A practical nurse suspects an adolescent client is using anabolic steroids. What is the most appropriate approach to initiate discussion?

A practical nurse suspects an adolescent client is using anabolic steroids. What is the most appropriate approach to initiate discussion?

• A. I've noticed that your muscle size has increased quite a bit and you have developed acne.
• B. Are you aware of the dangers of taking anabolic steroids?
• C. Did you know that using anabolic steroids would disqualify you from sports competitions?
• D. Are you taking any supplements to improve your performance?

Answer: (A)

Initiate with a nonjudgmental, observational opening that invites the adolescent to talk. By naming concrete changes you’ve seen—like increased muscle size and acne—you show you’re noticing health-related effects and you’re genuinely concerned, not accusing. This approach sets a respectful tone, reduces defensiveness, and opens the conversation so the teen can share what they’re experiencing, what they’re taking, and why, allowing you to assess health risks and provide support. Other options tend to feel corrective or didactic, which can put the teen on the defensive and limit honesty. Asking about awareness of dangers or potential consequences uses fear rather than collaboration, while mentioning sports disqualification similarly shifts the focus to consequences rather than the teen’s health and your concern. Asking about supplements is broader and may miss the opportunity to address steroids directly.

Initiate with a nonjudgmental, observational opening that invites the adolescent to talk. By naming concrete changes you’ve seen—like increased muscle size and acne—you show you’re noticing health-related effects and you’re genuinely concerned, not accusing. This approach sets a respectful tone, reduces defensiveness, and opens the conversation so the teen can share what they’re experiencing, what they’re taking, and why, allowing you to assess health risks and provide support.

Other options tend to feel corrective or didactic, which can put the teen on the defensive and limit honesty. Asking about awareness of dangers or potential consequences uses fear rather than collaboration, while mentioning sports disqualification similarly shifts the focus to consequences rather than the teen’s health and your concern. Asking about supplements is broader and may miss the opportunity to address steroids directly.