Behavioral Science & Ethics USMLE Step 1 Practice Question
A 10-year-old boy presents with fatigue and pallor. Laboratory studies reveal microcytic anemia with serum iron of 35 mcg/dL and ferritin of 12 ng/mL, consistent with iron deficiency anemia. Vital signs are stable. His mother reports the family follows a lacto-ovo vegetarian diet for religious reasons. She expresses concern about his anemia but notes that her son refuses to eat dark leafy greens, stating they upset his stomach, and is reluctant to take iron supplements. The mother asks what she should do. Which of the following is the physician's most appropriate next step?
Answer choices
- ARefer the family to a dietitian who specializes in vegetarian nutrition to identify iron-rich plant-based foods the child finds palatableCorrect answer
- BPrescribe a daily iron supplement and inform the mother that the child must take it regardless of his preference
- CInquire about the family's specific religious beliefs regarding which foods are prohibited and whether medical exceptions exist
- DRecommend the family reconsider their vegetarian diet since plant-based iron has lower bioavailability than heme iron
- ESchedule a separate appointment with the child to discuss why he refuses vegetables and use motivational interviewing to change his preferences
- FOrder a blood transfusion given the child's documented iron deficiency and resistance to dietary intervention
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.