21 Questions
What is a common marker used to evaluate if a patient is developing drug tolerance?
Comparing the patient's self-reported pain scale at each visit
What is a mechanism to address drug tolerance in a patient?
Switching the patient to a different opioid medication (opioid rotation)
What is the recommended initial dose reduction when performing opioid rotation for a patient receiving a relatively high dose of the current opioid?
50%
Which of the following statements about addiction is true according to the text?
Addiction is characterized by a series of behaviors
What is a common misconception about tolerant patients?
Tolerant patients are often mistaken for addicted patients
What is a characteristic of drug tolerance mentioned in the text?
Over time, a gradual increase in medication dose may be needed to achieve the same level of pain control and functional ability
Which of the following screening tools should NOT be used to assess for potential opioid misuse problems?
PHQ-9
What percentage of patients taking opioids for chronic pain are estimated to not pose problems and be compliant with their treatment plan?
80%
Which of the following is NOT considered a common "red flag" behavior that can indicate a problem with opioid misuse?
The patient reports taking the medication as prescribed without any issues
What should the NP do if screening tools are used to assess for potential opioid misuse problems?
Evaluate the results, discuss them with the patient, and document how the results affected the plan of care
What is the purpose of using a sample visit summary encounter checklist, as mentioned in the text?
To aid the NP in documenting all areas of the patient's visit
What is the main reason the NP should be vigilant to identify the 20% of patients taking opioids for chronic pain who may pose problems?
To ensure these patients are using the opioids as prescribed and not misusing them
Which of the following behaviors is NOT commonly associated with addiction?
Stockpiling medications as an insurance against pain
What is the primary goal for the nurse practitioner when prescribing opioids for chronic pain?
To present the expectation of an end point to using opioids from the outset
What should the nurse practitioner do regarding the Prescription Drug Monitoring Program (PDMP) at each visit/encounter?
Check the PDMP for benzodiazepines and opioids and document that it was checked
How should the nurse practitioner handle non-compliance with the Patient-Provider Agreement (PPA)?
Document an explanation and mitigation strategy for the non-compliance
What should be done regarding informed consent for opioid treatment?
Each opioid should have its own informed consent
When should a urine drug test (UDT) be performed during chronic opioid treatment?
Only when a problem is suspected or at least every 12 months
What should be done if a urine drug test (UDT) shows unexpected positive results?
Discuss the result with the laboratory, then with the patient, and document a mitigation strategy
Which of the following statements about pseudo-addiction is true?
Pseudo-addictive behaviors are related to a fear of being in pain
What does dependence refer to in the context of opioid treatment?
The patient's ability to meet functional goals when using the medication and when not using it
Explore the definitions and meanings of pain and Substance Use Disorder (SUD) terminology based on the National Institute on Drug Abuse (NIDA) guidelines from 2017. Learn about drug tolerance and how to assess patients' pain control and functional ability over time.
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