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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A rationale:

Deflecting the client's concerns to the physician dismisses the client's immediate need for emotional support and therapeutic communication.

It can hinder the development of a trusting nurse-client relationship.

The nurse is responsible for addressing the client's psychosocial needs, not solely deferring them to other healthcare professionals.

Choice B rationale:

Offering false reassurance is inappropriate and potentially harmful. It can erode trust if the client's fears are later realized.

It minimizes the client's legitimate concerns and invalidates their emotional experience.

Choice C rationale:

While lifestyle modifications are essential for managing coronary artery disease, providing unsolicited advice at this moment disregards the client's emotional distress.

It prioritizes physical health over the client's psychological well-being. It can be perceived as dismissive of the client's fears and concerns.

Choice D rationale:

Inviting the client to elaborate on their fears demonstrates active listening and encourages therapeutic communication. It validates the client's concerns and shows empathy for their emotional experience.

It provides an opportunity to assess the client's understanding of their condition and identify specific fears or misconceptions. It establishes a foundation for exploring coping mechanisms and providing appropriate support and education.

A. "She is always bossing me around. Should she do that?" B. "Please do not raise your voice at the children. I am the one who left dishes in the sink." C. "If you keep saying that, I will tell everyone what you did last night." D. "Can you tell me the reason you get upset each time you go to the mall?".

Correct Answer is D

Explanation

Choice A rationale:

This statement is accusatory and blaming, rather than promoting understanding and problem-solving. It focuses on the negative behavior of the sibling and seeks external validation for the speaker's feelings, rather than attempting to address the underlying issue directly with the sibling.

It uses "should" language, which can come across as judgmental and critical, potentially escalating conflict.

It does not express the speaker's own feelings or needs, making it difficult for the other person to understand and respond effectively.

Choice B rationale:

While this statement demonstrates a willingness to take responsibility for actions, it does not directly address the communication between the family members. It focuses on redirecting the father's anger rather than exploring the underlying reasons for the conflict.

It could be interpreted as silencing the children's voices and potentially reinforcing a hierarchical dynamic within the family, where one parent holds authority over the others.

Choice C rationale:

This statement is manipulative and threatening, using a fear of exposure to control the other person's behavior. It undermines trust and safety within the family, making it difficult to have open and honest communication.

It does not address the core issue at hand and instead escalates conflict by using a "tit-for-tat" approach.

Choice D rationale:

This statement effectively demonstrates several key principles of effective communication: It expresses curiosity and a genuine desire to understand the other person's perspective.

It avoids accusations or assumptions, instead inviting open dialogue.

It focuses on specific behaviors and events ("each time you go to the mall") rather than making sweeping generalizations about the person's character.

It uses "I" language to express the speaker's own feelings and concerns, inviting empathy and understanding.

It creates an opportunity for the other person to share their perspective and work towards a resolution together.

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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)

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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)