# A client with chronic primary low back pain is developing a nonsurgical plan. For each finding or intervention, select the best classification. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=396150&lang=en > language: en > subject: Nonpharmacological Comfort > category: BCC ## Question A client with chronic primary low back pain is developing a nonsurgical plan. For each finding or intervention, select the best classification. | | Supported core care | Conditional adjunct after preference and risk review | Red flag requiring diagnostic reassessment | | --- | --- | --- | --- | | Use education and self-management goals with a graded exercise program matched to function and preferences | | | | | Add a psychological approach such as cognitive behavioral therapy when pain-related fear or coping limits activity | | | | | Consider spinal manipulative therapy only as part of a broader plan after discussing preferences and likely benefit | | | | | Consider a time-limited NSAID trial after reviewing gastrointestinal, renal, cardiovascular, and medication risks | | | | | New urinary retention with saddle sensory loss and rapidly progressive leg weakness | | | | | New fever, unexplained weight loss, night pain, and a history of cancer or recent serious infection | | | | ## Explanation Chronic primary low back pain care is person-centered and may combine education, self-care support, exercise, psychological approaches, selected physical therapies, and appropriate medicines after individual risk review. No single intervention is routinely sufficient. New bladder dysfunction, saddle sensory loss, progressive neurologic deficit, fever, cancer history, or systemic illness requires prompt reassessment for a secondary cause. ## In-depth explanation Correct Answer Two rows support core active care, two are conditional adjuncts requiring shared decision-making and risk review, and two are red flags requiring diagnostic reassessment. Why It Fits The item avoids an obvious “bad treatment” column and instead distinguishes current core care from optional adjuncts and a changed diagnostic pathway. Clinical Picture Education and exercise can be combined with psychological care. Manual therapy or an NSAID may fit selected clients, but contraindications, preferences, and response matter. Memory Link Active core, selective adjunct, red flag reroute. NCLEX Rule Chronic pain does not protect a client from developing a new serious cause of back pain. Why the Alternatives Fail Routine passive-only care is not the goal, but a potentially useful adjunct is not automatically wrong. Red flags should not be folded into the chronic-primary plan. Sources 1WHO Chronic Primary Low Back Pain Guideline 22026 NCLEX-RN Test Plan ## Clinical scenario Diagnostic evaluation has not identified a specific underlying disease. The nurse supports a person-centered biopsychosocial plan while continuing to recognize new findings that fall outside the chronic-primary pathway. ## Key concepts - **Chronic primary low back pain** — Pain lasting more than 3 months without a specific underlying disease or structural lesion that explains it. - **Red flag** — A finding that raises concern for a serious secondary cause and changes the diagnostic pathway. ## Related questions - [A 68-year-old client with end-stage pancreatic cancer is receiving morphine 4 mg IV every …](https://mymerci.kr/pages/nclex_q.php?qn_id=363265&lang=en) - [A nurse is caring for a 78-year-old client receiving comfort-focused end-of-life care. The…](https://mymerci.kr/pages/nclex_q.php?qn_id=364304&lang=en) - [A nurse is caring for an 84-year-old client with end-stage Alzheimer disease admitted to i…](https://mymerci.kr/pages/nclex_q.php?qn_id=368152&lang=en) - [A 58-year-old male is on postoperative day 1 following laparoscopic cholecystectomy. 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Which statement indicates correct un…](https://mymerci.kr/pages/nclex_q.php?qn_id=396628&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=396150&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=396150&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=396150&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=396150&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=396150&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._