# Stage 6 — Evaluate outcomes. Review the behavioral-safety trend and answer both questions.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568695&lang=en  
> language: en  
> subject: Psychosocial Integrity  
> category: PSI

## Question

Stage 6 — Evaluate outcomes. Review the behavioral-safety trend and answer both questions.

| Time | Data |
| --- | --- |
| Admission | Specific plan for tonight, accessible pills, stated intent, preparatory behavior, previous attempt |
| Day 2 | Denies current intent but remains guarded and reports passive wishes to die; observation continues |
| Day 5 | Names warning signs and two coping steps; contacts chosen support person; participates in treatment |
| Day 7 | Consistently reports risk honestly; means secured by support person; crisis plan rehearsed; follow-up appointments confirmed |

Q1. Which interpretation is best supported by the full trend?

The Day 2 denial alone established discharge readiness
Risk mitigation has improved, but discharge still depends on the current documented assessment and plan
Normal vital signs eliminated suicide risk at admission
Medication use alone accounts for all improvement

Q2. Which new statement requires immediate reassessment and renewed precautions?

I used paced breathing when the urge rose
My sister has secured the extra medications
I know how to reach the crisis line and my therapist
I feel calm because I finally decided exactly how I will die

## Explanation

Improvement is supported by a sustained pattern: reduced intent, direct disclosure, coping-skill use, rehearsed crisis steps, secured means, engaged supports, and scheduled follow-up. A sudden calm statement linked to deciding how to die signals possible resolved intent and requires immediate reassessment.

## In-depth explanation

Quick answer
The multi-day pattern shows better mitigation, not zero risk; sudden calm tied to a decided method requires immediate renewed assessment.

Why this is correct
Readiness is supported by honest reporting, coping ability, support engagement, means safety, crisis planning, and follow-up together. A new plan or intent overrides a previously reassuring trend.

Easy analogy or mental picture
Risk assessment is a moving weather map. Several improving readings help, but a new severe warning immediately changes the route.

Memory hook
Trend the whole plan; a new method resets the alarm.

NCLEX decision rule
Evaluate suicide-risk outcomes longitudinally and treat any new plan, intent, or preparatory cue as an immediate change requiring reassessment and protection.

Why the other choices are wrong
One denial, normal vital signs, or medication exposure cannot prove safety. Coping, secured means, and crisis contacts are protective findings unless new risk information appears.

References
1Joint Commission National Patient Safety Goal 15.01.01Validated screening, direct risk assessment, observation, environmental safety, reassessment, and discharge follow-up
2FDA Escitalopram Capsules Prescribing InformationYoung-adult suicidality monitoring, bipolar screening, serotonin syndrome, and discontinuation precautions

## Clinical scenario

Case update
The interprofessional team performs repeated suicide-risk assessments while the client participates in treatment and safety planning.

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