Question

you are called to care for an adolescent, who the mother describes as \a perfectly normal teen-ager\. you discover the patients wrists have been cut. what is a priority assessment in this patient?

identifying if drug use is involved.
ask her what she used to cut her wrists.
asking if she recently broke up with a boyfriend.
questioning the relationship between parent and child.

Explanation:

Identify the clinical presentation

The patient is an adolescent who has cut her wrists, which is a presentation of self-harm. In any self-harm or psychiatric emergency, the primary clinical objective is to assess the patient's safety, intent, and potential for further self-harm or suicide.

Evaluate the priority assessment

Using the Patient Assessment Protocols and Behavioral Emergencies knowledge points:

• Identifying the tool used to cut the wrists is a critical physical assessment step to determine the severity of potential wounds, locate any missing sharp objects for scene safety, and guide wound care.
• While exploring psychosocial factors (such as drug use, relationship breakups, or parent-child dynamics) is part of a comprehensive history, these are secondary to immediate physical safety, wound assessment, and determining the mechanism of injury.

Analyze the options

• Identifying if drug use is involved: Secondary assessment, not the immediate priority over physical injury assessment.
• Ask her what she used to cut her wrists: Correct. This directly addresses the mechanism of injury, helps locate the weapon/tool for scene safety, and guides wound management.
• Asking if she recently broke up with a boyfriend: Psychosocial history, not an immediate priority.
• Questioning the relationship between parent and child: Psychosocial history, not an immediate priority.

Answer:

• Identifying if drug use is involved.
• Ask her what she used to cut her wrists. (Correct answer)
• Asking if she recently broke up with a boyfriend.
• Questioning the relationship between parent and child.