Clinical Case Studies for the Family Nurse Practitioner Leslie Neal-Boylan

Nathan, a 16 - year - old patient, is brought to the offi ce by his mother. She is insisting that Nathan be tested for “ drugs . . . all of them, because his grades are terrible and I don ’ t like his friends. ” You ask his mother to be more specifi c about her concern regarding drug use. She explains that his grades have slipped in the last 2 months or so and says, “ I won ’ t have a son of mine using drugs. ” His mother denies having any drugs in the house but comments that his teachers say, “ He seems zoned out in class and sometimes falls asleep. ” She has also noticed the same thing but realizes that he has been very busy with school and helping with her recovery from hip surgery. The clinician fi rst interviews Nathan alone, Nathan denies any complaints other than fatigue. He sleeps 6 – 7 hours per night and occasionally naps when he does not have football practice after school. He does not have nightmares or wake in the middle of the night. Past m edical h istory: Broken arm last summer with a surgical repair.