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Retired NBME 18 Answers

nbme18/Block 2/Question#6 (reveal difficulty score)
A 17-year-old boy is brought to the physician ...
"Tell me more about your concerns about your son's height." 🔍 / 📺 / 🌳 / 📖
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 +4  upvote downvote
submitted by azibird(279)
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What is going on here? The mother is not the patient, why are we exploring this further when the son is completely normal? I get it that we would say this if the patient were concerned, but he's not and he's normal so why don't we just tell her that everything is normal? Exploring further will probably make the patient feel worse.

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drdoom  Another way to read the stem is like this: “Assume you will make a statement that assures mom that boy is fine. What other statement do you want to make?” Since we’re *already* assuring mom, the best next thing is to ask an open-ended question. There’s a reason for this. As a physician, you really don’t want to say more than what you are (1) sure of or (2) obliged to. “Accept him as he is” = judgy. “He’s not going to get any taller” = you don’t know this for sure. +7
cbreland  I had it down between the correct answer and "your son is average". Picked the wrong one. As stated by @drdoom, the stem says you have already reassured that everything is fine. It would be a good time to get extra info from mom instead of say the same thing over again. Really the question gave us the answer (I still picked wrong, but we'll do better on test day!) +2



 +3  upvote downvote
submitted by drdoom(1206)
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Responding to @azibird’s comment:

Another way to read the stem is like this: “Assume you will make a statement that assures mom that boy is fine. What other statement do you want to make?”

Since we’re *already* assuring mom, the best next thing is to ask an open-ended question. There’s a reason for this. As a physician, you really don’t want to say more than what you are (1) sure of or (2) obliged to.

“Accept him as he is” = judgy.

“He’s not going to get any taller” = you don’t know this for sure.

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 +1  upvote downvote
submitted by agraham416(5)
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I eliminated this answer because the mother already stated her concerns, which was that he's shorter than the father's height and about him not having a growth spurt. Is that not a concern?

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 +0  upvote downvote
submitted by amandlima12(1)
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always ask the patient "tell me more" that’s usually always the answer to addressing patients concerns.

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