After receiving a diagnosis of chronic low back pain, a 48-year-old male patient with a history of major depressive disorder and substance use disorder in partial remission asks about medication options. Which of the following is not an appropriate option given his clinical scenario?
Duloxetine (Cymbalta)
Opioids
Naproxen
Acetaminophen
The Correct Answer is B
Choice A reason: Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved for chronic musculoskeletal pain and also treats depression. It is appropriate for this patient due to its dual benefit and non-addictive profile.
Choice B reason: Opioids pose a high risk of relapse in individuals with a history of substance use disorder. They are generally contraindicated unless all other options have failed and strict monitoring is in place. In this case, they are not appropriate.
Choice C reason: Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) effective for chronic pain. It is non-addictive and suitable for patients with substance use history, assuming no contraindications like GI or renal issues.
Choice D reason: Acetaminophen is a safe, non-opioid analgesic for mild to moderate pain. It is appropriate for patients with substance use disorder and can be used alone or in combination with other non-opioid agents.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Nausea and vomiting are common in both opioid and benzodiazepine withdrawal. They are nonspecific symptoms and do not help differentiate between the two conditions.
Choice B reason: Frequent yawning is a hallmark symptom of opioid withdrawal and is not typically seen in benzodiazepine withdrawal. It is a distinctive autonomic sign that can help clinicians identify opioid withdrawal.
Choice C reason: Restlessness and agitation are seen in both types of withdrawal. While they are important clinical features, they do not help distinguish between opioid and benzodiazepine withdrawal.
Choice D reason: Anxiety is a prominent symptom in benzodiazepine withdrawal and can also occur in opioid withdrawal. However, it is more characteristic of benzodiazepine withdrawal and does not serve as a distinguishing feature.
Correct Answer is B
Explanation
Choice A reason: While 12-step facilitation and meditation can support recovery, they are not considered the primary evidence-based tools for relapse prevention. Meditation may help with stress management, but it lacks the structured approach needed to address triggers and cognitive distortions.
Choice B reason: Addiction counseling and medication-assisted therapy (MAT) are the two most validated and widely used tools for relapse prevention. Counseling provides behavioral strategies, coping mechanisms, and emotional support, while MAT addresses physiological cravings and withdrawal symptoms through medications like buprenorphine, methadone, or naltrexone.
Choice C reason: Cognitive behavioral therapy is a core component of relapse prevention, but pairing it with mind-body relaxation alone does not encompass the full scope of treatment. Relaxation techniques are supportive but not primary.
Choice D reason: Family therapy and yoga may enhance recovery by improving relationships and reducing stress, but they are adjunctive rather than primary tools. They do not directly target the mechanisms of relapse.
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