A 16-year-old girl is being evaluated by the PMHNP for a chief complaint of anxiety. She worries about her friends who have started drinking, especially her female friends. She assures the PMHNP she has never used a psychoactive substance. Which of the following is an appropriate next step for the PMHNP?
Explanation & Rationale
Choice A reason: The CRAFFT screening tool is specifically designed for adolescents and young adults to assess substance use and related risks. Asking question 1 — “Have you ever ridden in a Car driven by someone (including yourself) who was ‘high’ or had been using alcohol or drugs?” — is a developmentally appropriate and validated approach for this age group. Choice B reason: The CAGE questionnaire is intended for adults and is less effective in identifying substance use issues in adolescents. It lacks the contextual sensitivity needed for youth screening. Choice C reason: While offering advice may be helpful later, the priority is to assess the client’s own risk and exposure. Prematurely giving advice without screening may overlook important information. Choice D reason: Moving on without screening would be inappropriate. Even if the client denies use, her concern about peers warrants further exploration using a validated tool like CRAFFT.