A client with subacute back pain asks the nurse about strategies to help keep the low back pain from becoming chronic.
Which of the following responses is appropriate for the nurse to make at this time?
Try to get plenty of rest every night.
There is nothing that you can do.
It is okay if you take your medication a few hours early if you need to.
Try to maintain good posture and strengthen your core.
The Correct Answer is D
Choice A rationale
While adequate rest is generally beneficial for overall health, excessive or prolonged rest for subacute back pain can actually be detrimental. Prolonged inactivity can lead to deconditioning of core muscles, joint stiffness, and a decrease in spinal mobility, which can contribute to the transition of subacute pain to chronic pain. Moderate activity and movement are generally encouraged.
Choice B rationale
Stating there is nothing a patient can do is inaccurate and unhelpful. There are numerous evidence-based strategies, including exercise, physical therapy, ergonomic adjustments, and lifestyle modifications, that can significantly impact the progression and chronicity of back pain. This response does not empower the patient with self-management techniques or provide accurate information.
Choice C rationale
Adjusting medication schedules without professional guidance can be dangerous and lead to adverse effects, inadequate pain control, or drug dependency. Medications for pain, especially analgesics, have specific dosing intervals based on pharmacokinetics and pharmacodynamics to maintain therapeutic levels and minimize side effects. Self-adjusting doses can lead to toxicity or insufficient pain relief.
Choice D rationale
Maintaining good posture and strengthening core muscles (abdominal and back muscles) are fundamental strategies for preventing chronic low back pain. A strong core provides essential support for the spine, improves spinal alignment, reduces mechanical stress on spinal structures, and enhances overall biomechanics during daily activities, thereby mitigating factors contributing to chronicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While depression can co-occur with various headache types, it is not consistently identified as a direct or primary precipitating factor common to both tension-type and cluster headaches; rather, stress is a more widely recognized shared trigger.
Choice B rationale
Stress is a well-established precipitating factor for both tension-type headaches, where muscle tension is often exacerbated by stress, and cluster headaches, where stress can trigger attacks in susceptible individuals, demonstrating a shared neurobiological pathway.
Choice C rationale
Smoking is a strong precipitating factor specifically for cluster headaches, with a high prevalence among sufferers, but it is not a commonly cited or significant precipitating factor for the typical presentation of tension-type headaches.
Choice D rationale
Poor posture is frequently associated with and can contribute to the development of tension-type headaches due to increased muscle strain in the neck and shoulders, but it is not a recognized or common precipitating factor for cluster headaches.
Correct Answer is C
Explanation
Choice A rationale
Allopurinol primarily targets purine metabolism, not potassium regulation. Potassium homeostasis is managed by the kidneys and aldosterone, and allopurinol does not directly impact serum potassium levels, which normally range from 3.5 to 5.0 mEq/L.
Choice B rationale
Interleukin-1 is a cytokine involved in inflammatory responses, and while inflammation is present in gout, allopurinol's primary mechanism of action is not direct antagonism of interleukin-1. Its effect is on uric acid metabolism.
Choice C rationale
Allopurinol is a xanthine oxidase inhibitor. Xanthine oxidase is an enzyme crucial in the metabolic pathway that converts purines into uric acid. By inhibiting this enzyme, allopurinol effectively reduces the production of uric acid, lowering blood levels.
Choice D rationale
Creatinine is a waste product from muscle metabolism and is primarily excreted by the kidneys; its blood levels reflect renal function. Allopurinol does not directly reduce creatinine levels, as its action is specific to uric acid synthesis.
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