一位精神科病房病人表達自殺意念，護理師應執行哪些措施？（選所有適合的）
A client on the psychiatric unit expresses suicidal ideation. Which of the following actions should the nurse perform? (Select all that apply.)
- APerform a thorough search of the client's belongings for contraband✓ 正解徹底搜查病人的物品以查找違禁品
- BAssign the client to a room near the nursing station for observation✓ 正解將病人安置在靠近護理站的房間以便觀察
- CInitiate one-on-one observation until a new safety plan is established✓ 正解在新安全計畫建立前實施一對一觀察
- DEncourage the client to keep their feelings private to maintain dignity鼓勵病人將感受保密以維持尊嚴
- EEnsure the client has no access to sharps or belts✓ 正解確保病人無法取得尖銳物品或皮帶
當病人表達自殺意念（Suicidal ideation）時，精神科護理的首要任務是確保病人安全（Safety）並進行風險評估。核心概念是採取積極的預防措施，盡可能降低病人傷害自己的可能性。 正確答案 A, B, C, E 都是安全措施。A（徹底搜查物品）是為了移除任何可能被用來自殺的工具或危險物品（contraband），如藥物、尖銳物品等。B（安排靠近護理站的房間）能讓護理人員更容易觀察病人的行為與情緒變化。C（啟動一對一觀察）是最高級別的安全監測，當病人自殺風險極高時，指定一名護理師全程陪伴病人，嚴密監控其一舉一動，直到風險降低或有新的安全計畫。E（移除危險物品）是環境安全管理的一部分，確保病人無法取得刀片、繩索、皮帶等可能造成傷害的物品。 選項 D 錯誤，鼓勵病人將自殺意念私下隱藏，這與精神科照護的開放溝通原則背道而馳。護理師應鼓勵病人表達其感受與想法，建立信任關係，並共同制定安全計畫。壓抑情緒反而可能加劇病人的絕望感，提高自殺風險。
When the patient expresses suicidal ideation, the first task of psychiatric nursing is to ensure patient safety and to perform a risk assessment. The core concept is to take active preventive measures to minimize the possibility of self-harm. Correct answers A, B, C, and E are all safety interventions. A (thorough search of belongings) is intended to remove any contraband that could be used for self-harm, such as medications and sharp objects. B (assigning a room near the nurses' station) makes it easier for staff to observe behavioral and emotional changes. C (initiating one-to-one observation) is the highest level of safety monitoring; when suicide risk is very high, a nurse is assigned to stay with the patient at all times to monitor every action until risk decreases or a new safety plan is in place. E (removing dangerous items) is part of environmental safety management to ensure the patient cannot access blades, ropes, belts, or other items capable of causing harm. Option D is incorrect because encouraging the patient to hide suicidal thoughts contradicts the principle of open communication in psychiatric care. The nurse should encourage the patient to express feelings and thoughts, build a trusting relationship, and develop a safety plan together. Suppressing emotions may worsen hopelessness and increase suicide risk.