A nurse is evaluating teaching for a client who has newly diagnosed depression and a new prescription for bupropion. Which of the following statements by the client indicates understanding of the teaching?

A. "His favorite teacher committed suicide a few weeks ago." This statement is a red flag. A recent loss, particularly by suicide, can significantly impact an adolescent's emotional well-being. Adolescents who are emotionally attached to individuals who die by suicide are at increased risk for suicidal ideation, especially if the loss triggers emotional distress or serves as a model for the adolescent. This concern should prompt further assessment for suicidal thoughts or behaviors.

B. "He is very religious and attends services twice a week." Being religious and attending services regularly is generally a protective factor against suicide. Religious involvement may provide a sense of community, purpose, and support, which can act as a buffer against suicidal ideation.

C. "He spends much of his time with his two school friends." Having a small but close social group is typical for many adolescents and, by itself, is not a risk factor for suicide. It’s important to consider the quality of these relationships, but this statement alone does not suggest immediate concern.

D. "He has slept 9 hours each night for the past 2 years." Sleeping 9 hours a night is generally within the recommended range for adolescents. This does not indicate a risk for suicide and may even suggest that the adolescent is maintaining a healthy sleep schedule.

A. Pseudoparkinsonism is a side effect of antipsychotic medications, characterized by symptoms such as tremors, rigidity, and bradykinesia. However, it does not typically cause hyperpyrexia (fever), diaphoresis (sweating), or blood pressure changes. It is usually less severe than neuroleptic malignant syndrome (NMS).

B. Tardive dyskinesia is a movement disorder caused by long-term use of antipsychotic medications. It is characterized by involuntary, repetitive movements such as tongue thrusting, lip smacking, and facial grimacing. It does not cause the acute symptoms described, such as hyperpyrexia and changes in blood pressure.

C. Neuroleptic malignant syndrome (NMS) is a potentially life-threatening reaction to antipsychotic medications, characterized by symptoms such as hyperpyrexia (fever), diaphoresis, altered mental status, muscle rigidity, and autonomic dysfunction (e.g., changes in blood pressure). This is a medical emergency, and the client needs immediate intervention.

D. Acute dystonia involves sudden, severe muscle spasms, particularly in the neck, face, or back. While it is an adverse effect of antipsychotic medications, it does not typically cause hyperpyrexia or the severe autonomic dysfunction seen in NMS.