DEPRESSION AND SUICIDE

CNA Training Advisor
DEPRESSION AN D SUICIDE
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CNA Training Advisor
DEPRESSION AN D SUICIDE
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CNA Training Advisor
DEPRESSION AN D SUICIDE
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MAY 2013 Volume 11 Issue No. 5
CNA Professor
DEPRESSION AND SUICIDE
Mark the correct response.
Name:
1.
2.
Date:
Depression just means that a person is sad.
6.
What can ignoring depression in older adults lead to?
a. True
a. worsened symptoms of other illnesses
b. False
b. a few days of sadness, but not much more than
that
c. bedsores, dehydration, contractures, or further
disability
What factor could lead someone to suffer from
depression?
d. both a and c
a. Chemical imbalance
b. Genetics
7.
c. Loss of a family member
d. All of the above
If you think someone is suicidal, you should leave him or
her alone with their thoughts and get help if they ask for
it.
a. True
3.
What is not a symptom of depression?
b. False
a. Excitement over new activities
b. Problems sleeping
8.
c. Changes in appetite
Suicide is defined as ___________.
a. a nonfatal self-directed potentially injurious behavior
with any intent to die as a result of the behavior
d. Negative talk
b. thinking about, considering, or planning for suicide
4.
c. death caused by self-directed injurious behavior
with any intent to die as a result of the behavior
Symptoms of depression usually develop slowly over a
period of days or weeks.
d. none of the above
a. True
b. False
9.
5.
It is estimated that about ______ of Americans age 65
and over suffer from serious and persistent symptoms of
depression.
Some suicide risk factors vary with age, gender, or
ethnic group and may occur in combination or change
over time.
a. True
b. False
a. 10%
b. 2%
10.
c. 25%
d. 99%
What is a risk factor for suicide?
a. The stigma attached to mental health and
substance abuse disorders or suicidal thoughts
b. Isolation, a feeling of being cut off from other people
c. History of mental disorders
d. All of the above
A supplement to CNA Training Advisor