A 54-Year-Old Man Comes to the Office for an Initial

question 109

Multiple Choice

A 54-year-old man comes to the office for an initial appointment to evaluate lower back pain.  The patient's medical record shows that he has seen several physicians for back pain treatment.  He has been prescribed multiple pain medications and physical rehabilitation services but often stopped prematurely or did not follow through with recommendations.  At the beginning of the visit the patient says, "I'm tired of living with back pain, and I haven't been able to work in years.  Nothing has helped me-at this point I might as well just give up and go on disability."  Which of the following statements is the most appropriate initial response to this patient?

• A)"Although previous medications have not worked, consultation with a pain specialist may be helpful."
• B)"I understand the difficulty of your situation, but applying for disability will not improve your back pain."
• C)"I understand your frustration, but it is difficult to help when you think nothing will work."
• D)"It must be frustrating to have chronic back pain and feel like there are no options to ease your suffering."
• E)"Your chances of improving would be better if you followed recommendations and remained in treatment."

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Definitions:

Mourning

The process and expression of grief following the death of a loved one, often including rituals and practices varying across cultures and religions.

Prescribed

Recommended or authorized by a medical professional or by law, often referring to medication or certain courses of action.

Culture

The accumulated habits, beliefs, customs, arts, and institutions shared by a group of people, which shape their collective identity and behavior.

Embalmed

The process of preserving a dead body to delay decomposition, typically involving the use of chemicals.