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32. A 15-year-old girl is brought by her mother for a routine health maintenance examination. The girl asks to speak to the physician alone and reports that her father fights with her constantly about grades, friends, and after-school activities. She says that he has raised his hand as if to strike heron one or two occasions. She says that recently she "lost it" and told him that she hates him and can hardly wait to leave home. She admits that she often cries. Her mother has a history of severe migraines, and the patient is reluctant to tell her mother about her problems because it might cause a migraine. The patient weighs 50 kg (110 lb) and is 157 cm (62 in) tall. Her temperature is 36.9°C (98.4°F), blood pressure is 98168 mm Hg, pulse is 76/min, and respirations are 161min. Physical examination shows no abnormalities. On mental status examination, she is animated, articulate, and relates well to the examiner. Which of the following is the most appropriate next step in management?

O A) Reassurance that this is normal adolescent stress
O B) Notifying child protective services
O C) Admission to the psychiatric unit
O D) Family therapy
0 E) Trial of fluoxetine

i think family therapy is a good choice here.a/c/e are wrong answers. we would choose Notification to CPS if d was not there in the answer.When to notify CPS can be found in this website...http://assembly.state.ny.us/comm/Children/20011016/htmldoc.html

the dad never hit her he just raised his hand at her (every indian person has this happen in their lives russell peters) but yes i would go with D and there is no reason to pick B no harm to the child has been done and these are the type's of stressors that happen when you have a child growing up....my 2 cents

Thanks a lot for explanation. have a nice holiday!

B