A school nurse is speaking to the mother of a 16-year-old male adolescent. The mother has concerns about her son. Which of the following statements by the mother should indicate to the nurse that the adolescent is at risk for suicide?
"His cousin committed suicide a few weeks ago.”
"He spends much of his time with his two school friends.”
"He has slept 9 hours each night for the past 2 years.”
"He is very religious and attends services twice a week.”
The Correct Answer is A
Choice A rationale:
"His cousin committed suicide a few weeks ago." This statement is a significant red flag indicating a higher risk of suicide. When an adolescent is exposed to suicide, especially within their family or close social circle, they become more vulnerable due to the potential for social contagion. This scenario increases the urgency for intervention and support to prevent a similar outcome.
Choice B rationale:
"He spends much of his time with his two school friends." While changes in social behavior might raise concerns, this statement alone does not directly indicate a risk of suicide. Adolescents can experience shifts in their social preferences for various reasons, and it's not a definitive sign of suicidal ideation or intent.
Choice C rationale:
"He has slept 9 hours each night for the past 2 years." Sleeping patterns alone do not strongly correlate with suicide risk. However, drastic changes in sleep patterns, such as insomnia or hypersomnia, might be indicative of underlying mental health issues. In this case, the consistent sleep pattern mentioned does not directly signal a risk of suicide.
Choice D rationale:
"He is very religious and attends services twice a week." Religious involvement can have protective effects on mental health, and attending religious services can provide a support network. While religion might offer some resilience against suicide, it is not a definitive indicator. Other factors need to be considered in conjunction with religious activities. For , the statement indicating an adolescent's higher risk of suicide is "His cousin committed suicide a few weeks ago" (Choice A). This experience increases the risk due to the potential for social contagion. The other options, including spending time with school friends, sleep patterns, and religious involvement, do not directly suggest an imminent risk of suicide.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. Erotomanic.
Choice A rationale:
Persecution. Persecutory delusions involve the belief that one is being targeted, harmed, or conspired against by others. This choice is not applicable in this scenario because the client is not expressing fear or belief that they are being persecuted.
Choice B rationale:
Erotomanic. Erotomanic delusions involve the false belief that someone, often of higher social status, is in love with the individual. In this case, the client's statement about being engaged to the Prince of England suggests an erotomanic delusion. The client is holding a grandiose belief that they are romantically involved with someone of prominence.
Choice C rationale:
Somatic. Somatic delusions involve the belief that there is something physically wrong with the individual's body. These delusions often manifest as the belief in having an illness or defect that is not actually present. The client's statement does not revolve around physical health or bodily concerns, making somatic delusion an unlikely option.
Choice D rationale:
Control. Control delusions involve the belief that one's thoughts, feelings, or actions are being controlled by external forces. This choice is not applicable in this scenario, as the client's statement does not indicate any perceived loss of control over their thoughts or actions.
Correct Answer is A
Explanation
Choice A rationale:
Neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition that can occur as a severe adverse effect of antipsychotic medications, such as risperidone (Risperdal). Symptoms of NMS include flu-like symptoms (fever, muscle rigidity, and sweating) along with altered mental status, and autonomic dysregulation. It's crucial for the nurse to recognize this potentially fatal condition promptly and intervene appropriately.
Choice B rationale:
Tardive dyskinesia is a movement disorder that is often a result of long-term use of antipsychotic medications, but it is characterized by repetitive, involuntary movements of the face and other body parts. It doesn't typically present with flu-like symptoms or low blood pressure.
Choice C rationale:
Acute dystonia is characterized by involuntary muscle contractions and spasms, often involving the muscles of the face, neck, and back. It usually occurs shortly after starting antipsychotic treatment. While it can cause discomfort, it doesn't present with flu-like symptoms and low blood pressure as described in the scenario.
Choice D rationale:
Pseudoparkinsonism, also known as drug-induced parkinsonism, is characterized by symptoms similar to Parkinson's disease, such as tremors, bradykinesia (slowness of movement), and rigidity. It doesn't typically cause flu-like symptoms and low blood pressure.
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