| Course | PA 650 Capstone Project |
|---|---|
| Week | 7 |
| Paper type | Clinical recommendation |
| Length | About 500 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 650 Week 7
Bedside Recommendation Statement: Prescribe Naproxen Without an Added Muscle Relaxant for Adults 18 to 64 Discharged With Acute Nonradicular Low Back Pain, With Three Exceptions Each Carrying a Substitute
Student Name
Chamberlain University
PA 650: Capstone Project
Instructor Name
Month Day, Year
Bedside Recommendation Statement: Prescribe Naproxen Without an Added Muscle Relaxant for Adults 18 to 64 Discharged With Acute Nonradicular Low Back Pain, With Three Exceptions Each Carrying a Substitute
The Statement
"For adults 18 to 64 leaving the emergency department or an urgent care clinic with low back pain for two weeks or less, no trauma and no pain below the knee, prescribe naproxen, advise staying active and do not add a skeletal muscle relaxant."
A Verb Somebody Could Perform
"Prescribe," "advise" and "do not add" are things a clinician does at discharge. The statement does not say "consider" or "may be appropriate," which nobody can check.
Exceptions, Each With a Substitute
1. Cannot take an NSAID, for example because of kidney disease or a past gastrointestinal bleed: substitute acetaminophen and heat, and still do not add a muscle relaxant routinely.
2. Pain severe enough that the patient cannot walk to the exit: reassess for red flags before discharge; if none, discharge on naproxen with a follow-up call in 48 hours rather than adding a drug.
3. Pain that prevents sleep despite naproxen, in a patient who does not drive or operate machinery the next day: a single bedtime dose of a non-benzodiazepine muscle relaxant for no more than three nights may be offered after discussing the uncertain benefit and the sedation.
Each exception names what to do instead, so a clinician meeting an exception is not left with a blank. The substitutes were chosen because they carry no extra sedation and do not require a new prescription with uncertain benefit.
Strength Tied to Named Rows
The main statement rests on the three emergency department trials that found no added benefit in function at one week (Friedman et al., 2015; Friedman et al., 2017; Friedman et al., 2018). Exception 3 rests on the review's small, very low certainty pain benefit and its higher adverse event rate (Cashin et al., 2021). The guideline does not contradict the statement; it allows an NSAID as the choice when medication is wanted (Qaseem et al., 2017).
Where It Stops
The statement does not cover adults 65 and older, people with sciatica, chronic back pain or patients already taking opioids or benzodiazepines. For those, the clinician uses judgment without this statement.
The statement also does not tell a clinician what to do when a patient asks for a muscle relaxant by name. That conversation is left to judgment, with the evidence summary available to share. The statement is written for the clinician at discharge and is short enough to fit in an order set comment or a department guideline line, where it can be found during a shift rather than in a project report.
References
Cashin, A. G., Folly, T., Bagg, M. K., Wewege, M. A., Jones, M. D., Ferraro, M. C., Leake, H. B., Rizzo, R. R. N., Schabrun, S. M., Gustin, S. M., Day, R., Williams, C. M., & McAuley, J. H. (2021). Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: Systematic review and meta-analysis. BMJ, 374, Article n1446. https://doi.org/10.1136/bmj.n1446
Friedman, B. W., Cisewski, D., Irizarry, E., Davitt, M., Solorzano, C., Nassery, A., Pearlman, S., White, D., & Gallagher, E. J. (2018). A randomized, double-blind, placebo-controlled trial of naproxen with or without orphenadrine or methocarbamol for acute low back pain. Annals of Emergency Medicine, 71(3), 348-356. https://doi.org/10.1016/j.annemergmed.2017.09.031
Friedman, B. W., Dym, A. A., Davitt, M., Holden, L., Solorzano, C., Esses, D., Bijur, P. E., & Gallagher, E. J. (2015). Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: A randomized clinical trial. JAMA, 314(15), 1572-1580. https://doi.org/10.1001/jama.2015.13043
Friedman, B. W., Irizarry, E., Solorzano, C., Khankel, N., Zapata, J., Zias, E., & Gallagher, E. J. (2017). Diazepam is no better than placebo when added to naproxen for acute low back pain. Annals of Emergency Medicine, 70(2), 169-176. https://doi.org/10.1016/j.annemergmed.2016.10.002
Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514-530. https://doi.org/10.7326/M16-2367
The Chamberlain PA 650 Week 7 instructions
The seventh week asks for a recommendation statement of a few sentences, and its shortness is the difficulty. It should contain a subject someone could point at, a verb they would recognize from a working day and your defined population named inside it. Avoid hedges such as "consider" that nobody can check. List exceptions, and give each one a substitute action rather than leaving a gap. Tie the strength of each part of the statement to specific rows of your evidence. Say where the statement stops: which patients or situations it does not cover. The statement is addressed to the clinician making the decision and does not replace the conclusion of the project. Cite the evidence each part rests on.
How this PA 650 Week 7 example is built
The statement is quoted in one sentence naming the population, the actions "prescribe," "advise" and "do not add," and the setting. A short section explains choosing verbs over hedges. Three exceptions follow with substitutes: NSAID contraindication leading to acetaminophen and heat, pain too severe to walk leading to red-flag reassessment and a 48-hour call, and sleep-limiting pain in a patient who will not drive leading to a bedtime non-benzodiazepine dose for up to three nights after discussion. The strength section ties the main statement to Friedman et al. (2015), Friedman et al. (2017) and Friedman et al. (2018), the sleep exception to Cashin et al. (2021) and notes that Qaseem et al. (2017) allows an NSAID as the medication choice. A final section excludes adults 65 and older, sciatica, chronic pain and patients on opioids or benzodiazepines.
Where the points sit in the PA 650 Week 7 rubric
Statements lose the most when they hedge, with "consider" or "may be appropriate," because nobody can tell whether they were followed. Next comes a statement that names a condition but not the defined population. Exceptions without substitutes leave the clinician with nothing to do and cost a defined share. Faculty reward one clear instruction, verbs a clinician performs and strength tied to named evidence rows. Saying where the statement stops earns credit. A recommendation stronger than the evidence is penalized, as is one weaker than it. Citation of each source behind each part, in APA form, completes the rubric.
Common PA 650 Week 7 mistakes, and how to avoid them
Recommendation statements most often go wrong by becoming a paragraph of background with the actual instruction buried in the middle. Another frequent problem is "consider a muscle relaxant on a case-by-case basis," which says nothing. Some statements also list exceptions without saying what to do instead. If your capstone reached a different conclusion, send your evidence table and balance; a statement written for you would name the population, use performable verbs, give exceptions with substitutes, tie each part to specific evidence and state where it stops. If your audience is a specific clinic, the statement would name its setting and staff roles.
Get a PA-650 Week 7 example written to your instructions
Send the Week 7 instructions plus the population and comparison you have been working with, and a custom bedside recommendation statement written to your rubric comes back inside 24-48h, the first one free. If your section wants the statement folded into a longer conclusion, say so and the sample arrives in that form.
More PA 650 papers and MPAS samples
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- PA 650 Week 6: Harm and Benefit Balance
- PA 650 Week 8: Clinical Poster Draft
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- PA 502 Week 7: Decision Aid Draft
- PA 503 Week 7: Verbal Case Summary
PA 650 Week 7 questions, answered
How strong is a recommendation allowed to be?
As strong as the table underneath it, and no stronger. Where the rows are thin, the honest statement says what to do and admits the ground is soft, which most rubrics reward more than confidence. What reads badly is either extreme: a hedged instruction nobody can act on, or a firm one resting on two small studies the project itself marked as distant from the population.
Who is the statement addressed to?
Name them. Providers should is the phrasing that empties the sentence, because nobody in a clinic answers to it. A statement addressed to the person who actually does the thing, in the setting the project described, can be held against a real working day, and that is what faculty are testing when they ask whether somebody could carry it out.
Does this replace the conclusion of the project?
Sections differ and several keep both, in which case the conclusion carries the reasoning and the statement carries the instruction. Where only one is required, write the instruction and let the preceding sections be the argument. The common mistake is producing two documents that recommend slightly different things, which a marker reading the project end to end finds without looking for it.
Where can I find a free PA 650 Week 7 sample paper?
The complete PA 650 Week 7 bedside recommendation on naproxen without an added muscle relaxant, with three exceptions and their substitutes, is on this page.
When does the PA 650 Week 7 sample allow a muscle relaxant?
For pain that prevents sleep despite naproxen, in a patient who will not drive or operate machinery the next day, as a bedtime dose for up to three nights.