A 13-Year-Old Boy Is Brought to the Physician by His

A 13-year-old boy is brought to the physician by his mother for a routine physical examination and follow-up of type 1 diabetes mellitus.  The patient appears irritated, and his mother begins the visit by exclaiming, "Here's the doctor; he's going to tell you how badly you've been doing."  Laboratory tests show a random blood glucose of 350 mg/dL and a hemoglobin A1c of 9% (normal: <6%-7%) .  When the physician asks the patient how he is doing with his insulin, the mother interrupts and shouts, "He never remembers to use it!"  When the boy is asked about his diet, the mother puts her hands on her hips, glares at her son, and says, "Pizza, soda, and candy!"  After acknowledging the mother's concerns regarding diabetic control, which of the following is the most appropriate course of action?

A) Ask the mother if she has any concerns about the patient's mood
B) Ask the patient if he agrees with his mother's responses
C) Ask the patient if he has felt irritable most days of the week
D) Explain to the mother that her critical tone may discourage the patient
E) Request to speak with the patient alone

Correct Answer:

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