護理師正在評估病人的自殺風險。下列哪些發現應被視為高風險的警訊？（選所有適合的）
The nurse is assessing a client for potential suicidal risk. Which of the following findings should the nurse identify as high-risk warning signs? (Select all that apply.)
- AThe client gives away their favorite collection of rare books✓ 正解客戶將他們收藏的稀有書籍送人
- BThe client suddenly appears calm and happy after a period of deep depression✓ 正解客戶在長期深度抑鬱後突然顯得平靜和快樂
- CThe client expresses concern about who will care for their pet客戶擔心誰來照顧他們的寵物
- DThe client asks about the lethality of various over-the-counter medications✓ 正解客戶詢問各種非處方藥物的致死性
- EThe client refuses to attend group therapy sessions客戶拒絕參加團體治療課程
自殺預防的評估需要識別行為與情緒的顯著變化。選項 A（贈送財物）是典型的「交代後事」行為。選項 B（情緒突然好轉）極度危險，因為這通常意味著病人已經下定決心自殺，且感到解脫，或者終於有了足夠的能量（Energy boost）去執行計畫。選項 D（詢問致死方法）顯示病人正在物色手段，屬於具體的自殺計畫評估。選項 C（擔心寵物）通常被視為一種「保護因素」（Protective factor），顯示病人仍有責任感與牽掛。選項 E（拒絕團體治療）可能是憂鬱症狀的惡化，但不如其他選項那樣直接指向自殺高風險。
Suicide risk assessment requires identifying significant changes in behavior and mood. Option A (giving away possessions) is a classic 'putting affairs in order' behavior. Option B (sudden improvement in mood) is extremely dangerous because it often means the client has decided to end their life and feels relief, or has finally gained enough energy (energy boost) to execute the plan. Option D (asking about lethal methods) indicates the client is researching means and reflects concrete suicidal planning. Option C (concern about the pet) is generally regarded as a protective factor, suggesting that the client still has a sense of responsibility and attachment. Option E (refusal to attend group therapy) may reflect worsening depression but does not point as directly to high suicide risk as the other options.
美國的自殺評估常使用標準化量表（如 Columbia-Suicide Severity Rating Scale），護理師必須詳細記錄病人的每一種行為變化。台灣臨床環境中，護理師常依賴與病人的日常互動觀察，且對於「交代後事」的警覺性在教育中被高度強調，但對於情緒突然轉好（B）的警覺有時會被誤認為治療奏效。