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Comprehensive Case Study: 54-Year-Old with Chronic Back Pain - Week 9 (iHuman, Walden University)
54-Year-Old with Back Pain: Complete Case Study Analysis - Week 9 iHuman Walden University
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In patients with chronic back pain, which of the following interventions has been shown to reduce pain and improve function?
Which of the following is a common side effect of using opioid medications for back pain? A) High-intensity exercise
A) Increased appetite B) Cognitive-behavioral therapy (CBT)
B) Drowsiness and constipation C) Complete bed rest
C) Decreased pain tolerance D) Exclusive use of narcotic medications
D) Improved mobility
Answer: B) Cognitive-behavioral therapy (CBT)
Answer: B) Drowsiness and constipation
71. When is a referral to a specialist (e.g., orthopedist or neurologist) most appropriate for a back pain patient?
62. What is the most effective non-pharmacological approach for managing chronic lower back pain? A) If there is no response to conservative treatments after 4-6 weeks
A) Corticosteroid injections B) If the patient requests it immediately
B) Chiropractic manipulation C) If the patient experiences mild discomfort after lifting
C) Physical therapy and exercise D) If the patient is under 40 years old
D) Acupuncture
Answer: A) If there is no response to conservative treatments after 4-6 weeks
Answer: C) Physical therapy and exercise
72. A lumbar spine X-ray might reveal which of the following conditions?
63. When should imaging studies like MRI be considered in a patient with back pain? A) Herniated disc
A) After 1-2 days of mild pain B) Spinal fractures or deformities
B) When there is a history of cancer or trauma, or if symptoms persist beyond 6 weeks C) Soft tissue injuries
C) Immediately after the first visit D) Nerve compression
D) Only if the patient insists on it
Answer: B) Spinal fractures or deformities
Answer: B) When there is a history of cancer or trauma, or if symptoms persist beyond 6 weeks
73. Which of the following is a characteristic of a "red flag" in back pain patients, suggesting a more serious underlying condition?
64. A positive "slump test" during a physical exam suggests: A) Pain that resolves with movement
A) Herniated disc B) Pain with a fever, weight loss, or a history of cancer
B) Sciatica or nerve root compression C) Mild, intermittent discomfort
C) Muscle strain D) Pain that improves with rest
D) Spinal stenosis
Answer: B) Pain with a fever, weight loss, or a history of cancer
Answer: B) Sciatica or nerve root compression
74. Which of the following is an appropriate physical therapy exercise for strengthening the lower back muscles?
65. What is the most appropriate initial treatment for a patient with acute lower back pain? A) Crunches
A) Immediate MRI B) Prone leg raises
B) Bed rest for two weeks C) High-impact running
C) Use of NSAIDs and gentle movement D) Push-ups
D) Spinal fusion surgery
Answer: B) Prone leg raises
Answer: C) Use of NSAIDs and gentle movement
75. What is a potential complication of untreated severe back pain that leads to nerve compression?
66. What is the main goal of using muscle relaxants in the treatment of back pain? A) Loss of bladder control and leg weakness
A) To decrease inflammation B) Decreased appetite
B) To increase muscle flexibility C) Excessive sweating
C) To reduce muscle spasms D) Increased muscle strength
D) To improve sleep quality
Answer: A) Loss of bladder control and leg weakness
Answer: C) To reduce muscle spasms
76. Which of the following treatment options is most commonly used to manage severe, persistent sciatica pain?
67. In a patient with chronic back pain, which of the following lifestyle changes can help manage symptoms? A) Acupuncture
A) Increase sedentary activities B) Oral corticosteroids
B) Quit smoking C) Bed rest for weeks
C) Avoid all forms of exercise D) Spinal cord stimulation
D) Take high-dose vitamins
Answer: B) Oral corticosteroids
Answer: B) Quit smoking
77. When considering surgical intervention for back pain, which of the following is a key indicator that surgery may be necessary?
68. Which of the following is the most common psychological factor contributing to chronic back pain? A) The patient is under 40 years old
A) Anxiety and depression B) The pain is unrelieved by conservative treatment and there is nerve compression
B) Hallucinations C) The pain is intermittent and mild
C) Excessive happiness D) The patient has a history of heart disease
D) Sleep apnea
Answer: B) The pain is unrelieved by conservative treatment and there is nerve compression
Answer: A) Anxiety and depression
78. Which of the following is a typical presentation of a herniated lumbar disc?
69. The patient with back pain also reports difficulty standing up after sitting for long periods. This symptom may be A)
indicative
Suddenof:
onset of high fever and chills
A) Spinal stenosis B) Pain radiating down the leg, numbness, and tingling
B) Disc herniation C) Pain that worsens with standing still
C) Osteoporosis D) Back pain that improves with rest
D) Degenerative disc disease
Answer: B) Pain radiating down the leg, numbness, and tingling
Answer: A) Spinal stenosis
79. What is the primary benefit of using heat therapy for back pain management?
A) To reduce inflammation
B) To relax tense muscles and improve blood flow
C) To cure the underlying condition
D) To strengthen the muscles

Answer: B) To relax tense muscles and improve blood flow

80. What is the most important advice for a patient with back pain about their posture when sitting for prolonged periods?
A) Always slouch to reduce strain
B) Sit with a straight back and feet flat on the floor
C) Cross legs frequently to reduce tension
D) Lean forward to support the lower back

Answer: B) Sit with a straight back and feet flat on the floor