A 59-Year-Old Woman Comes to the Office to Follow Up

question 58

Multiple Choice

A 59-year-old woman comes to the office to follow up for chronic back pain caused by a motor vehicle collision.  A month ago, the patient was given scheduled-dose oral morphine.  Her pain level has decreased from 8 to 3 on a scale of 0-10, and pain no longer interferes with activities of daily living.  There has been no drowsiness, constipation, or nausea.  Other medications include naproxen, acetaminophen, and a lidocaine patch as needed.  Temperature is 37 C (98.6 F) , blood pressure is 114/76 mm Hg, pulse is 64/min, and respirations are 12/min.  On examination, the back has greater range of motion than it did during the last visit.  Which of the following would be most helpful in the early detection of prescription opioid misuse in this patient?

• A)Assessing back range of motion at each visit
• B)Assessing pain level at each visit
• C)Monitoring vital signs at each visit
• D)Obtaining a scheduled urine drug screening at each visit
• E)Querying the prescription drug monitoring database at each visit

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Definitions:

P-chart

A type of control chart used in statistical quality control to monitor the proportion of defective items in a process over time.

Lower Control Limit

The lowest threshold in statistical quality control, below which a process is considered out of control.

P-chart

A statistical control chart for studying the proportion of defective units in a batch.

Percent Defective

The percentage of all units produced that fail to meet the required quality standards.