Sixty-six-year-old Mr. O’Day is visiting the office of his primary physician for an annual exam. During the assessment,

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Sixty-six-year-old Mr. O’Day is visiting the office of his
primary physician for an annual exam. During the assessment, the
nurse learns that Mr. O'Day has significant joint restrictions in
his lower extremities due to arthritis and the consequences of a
poorly healed fracture. When asked about related pain, Mr. O’Day
seems evasive and responds, “I manage it.” He is vague when the
nurse questions how he manages it. “I've got it under control,” he
states. The nurse steps outside the examining room to afford Mr.
O’Day privacy in undressing and is approached by Mrs. O’Day. “He's
probably not going to tell you,” his wife says, “but he has some
pretty bad pain in his hips and knees, and he deals with it by
buying marijuana and pain pills from some guys in the neighborhood.
Sometimes he is so doped up he can barely walk and talk.”
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