents had no known mental health condition at the time of
death, though undiagnosed conditions are common, while relationship, financial, legal and health
problems often contributed. Mental illness is an important risk factor but not the only one.
9. Command auditory hallucinations telling a patient to harm themselves:
A. Require careful assessment of the patient's response and urgent safety measures
B. Are harmless because voices are not real
C. Should be ignored if the patient denies plans
D. Only occur in dementia
Correct Answer: A. Require careful assessment of the patient's response and urgent safety
measures
Rationale: Command hallucinations, especially with distress, belief in the voice's power or previous
compliance, increase risk of self-harm. Patients should be asked how they respond to the voices. These
symptoms occur in psychotic and mood disorders, not mainly in dementia.
, 10. Emotional dysregulation contributes to suicide risk by:
A. Making emotions easier to tolerate
B. Preventing self-harm
C. Only affecting physical health
D. Making intense emotions feel unmanageable, leading to impulsive self-harm to escape them
Correct Answer: D. Making intense emotions feel unmanageable, leading to impulsive
self-harm to escape them
Rationale: Difficulty tolerating and modulating emotions is a core feature of borderline personality
disorder and is linked to self-harm and suicidal behavior; DBT targets these skills. It increases, rather than
prevents, self-harm risk.
11. Cognitive rigidity increases suicide risk because it:
A. Limits the ability to generate alternative solutions to problems
B. Increases flexibility
C. Improves coping
D. Prevents hopelessness
Correct Answer: A. Limits the ability to generate alternative solutions to problems
Rationale: People in suicidal crises often show tunnel vision and difficulty seeing options, which
problem-solving and cognitive therapies target. Rigidity worsens rather than improves coping.
Recognizing it helps clinicians guide collaborative safety planning.
12. Feeling trapped, with no way out of an unbearable situation, is called:
A. Resilience
B. Protective factor
C. Psychosis
D. Entrapment, a key component of the integrated motivational-volitional model
Correct Answer: D. Entrapment, a key component of the integrated motivational-volitional
model
Rationale: Defeat and entrapment drive the development of suicidal ideation in the IMV model. Helping
the person see alternatives through problem solving and safety planning can reduce entrapment. It is not
a protective factor.
