A nurse is caring for four patients. The nurse would be concerned about which patient develop-ing a substance use disorder?
a. A college student who reports having ex-perimented with marijuana in the past year
b. An older adult patient with terminal can-cer who requires twice the normal dose of morphine for pain relief
c. A patient in moderate to severe pain after a total hip replacement who asks for pain medication an hour before the next dose is due
d. A patient whose history indicates the use of prescription narcotic analgesics for back and headache pain
D
Patients who use narcotics for minor pains are more likely to be compulsive drug seekers. A col-lege student who experiments with an illegal substance is not necessarily going to develop a sub-stance use disorder. An elderly patient with terminal cancer pain has most likely developed physical dependence and tolerance to morphine but is not a substance abuser. Patients with sig-nificant pain who ask for more frequent dosing are not showing substance use disorder.
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