41. An 18-year-old female college freshman comes to the health center because of a 3-month history of fatigue and intermittent headaches. She also has had an unintentional weight loss of 4 kg (9 lb) during the past 6 weeks and difficulty concentrating on her schoolwork. She moved from her home to a campus dormitory 5 months ago. She was an avid tennis player but says she has not played since school began because she has no energy and has lost interest in sports. She notes that she recently broke off her long- distance relationship with her boyfriend back home. She tearfully says she feels lonely and is frustrated with her performance on final examinations. She occasionally drinks alcoholic beverages "to help with sleep." She does not use illicit drugs. She appears thin and has a sad affect. Physical examination shows no abnormalities. Which of the following is the most appropriate initial response by the physician? A) "Although this is a difficult time for many, I'm concerned that you're not coping well. Have you had any feelings of hurting yourself?" B) "Have you made any friends on campus yet? Sometimes a student support group is the best remedy for transitional stress." C) "It seems that this difficult transition has made you depressed. What are your thoughts about receiving additional care in the hospital, where you can be in a safe environment?" D) "It's normal to feel homesick and lonely during your first year away from home. Planning a visit home to be with your family might help you feel better." OE) "Transitioning to college life is difficult for many students. It will get better once you become accustomed to your surroundings."

41. An 18-year-old female college freshman comes to the health center because of a 3-month history of fatigue and intermittent headaches. She also has had an unintentional weight loss of 4 kg (9 lb) during the past 6 weeks and difficulty concentrating on her schoolwork. She moved from her home to a campus dormitory 5 months ago. She was an avid tennis player but says she has not played since school began because she has no energy and has lost interest in sports. She notes that she recently broke off her long- distance relationship with her boyfriend back home. She tearfully says she feels lonely and is frustrated with her performance on final examinations. She occasionally drinks alcoholic beverages "to help with sleep." She does not use illicit drugs. She appears thin and has a sad affect. Physical examination shows no abnormalities. Which of the following is the most appropriate initial response by the physician? A) "Although this is a difficult time for many, I'm concerned that you're not coping well. Have you had any feelings of hurting yourself?" B) "Have you made any friends on campus yet? Sometimes a student support group is the best remedy for transitional stress." C) "It seems that this difficult transition has made you depressed. What are your thoughts about receiving additional care in the hospital, where you can be in a safe environment?" D) "It's normal to feel homesick and lonely during your first year away from home. Planning a visit home to be with your family might help you feel better." OE) "Transitioning to college life is difficult for many students. It will get better once you become accustomed to your surroundings."