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Retired NBME 22 Answers

nbme22/Block 3/Question#11 (reveal difficulty score)
A 38-year-old man with Down syndrome is ...
Contact adult protective services ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—usmleuser007(464)
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In cases of child or adult abuse

1) if there is clear evidence such as if a child states that parents punish by hitting, child is showing fear of parent ---- call child protection right away ( don't need to wait and ask)

2) same thing goes for the adult but call the adult protection services

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osler_weber_rendu  Does anyone not remember Dr Daugherty's lessons which said domestic violence on adults is NOT necessary to report? Instead help them find an escape route in case of an emergency and encourage them to report it themselves. +1
makinallkindzofgainz  @osler_weber_rendu: Domestic violence is not the same thing as dependent adult abuse, such as a special needs adult or an elderly adult (basically anyone who depends on others for care). What you said applies IF the adult is living independently and fully capable to make their own decisions. +8
chaosawaits  REAL STORY: a police officer caused his autistic child to freeze to death by leaving him in the cold to sleep in the garage +
l0ud_minority  I don't see how asking the pt. with the nephew present if he feels safe at home is wrong. You can still proceed to report after but will be able to gather more information. I guess what threw me off was "the most appropriate INITIAL action" in the stem of the question. I hate these questions. I got it wrong after changing my answer from the correct. +
ankigravity  My guess is because you have sufficient evidence to contact them. The nephew refused to leave and I took it as they wouldn't take kindly to me asking the patient if they felt safe. These questions are tricky for sure. +



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submitted by โˆ—angelaq11(83)
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I hate Qs like this. They make me feel all kinds of sadness.

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bbr  It is sad, but we are on the front lines and can intervene. And so we should keep an eye out for these types of situations. As mad eye moody said....."constant vigilance!" +2



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