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?

A. "His favorite teacher committed suicide a few weeks ago." This statement is a red flag. A recent loss, particularly by suicide, can significantly impact an adolescent's emotional well-being. Adolescents who are emotionally attached to individuals who die by suicide are at increased risk for suicidal ideation, especially if the loss triggers emotional distress or serves as a model for the adolescent. This concern should prompt further assessment for suicidal thoughts or behaviors. B. "He is very religious and attends services twice a week." Being religious and attending services regularly is generally a protective factor against suicide. Religious involvement may provide a sense of community, purpose, and support, which can act as a buffer against suicidal ideation. C. "He spends much of his time with his two school friends." Having a small but close social group is typical for many adolescents and, by itself, is not a risk factor for suicide. It’s important to consider the quality of these relationships, but this statement alone does not suggest immediate concern. D. "He has slept 9 hours each night for the past 2 years." Sleeping 9 hours a night is generally within the recommended range for adolescents. This does not indicate a risk for suicide and may even suggest that the adolescent is maintaining a healthy sleep schedule.