Behavioral Science & Ethics USMLE Step 1 Practice Question
A 45-year-old man presents to his primary care physician accompanied by his wife. Three days ago, he was passed over for promotion at work, which he had anticipated receiving. Since that time, he has consumed alcohol daily, remained in bed most of the weekend, and has been tearful. He reports feeling hopeless about his career prospects but denies suicidal ideation. He states, "I need to pull myself together and get back to work tomorrow or I'll be fired." He has never had a psychiatric diagnosis, has no family history of mood disorders, and prior to this week drank alcohol only socially. Vital signs are within normal limits. Physical examination is unremarkable. Which of the following is the most appropriate next step in management?
Answer choices
- ASupportive psychotherapy and psychoeducation about the expected course of his conditionCorrect answer
- BStart sertraline 50 mg daily and refer to psychiatry
- CPrescribe lorazepam 1 mg TID and schedule follow-up in 1 week
- DRefer for inpatient psychiatric hospitalization
- ERefer to substance abuse treatment program immediately
- FReassure the patient and schedule follow-up in 6 weeks
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