An 18-Year-Old Man Comes to the Office for a Follow-Up

question 227

Multiple Choice

An 18-year-old man comes to the office for a follow-up visit.  He was seen in the emergency department 3 months ago because of panic attacks related to cocaine use.  The patient subsequently stopped using cocaine and has had no recurrent anxiety symptoms.  He graduated from high school, started a new job, and has been considering applying to community college.  At today's visit, the patient reports that he used cocaine at a friend's house this past weekend.  He says, "I really messed up.  I feel like a failure."  The patient has no history of illness.  He is in no physical discomfort.  Which of the following is the most appropriate statement by the physician at this time?

• A)"Do you think using cocaine again could have a negative impact on your job and going to college?"
• B)"It's hard to quit.  Let's go over the health effects of cocaine to help motivate you to stay sober."
• C)"Quitting is difficult, so don't be so hard on yourself.  Let's move forward from here."
• D)"Socializing with your friend probably contributed to your relapse.  Let's look at strategies to deal with peer pressure."
• E)"You've been making real progress in quitting.  What can we learn from this temporary setback?"

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Definitions:

Heterosexuality

A sexual orientation characterized by an attraction to people of the opposite sex.

Asexual

A person who does not experience sexual attraction to any group of people.

Sexual Attraction

An attraction that may include a desire for sexual contact or relationship with someone, based on their physical or personal qualities.

Intimacy

A close, familiar, and usually affectionate or loving personal relationship with another person or group.