A 22-Year-Old Man Comes to the Clinic for Routine Follow-Up

question 634

Multiple Choice

A 22-year-old man comes to the clinic for routine follow-up of his mild asthma.  He has a history of keeping his appointments but has missed the last three.  Today he seems distracted and uninterested, answering various questions with very brief replies.  At one point, the patient says that he would like to hurry the visit along so he can get home sooner.  Following inquiries about his social life, he becomes more animated and describes spending time with new friends who "really know how to party."  On further questioning, he says, "I have been snorting cocaine sometimes but it's not a big deal.  I haven't used any this past week.  I quit school because it was just stupid and I was wasting my money.  I'm working as a waiter now and enjoying it.  At least I can make my own money and not be dependent on my parents."  The patient says that he has been living with his new friends since his parents asked him to move out 2 weeks ago, but he would "rather not talk about that."  He denies any symptoms of depression, mania, or psychosis.  Temperature is 37.7 C (99.9 F) , blood pressure is 120/82 mm Hg, pulse is 86/min, and respirations are 15/min.  Physical examination shows perforations of the nasal septum.
Which of the following is the most appropriate next step in management of this patient?

• A)Encourage the patient to attend a 12-step mutual help group (eg, Narcotics Anonymous)
• B)Inform the patient that he has a perforated septum and should abstain from cocaine use
• C)Obtain a urine toxicology screen
• D)Perform a brief counseling intervention
• E)Refer the patient for outpatient drug counseling

Explain the significance of accountability measures, such as those outlined in the Every Student Succeeds Act (ESSA), for English Language Learners (ELLs).

Recognize the concept of twice-exceptional students and the implications for their education.

Acknowledge the impact of IDEA’s reauthorization on the identification of students with disabilities.

Understand the best practices for conducting formal and informal conferences with parents or families.

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Definitions:

Bit Status

Refers to the on or off condition of a bit within a digital system, where '0' typically represents off and '1' represents on.

Logic Continuity

The consistent application and flow of logical operations or conditions within a system, ensuring coherent and expected behavior.

OFF Condition

A state or mode in which a system, circuit, or device is deactivated or not functioning.

ON Condition

A state where a circuit is complete, allowing current to flow, or a logical condition that has been met.