Understanding Pain and SUD Terminology from NIDA (2017)

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What is a common marker used to evaluate if a patient is developing drug tolerance?

Observing if the patient requests a dose increase more frequently

Checking if the patient is experiencing withdrawal symptoms

Comparing the patient's self-reported pain scale at each visit (correct)

Monitoring the patient's behavior for signs of drug-seeking

What is a mechanism to address drug tolerance in a patient?

Prescribing a non-opioid pain medication in addition to the current one

Switching the patient to a different opioid medication (opioid rotation) (correct)

Discontinuing the opioid medication and exploring non-pharmacological pain management options

Gradually increasing the dose of the same medication

What is the recommended initial dose reduction when performing opioid rotation for a patient receiving a relatively high dose of the current opioid?

25%

No dose reduction is necessary

75%

50% (correct)

Which of the following statements about addiction is true according to the text?

Addiction is characterized by a series of behaviors Signup and view all the answers

What is a common misconception about tolerant patients?

Tolerant patients are often mistaken for addicted patients Signup and view all the answers

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 Signup and view all the answers

Which of the following screening tools should NOT be used to assess for potential opioid misuse problems?

PHQ-9 Signup and view all the answers

What percentage of patients taking opioids for chronic pain are estimated to not pose problems and be compliant with their treatment plan?

80% Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

Which of the following behaviors is NOT commonly associated with addiction?

Stockpiling medications as an insurance against pain Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

How should the nurse practitioner handle non-compliance with the Patient-Provider Agreement (PPA)?

Document an explanation and mitigation strategy for the non-compliance Signup and view all the answers

What should be done regarding informed consent for opioid treatment?

Each opioid should have its own informed consent Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

Which of the following statements about pseudo-addiction is true?

Pseudo-addictive behaviors are related to a fear of being in pain Signup and view all the answers

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 Signup and view all the answers