A concerned parent calls the school nurse because of changes in his 15-year-old's behavior. Which behaviors would the nurse identify as most likely to be abnormal and indicate possible substance abuse in an adolescent?
1. Becoming very involved with friends and in activities related to the basketball team that she is on, never seeming to be home, and, when she is home, preferring to be in her room with the door shut
2. Becoming moody, crying, and weeping one minute and then cheerful and excited the next
3. Receiving numerous detentions lately from teachers for sleeping in class
4. Buying baggy, oversized clothing at thrift shops and dyeing her hair black
3
Rationale 1: Periodically distancing themselves from their parents and preferring involvement with their peers are normal adolescent behaviors.
Rationale 2: Mood swings are normal adolescent behaviors.
Rationale 3: Even though most teens do prefer staying up late, they are not usually so tired that they fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and could indicate involvement with substance abuse or an underlying pathology.
Rationale 4: Experimenting with clothes and hair is a normal adolescent behavior.
Global Rationale:
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