A nurse is performing a psychosocial assessment on an adolescent client.
Which of the following should indicate to the nurse a potential risk for suicide? (Select all that apply)
Recent or impending move
Sudden decline in school performance
Death of a parent at a young age
Low parental expectations.
Correct Answer : A,B,C
The correct answer/s is Choices A, B, and C.
Choice A Rationale:
Recent or impending moves can be a significant stressor for adolescents, disrupting their social networks, routines, and sense of belonging. This disruption can exacerbate existing mental health problems or trigger new ones, increasing the risk of suicidal ideation or behavior. Studies have shown that adolescents who relocate are more likely to experience depression, anxiety, and substance abuse, all of which are risk factors for suicide. Additionally, the feeling of loss and displacement associated with moving can lead to feelings of isolation and hopelessness, further increasing the risk.
Choice B Rationale:
A sudden decline in school performance can be a sign of underlying emotional distress in adolescents. This decline may be due to depression, anxiety, or other mental health problems that can impede concentration, motivation, and overall academic functioning. Suicidal ideation or behavior can also lead to a decline in school performance as the adolescent withdraws from their usual activities and struggles to cope with their emotions. Therefore, a sudden drop in grades or academic engagement should raise a red flag for the nurse and warrant further investigation into the adolescent's emotional well-being.
Choice C Rationale:
The death of a parent at a young age is a major life event that can have a profound impact on an adolescent's emotional and psychological development. This loss can lead to feelings of grief, sadness, anger, and isolation, all of which are risk factors for suicide. Additionally, adolescents who lose a parent may be more likely to experience depression, anxiety, and substance abuse, further increasing their vulnerability to suicidal thoughts and behaviors. The nurse should be particularly concerned if the death of the parent was recent or if the adolescent has not adequately processed their grief.
Choice D Rationale:
While low parental expectations can be a negative influence on an adolescent's self-esteem and motivation, it is not directly linked to an increased risk of suicide. In fact, some studies have suggested that high parental expectations can be equally detrimental to adolescent mental health. Therefore, while low parental expectations may not be a standalone risk factor for suicide, it is important to consider this factor in the context of the adolescent's overall psychosocial assessment.
Summary:
A recent or impending move, a sudden decline in school performance, and the death of a parent at a young age are all significant stressors that can increase the risk of suicidal ideation or behavior in adolescents. The nurse should be alert to these warning signs and conduct a thorough psychosocial assessment to identify any underlying mental health issues or risk factors. Early intervention and support can significantly reduce the risk of suicide and help adolescents cope with these challenging life events.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer(s) is/are:
C. Telling his parents that he doesn't want to talk about the suicide attempt.
Rationale:
Choice A: Planning to give his Xbox console to his best friend.
While giving away possessions can be a sign of hopelessness or detachment, in this case, it could also be interpreted as a gesture of closure or wanting to leave something meaningful behind for a loved one. It doesn't necessarily indicate ongoing suicidal intent.
Choice B: Stating that he wants to be with his peers more than with his parents.
This desire for social connection and autonomy is actually a positive sign in a post-suicidal attempt adolescent. It demonstrates a shift towards seeking support from outside the family unit and engaging with life beyond the immediate aftermath of the attempt.
Choice C: Telling his parents that he doesn't want to talk about the suicide attempt. This reluctance to discuss the attempt can be a red flag for several reasons:
Avoidance: Suppressing or avoiding thoughts and feelings related to the attempt can indicate a struggle to cope with the emotional trauma and potentially harboring lingering suicidal ideation.
Isolation: Withdrawing from open communication about the event can isolate the adolescent further, hindering the support system and potentially increasing the risk of reattempt.
Underlying distress: The inability to talk about the event may suggest unresolved emotional distress, unresolved conflicts, or ongoing stressors that could contribute to suicidal thoughts.
Therefore, while not wanting to talk doesn't definitively signify current suicidal intent, it warrants further exploration by the nurse to understand the underlying reasons behind the avoidance and ensure appropriate support and safety measures are in place.
Choice D: Preferring to eat his meals while watching TV.
This behavior is relatively neutral and doesn't directly suggest ongoing suicidal intent. While it might indicate depression or low motivation, it's not a specific indicator of suicide risk.
Conclusion:
Based on the rationale above, "telling his parents that he doesn't want to talk about the suicide attempt" (Choice C) is the most concerning behavior that suggests the adolescent might still have suicidal intent. It's crucial for the nurse to address this reluctance with empathy and understanding, exploring the underlying reasons and ensuring continued monitoring and support for the adolescent.
Correct Answer is D
Explanation
Choice A rationale: Fear of rejection from staff is not typically a driving factor for the repetitive behaviors seen in OCD. While social anxiety can be a component of many mental health disorders, the compulsions in OCD are usually driven by intrusive thoughts or fears that are specific to the individual, rather than fears about social rejection.
Choice B rationale: Narcissistic Personality Disorder (NPD) is a separate condition from OCD. While individuals with NPD may exhibit certain repetitive behaviors, these are typically driven by a need for admiration and a lack of empathy for others, rather than the intrusive thoughts and fears that drive the compulsions in OCD12.
Choice C rationale: While certain medications can have side effects that might cause unusual behaviors, the repetitive behaviors (compulsions) seen in OCD are not typically a side effect of antidepressant medications. In fact, certain types of antidepressants are often used in the treatment of OCD12.
Choice D rationale: The repetitive behaviors observed in individuals with OCD, such as repeatedly applying, removing, and reapplying makeup, are indeed attempts to reduce anxiety. These individuals experience intrusive thoughts, fears, or images (obsessions) that cause significant anxiety. The repetitive behaviors (compulsions) are performed in an attempt to alleviate the distress caused by these obsessions. Despite the temporary relief, the individual often ends up trapped in a cycle of obsessions and compulsions.
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