A nurse is collecting data from an adolescent during an annual physical examination. Which of the following statements by the client indicates that they are at risk for suicide?

A) "Our child has a better grasp of reality":
While methylphenidate can improve focus and reduce impulsivity in children with ADHD, a "better grasp of reality" is not a typical or direct effect of the medication. The goal of medication like methylphenidate is to manage symptoms of ADHD, such as inattention, hyperactivity, and impulsivity, rather than altering the child's sense of reality. Therefore, this statement does not reflect an expected outcome of the medication.

B) "Our child has lost some weight since his last appointment":
Weight loss can be a side effect of methylphenidate, as it may reduce appetite. However, this is not an indication that the medication is effective in managing ADHD symptoms. A decrease in weight does not correlate with the desired effects of improved concentration or behavior control. In fact, parents should be educated on monitoring the child’s nutritional intake and discussing any concerns about weight loss with the healthcare provider.


C) "Our child has increased his daily caloric intake":
While it is beneficial for children taking methylphenidate to maintain adequate nutrition, an increase in caloric intake is not directly related to the medication’s effectiveness in treating ADHD. The goal is to improve symptoms of inattention, hyperactivity, and impulsivity, not to focus on changes in food consumption.

D) "Our child is able to complete his homework on time":
This statement is a clear indicator that methylphenidate is working effectively. One of the main goals of treating ADHD is to improve the child's ability to focus and complete tasks, such as homework, within a reasonable time frame. The child being able to complete homework on time reflects the positive effect of the medication in improving concentration, attention, and task completion.

A) Slurred speech:
Slurred speech is not a common adverse effect of gentamicin. It could indicate neurological issues, but it is not typically associated with gentamicin use. If this occurs, the nurse should investigate other possible causes, such as a stroke or another neurological condition, rather than attributing it to the gentamicin.

B) Constipation:
Constipation is not a typical adverse effect of gentamicin. While antibiotics can sometimes cause gastrointestinal disturbances, gentamicin is more commonly associated with nephrotoxicity and ototoxicity, rather than constipation. If constipation occurs, it is more likely related to other factors such as diet or fluid intake.

C) Hypotension:
While hypotension can be a side effect of many medications, it is not a specific or common adverse effect of gentamicin. Gentamicin is more likely to cause nephrotoxicity and ototoxicity rather than significant blood pressure changes. However, hypotension could occur in the context of an infection or severe illness and should be monitored, but it is not directly associated with gentamicin.

D) New onset of hearing loss:
This is a well-known adverse effect of gentamicin. Gentamicin belongs to the class of antibiotics known as aminoglycosides, which can cause ototoxicity. New onset of hearing loss or tinnitus (ringing in the ears) is a significant warning sign of ototoxicity, which can occur due to gentamicin use. This side effect should be monitored closely, and if hearing loss occurs, the medication should be reevaluated, and alternatives should be considered.