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 D
Explanation
Choice A reason: CIWA-AR is used to assess and monitor alcohol withdrawal symptoms in patients undergoing detoxification. It is not a screening tool for identifying alcohol use disorder.
Choice B reason: T-ACE is a brief screening tool often used in prenatal settings. While useful, it is not as comprehensive as AUDIT for general adult populations.
Choice C reason: SBIRT is a framework for screening and intervention but does not refer to a specific diagnostic tool. It includes the use of validated instruments like AUDIT.
Choice D reason: AUDIT is a validated, comprehensive screening tool developed by the World Health Organization to identify alcohol use disorders. It assesses consumption, dependence symptoms, and alcohol-related problems, making it the most appropriate choice.
Correct Answer is B
Explanation
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.
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