A 49-year-old female patient has been taking gabapentin for 6 months. It has produced some relief for her neuropathic pain, but she still rates her average daily pain at about a 5. What would be the next most appropriate treatment?
Hydrocodone (Norco)
Acetaminophen (Tylenol)
Amitriptyline (Elavil)
Pregabalin (Lyrica)
The Correct Answer is D
Choice A reason: Hydrocodone is an opioid analgesic and may be considered for severe pain, but it is not first-line for chronic neuropathic pain due to risk of dependence and side effects.
Choice B reason: Acetaminophen is effective for mild to moderate nociceptive pain but has limited efficacy in neuropathic pain.
Choice C reason: Amitriptyline is a tricyclic antidepressant effective for neuropathic pain and could be considered, but switching to pregabalin is often preferred for patients already partially responsive to gabapentin due to similar mechanisms but potentially better efficacy.
Choice D reason: This choice is correct because pregabalin is a first-line agent for neuropathic pain and can be considered when gabapentin provides only partial relief. It works similarly but has different pharmacokinetics and dosing flexibility, making it an appropriate next step.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While true, this choice is a general health benefit and does not directly explain the reduction in knee pain or functional loss.
Choice B reason: This choice is correct because mechanical load on the knee joint increases disproportionately with body weight. Even a small amount of weight loss significantly reduces joint stress, thereby improving pain and function in osteoarthritis.
Choice C reason: Reducing cardiovascular strain is beneficial but does not directly impact knee joint load or osteoarthritis symptoms.
Choice D reason: Preventing falls is important but is an indirect benefit; the primary mechanism for pain reduction is decreased mechanical load on the joint.
Correct Answer is D
Explanation
Choice A reason: The temporal lobe primarily processes auditory information and is involved in memory formation, but abstract reasoning and proverb interpretation are not localized to this area.
Choice B reason: The parietal lobe integrates sensory information and contributes to spatial awareness, which is unrelated to abstract reasoning or interpretation of proverbs.
Choice C reason: The occipital lobe is mainly responsible for visual processing and does not govern executive functions or abstract thought.
Choice D reason: The frontal lobe, particularly the prefrontal cortex, is critical for executive functioning, abstract reasoning, planning, and judgment. Interpreting proverbs like “A rolling stone gathers no moss” requires conceptualization, abstraction, and insight, making this portion of the MSE a test of frontal lobe functioning.
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