Massachusetts Medical Society: Question 12

Question 12

 

Question:

 

Please read the following case and answer questions 12 and 13.

Brian, a 22-year-old healthy college student, has been a patient of yours for two years. You receive a message that he was seen in the Emergency Room over the weekend for acute chest trauma. At first, he said that he fell while rollerblading, but was then asked if he was being assaulted or harmed by someone when his CXR came back showing not just acute rib fractures, but also several older, healed rib fractures. He felt comfortable with the PA evaluating him in the Emergency Room and disclosed not only that he was gay but also that it was his boyfriend who has been abusing him for the last several months. He was sent to your office for follow-up of the Emergency Room visit. You are more than embarrassed that you never asked Brian about his sexual orientation and that you assumed his "roommate" was a friend.

Question 12

What should you do when Brian arrives in your office?

 

 

 

Answers

Answer:

Stick to the strictly medical issues by monitoring the healing of his rib fractures and by making sure his O2 saturation and respiratory rate are normal.
 

 

Correct Answer? 

 

Explanation:

A. Incorrect          Although appropriate medical care and follow up needs to be assured, the underlying reason for the patient's injury is intimate partner violence. Follow-up is key to the patient's safety and to assure that he gets referred to appropriate community-based resources.

 

Answers

Answer:

Caution him about the potential for drug abuse now that he has a condition characterized by pain; give him information about substance abuse treatment.
 

 

Correct Answer? 

 

Explanation:

B. Incorrect      Opioids, if prescribed at all, should be used only on a short-term basis. Since there is no history of drug abuse, no specific precautions beyond what would be normally offered to any other patient needing short-term narcotic analgesia would be warranted.

 

Answers

Answer:

Thank him for disclosing his situation to the care provider in the Emergency Room and tell him you’d like to understand more about his lifestyle and situation.
 

 

Correct Answer? 

 

Explanation:

C. CORRECT        Remaining open-minded, respectful and engaged, and demonstrating concern by arranging for follow-up promotes optimal patient care.

 

Answers

Answer:

Let him know you are unable to provide optimal ongoing care and refer him to a different provider.
 

 

Correct Answer? 

 

Explanation:

D. Incorrect         It is important to treat all patients with care and respect, regardless of their lifestyle or background. Health care providers should strive to provide optimal care for all patients.

 

 

Format:

Radio buttons (single select)

 

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