A patient has pain caused by a chronic condition. The patient is ...

[silviawilliams41]

A patient has pain caused by a chronic condition. The patient is reluctant to take opioids because of a fear of addiction. The primary care NP should tell the patient that opioids:
 
  a. carry a high risk of psychological dependence when used long-term.
  b. will help to improve the patient's functional outcomes and quality of life.
  c. will eventually become ineffective for treating pain when used over a long period.
  d. may require switching from one type of opioid to another to prevent tolerance over time.

Question 2

The primary care NP sees a child in the clinic who has a 5-day history of cough, poor fluid intake, and fever of 103 F. A chest radiograph shows areas of consolidation in the child's lungs.
 
  The child's cough is nonproductive, and the NP is unable to get a sputum specimen. The NP should: a. prescribe a broad-spectrum antibiotic to cover any possible causative organism.
  b. ask colleagues in the clinic about children they have treated and what they have prescribed.
  c. give the child's parents a specimen cup and ask that they try to bring in a sputum specimen for culture.
  d. refer the child to a pulmonologist or infectious disease specialist to help determine the proper treatment.

[frogdreck123456]

Answer to Question 1

B
Chronic pain requires routine administration of drugs, and addiction is generally not a concern, especially for patients with chronic pain or terminal illness. Opioid analgesics will help the patient improve function and quality of life. Tolerance may develop, and higher doses may be required to maintain effectiveness. Randomized, controlled trials are lacking to support switching opioids to manage tolerance and side effects.

Answer to Question 2

B
The child shows signs of a bacterial infection, but getting a sputum culture is not likely. The NP should ask colleagues about similar cases and treat according to those patterns. Broad-spectrum antibiotics increase the incidence of resistance. If this child's symptoms do not respond to empiric therapy, referral may be warranted.

[silviawilliams41]

TY

[frogdreck123456]

You're welcome