A 48-year-old man with a new diagnosis of chronic low back pain requests a prescription for opioids. Which of the following is the most appropriate response?
“Guidelines recommend nonpharmacologic therapies as first-line treatments for chronic low back pain.”
“Opioids are only recommended when other treatments are ineffective.”
“As a nurse practitioner, I cannot prescribe opioid medications.”
“I can prescribe opioids only after you have completed a comprehensive screening for addiction.”
The Correct Answer is A
Choice A reason: Clinical guidelines from organizations such as the CDC and American College of Physicians recommend nonpharmacologic therapies (e.g., physical therapy, exercise, cognitive behavioral therapy) as first-line treatments for chronic low back pain. This response aligns with evidence-based practice and promotes safer, more sustainable pain management.
Choice B reason: While technically accurate, this response lacks the emphasis on guideline-based care and may imply that opioids are a likely next step. It does not promote the preferred initial approach.
Choice C reason: This statement may be factually incorrect depending on the PMHNP’s scope of practice and state regulations. It also avoids addressing the clinical appropriateness of opioids.
Choice D reason: Although screening for addiction is important, this response implies that opioids are a viable option pending screening, which may not be appropriate as a first-line treatment. It also lacks the broader context of guideline-based care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The PHQ-9 is a depression screening tool that includes one item on suicidal ideation. While useful for identifying depression and some suicide risk, it is not designed to assess comprehensive suicide risk, especially in individuals with borderline personality disorder.
Choice B reason: The SBQ-R is specifically designed to assess suicide risk. It evaluates lifetime suicidal ideation and attempts, frequency of ideation, threat of suicide, and self-reported likelihood of future suicidal behavior. It is validated for use in both clinical and non-clinical populations and is particularly useful in assessing risk in individuals with borderline personality disorder.
Choice C reason: The ACSS-FAD measures fearlessness about death, which is a component of the interpersonal theory of suicide. While it provides insight into one aspect of suicide risk, it does not assess overall risk or history of suicidal behavior.
Choice D reason: The INQ assesses perceived burdensomeness and thwarted belongingness, which are psychological states associated with suicide risk. However, it does not directly evaluate suicidal behavior or intent, making it less comprehensive than the SBQ-R.
Correct Answer is B
Explanation
Choice A reason: Beneficence involves promoting good and preventing harm. It is a core ethical principle but does not specifically address equal treatment or fairness.
Choice B reason: Justice is the ethical principle that emphasizes fairness, equity, and impartiality. In nursing, it means treating all patients with equal respect and ensuring that care is distributed fairly, regardless of personal characteristics or social status.
Choice C reason: Respect is foundational to ethical practice, particularly in honoring autonomy and dignity. However, it does not explicitly mandate equal treatment across individuals, which is the domain of justice.
Choice D reason: Fidelity refers to loyalty, faithfulness, and keeping promises. It supports trust in the nurse-patient relationship but does not encompass the principle of equal respect for all.
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