I just thought of a way to (hopefully) avoid getting these types of answers wrong. First, when I read them I always look for the least "asshole" answer. Then, if you're still stuck, try to put the statement into a quote that you would say to a patient as a physician, remembering that open-ended, non-judgmental questions are ideal.

The answer for this could be phrased as a question/statement by the doctor, to the family, as "Tell me more about how this impacting your family and daily life." Had it been phrased like that, I DEFINITELY wouldn't have gotten it wrong. I would have never even had the opportunity to make an assumption about the family's fighting being due to diet concerns and thus needing a nutritionist referal (which is what I chose).

To get such vague questions right:

1. Consider saying all the statements in the snarkiest tone possible under your breath (translate to mother tongue if IMG for bonus effect).

"Stop Bickering" - while saying, don't you get a hint of paternalism, like the doctor treating the parents as teenagers themselves. They are fully grown-up themselves; they know they shouldn't bicker!

1. Don't choose the refer option on Step 1 (99% of the time correct).... unless no other option at all fits your case first UWorld has questions going to court as the right answer even! But in all of them, it was evident that no other option could come close to being polite/nice/ethical/legally correct.

2. Options that say - encourage/endorse/discuss/ask - are always preferred. Communication = Key Questions

Ugh... got tripped up with "Refer both patient and her parents to a dietician"

Over thinking...I thought the source of their arguments were at meal times especially...so maybe they can find a good solution with a dietician.

OCCAMs RAZOR THIS SHIT. keep it simple stupid. The answer fits the best after re reading it.

You can eliminate C because her diabetes was well controlled in the past. The fact that there is stress in her family and she has poor glucose control tells you that the her poor glucose control is secondary to the stress in her family. So you want to fix the real problem, and to do this, you need more information about it, so pick B, as open-ended questions will always give the physician more insight to what's going on and better be able to decide how to tackle the problem

I translated choice B to "the parents are arguing about their child and therefore by saying this i am adding fuel to the fire" I chose A because i figured thing are getting heated and therefore doc should try to calm things down before proceeding

awesome analogy . 3 steps to ethics

1. least asshole answer
2. politest
3. no short cuts ( like take the longer harder most painstakingly official route to any process.)

p.s last point, you will see its use in other questions, not this one