Disclosed suicidal ideation, a plan, or means requires immediate safety assessment and is reported now.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse is providing teaching to the parents of an adolescent who has been prescribed an SSRI for depression. Which information is essential to include?
Answer: A. Antidepressants carry a black box warning for increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially early in treatment. Parents must monitor closely for worsening mood or suicidal behavior and report it promptly. The drug should not be stopped abruptly or doubled at will.
Question 2 of 5
An adolescent client confides about a personal health matter. The nurse maintains confidentiality unless:
Answer: B. Maintain confidentiality except when there is risk of harm to self or others (e.g., suicidal intent, abuse) or mandatory reporting applies — then safety and legal duties take precedence.
Question 3 of 5
Which vaccine is recommended for preteens (around age 11 to 12 years) and again before college entry to protect against bacterial meningitis?
Answer: A. The meningococcal conjugate vaccine (MenACWY) is recommended at ages 11 to 12 with a booster at age 16, providing protection through the higher-risk adolescent and college years. It protects against several serogroups of Neisseria meningitidis.
Question 4 of 5
The HPV vaccine is routinely recommended for adolescents beginning at about:
Answer: B. HPV vaccination is routinely recommended at ages 11–12 (can start at 9), ideally before exposure, to prevent HPV-related cancers.
Question 5 of 5
A nurse teaches an adolescent about mental-health promotion. An important message is to:
Answer: B. Encourage healthy coping, sleep, activity, connection, and seeking help for persistent sadness or thoughts of self-harm — and that asking for help is a strength. Dismissing distress as 'just a phase' is harmful.
Keep the streak going with more questions like these, each with a full rationale.
What is adolescent health screening?
The HEEADSSS psychosocial interview (Home, Education, Eating, Activities, Drugs, Sexuality, Suicide/depression, Safety) structures the assessment. Confidential, one-on-one interviewing without the parent present is essential for honest answers.
Key points to remember
- Interview the adolescent alone for sensitive topics; assure confidentiality within legal limits.
- Suicide is a leading cause of adolescent death, so screen for depression and suicidal ideation directly.
- Screen for sexual activity, contraception, and sexually transmitted infections; offer HPV vaccination.
- Assess for substance use, tobacco, vaping, and risky driving behaviors.
- Screen for disordered eating and body image, and plot BMI and growth.
- Recommended adolescent immunizations include Tdap, meningococcal, and HPV series.
Nursing priorities
- Conduct part of the visit privately, separating the teen from the parent for sensitive history.
- Directly and nonjudgmentally screen for depression, suicidal ideation, and self-harm.
- Provide confidential counseling on safe sex, contraception, and STI prevention.
- Assess for bullying, abuse, dating violence, and seat belt and helmet use.
- Verify and update immunizations including HPV, Tdap, and meningococcal vaccines.
Labs & values
Patient teaching
- Reinforce that visit information is confidential unless safety is at risk.
- Counsel on safe sex, helmet and seat belt use, and avoiding tobacco, vaping, and alcohol.
Red flags: report now
- Disclosed suicidal ideation, a plan, or means requires immediate safety assessment and is reported now.
- Confidentiality is broken and reported for danger to self or others, abuse, or sexual exploitation.
- Signs of abuse, sudden weight loss, or self-harm require escalation and protection.
References
Clinical references for this topic
