An adolescent attempts suicide several days after a high school ...

[tichca]

An adolescent attempts suicide several days after a high school peer committed suicide. The student's mother is devastated that this could happen and that the family could be so unable to tell that their child was at risk.
 
  Which response by the school nurse best reflects our understanding of suicide in adolescence? Select all that apply. a. Most persons who attempt suicide conceal their despair and their intent from others quite effectively so no one will interfere with their attempt.
  b. Adolescents have an immature prefrontal cortex, leading to greater impulsiveness, impaired judgment, and less ability to tolerate frustration.
  c. Serotonin pathways are not fully developed until adulthood, leading to moodiness and sudden onset of depression in children.
  d. People, particularly adolescents, sometimes identify with others who have attempted suicide, leading them to decide to attempt suicide as well.
  e. The grief following a peer's death, by suicide or otherwise, can itself contribute to depression and a significant increase in suicide risk.
  f. Usually when one adolescent has committed suicide and others follow with their own attempts, they are trying to evoke the attention shown to the dead child.

Question 2

A terminally ill patient says, I know I will never get well, but..., and the patient's voice trails off. Select the most therapeutic response by the nurse.
 
  a. What do you hope for?
  b. Do you have questions about what is happening?
  c. You are not going to get well. It is healthy that you accept that..
  d. When you have questions, it is best to talk to the health care provider..

[mjenn52]

Answer to Question 1

B, D, E
The prefrontal cortex is not fully developed until early adulthood, resulting in impaired judgment, reduced frustration tolerance, and impulsive actions in children and adolescents. Identification with others who have committed suicide is associated with a higher risk of suicide, as is the grief following the loss of a peer. Most people provide some sort of indication of intent to attempt suicide, although truly impulsive acts may be the exception. Serotonin dysfunction contributes to depression, and low serotonin activity appears to be a factor in suicide, but serotonin abnormalities are not a feature of adolescents as a group. Although some suicide attempts involve a desire for attention, the belief that attempts are primarily attention seeking is a myth about suicide.

Answer to Question 2

A
This open-ended response is an example of following the patient's lead. It provides an opportunity for the patient to speak about whatever is on his mind. The distracters are not therapeutic; they block further communication, refocus the conversation, give advice, or suggest the nurse is uncomfortable with the topic.

[tichca]

Wow, this really help

[amit]

Excellent