A nurse is caring for a client with a known history of bipolar disorder who was brought to the emergency department after threatening to harm himself. During the intake assessment, the client states, 'I've been awake for three days, I gave away all my belongings last week, and I just don't see any reason to keep going.' Which of the following findings most directly indicates that this client is at high risk for suicide?
- Sleep deprivation lasting three days
- Presenting to the emergency department voluntarily
- Giving away personal belongings combined with expressing hopelessness
- History of bipolar disorder