Behavioral Science & Ethics USMLE Step 1 Practice Question
A 14-year-old boy is brought to the office by his mother after she discovered a marijuana cigarette in his bedroom. The mother is very concerned and worried this indicates her son is "heading down a bad path." She asks if you should report this to his school and whether he needs substance abuse treatment. The patient reports that his friends obtained marijuana out of curiosity, and he agreed to try it but denies ever actually using it. He expresses embarrassment about the incident and states, "I made a stupid decision." His grades are all A's and B's, he is a member of the debate team, and he has never had any disciplinary issues at school or legal problems. Vital signs are normal, and physical examination is unremarkable. On mental status examination, he is cooperative, shows appropriate affect, and demonstrates insight into his behavior. Which of the following is the most appropriate next step in management?
Answer choices
- AProvide reassurance to the mother that this represents normal adolescent experimentation and conduct individual counseling with the patient regarding substance use risksCorrect answer
- BImmediately report the incident to the school administration and request evaluation for possible school-based substance abuse program
- CDiagnose cannabis use disorder and refer the patient to an intensive outpatient rehabilitation program
- DDiagnose conduct disorder based on violation of school rules and recommend psychiatric referral for behavioral modification therapy
- EInform the patient that all information disclosed in the office visit is completely confidential and will not be shared with his parents under any circumstances
- FOrder urine drug screening and prescribe naltrexone to prevent future substance use experimentation
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