NR 547 Week 8: NR 547 Week 8 Practice Exam: Substance Abuse &
Addiction :100 Questions & Answers
(Holistic Foundations in Psychiatric Differential Diagnosis)
Section 1: General Definitions & Core Concepts
1. Which term describes a change in behavior caused by biochemical brain
changes, characterized by preoccupation with a substance despite
negative outcomes?
o A) Dependence
o B) Tolerance
o C) Addiction
o D) Intoxication
o Answer: C.
o Rationale: Addiction is a behavioral change resulting from
biochemical changes in the brain after continued use.
2. What occurs when a drug shows a decreased effect with repeated
ingestion, requiring higher doses to achieve the original effect?
o A) Tolerance
o B) Withdrawal
o C) Addiction
o D) Behavioral dependence
o Answer: A.
o Rationale: Tolerance is defined by the need for increasing doses to
achieve effects noted with original administration.
3. Physical symptoms that occur when a drug is discontinued abruptly after a
state of adaptation is known as:
, o A) Psychological dependence
o B) Physical dependence
o C) Intoxication
o D) Substance use disorder
o Answer: B.
o Rationale: Physical dependence is a state of adaptation where
physical symptoms occur upon abrupt discontinuation.
4. Substance Use Disorder (SUD) is defined as recurrent substance use
causing clinically significant impairment in which area?
o A) Health problems
o B) Disability
o C) Failure to meet responsibilities at home/work
o D) All of the above
o Answer: D.
o Rationale: SUD involves impairment across health, disability, and
major life responsibilities.
5. Which neurotransmitters are primarily related to the brain-reward
circuitry and the development of SUDs?
o A) Serotonin and Norepinephrine
o B) Opioid, catecholamine, and GABA
o C) Acetylcholine and Glutamate
o D) Histamine and Dopamine
o Answer: B.
o Rationale: The opioid, catecholamine, and y-aminobutyric acid
(GABA) neurotransmitters are central to brain-reward circuitry.
,Section 2: Clinical Medication Scenarios (MAT)
1. Bernita (64yo) has used heroin for 6 years, is unemployed, and has no
insurance. What is the most appropriate MAT given her flexibility for daily
attendance?
o A) Methadone
o B) Buprenorphine
o C) Naltrexone
o D) Naloxone
o Answer: A.
o Rationale: Methadone is a full mu-receptor agonist that prevents
withdrawal and is suitable for those who can attend daily federally
regulated programs.
2. Antoine (34yo) wants MAT for oxycodone abuse but is concerned about
roommates stealing his medication to get high. Which is the best option?
o A) Methadone
o B) Buprenorphine plus naloxone (Suboxone)
o C) Naltrexone
o D) Varenicline
o Answer: B.
o Rationale: Suboxone is less desirable as a "street drug" because the
naloxone component prevents rewarding effects if the drug is
injected.
3. Lisa (29yo) uses pills, heroin, and alcohol. She lives in a rural area and has
poor compliance history. What is the best long-acting option?
o A) Buprenorphine
, o B) Methadone
o C) Naltrexone (Vivitrol injection)
o D) Disulfiram
o Answer: C.
o Rationale: Monthly long-acting naltrexone (Vivitrol) is efficacious for
those with poor adherence and dual opioid/alcohol use.
4. Miranda (20yo) is 18 weeks pregnant and uses heroin. What is the
recommended MAT?
o A) Buprenorphine
o B) Buprenorphine/Naloxone
o C) Naltrexone
o D) Methadone
o Answer: A.
o Rationale: Buprenorphine is the recommended MAT for pregnant
women who use opioids.
5. A 56-year-old smoker with a history of seizure disorder wants to quit.
Which medication is contraindicated?
o A) Varenicline
o B) Nicotine gum
o C) Bupropion
o D) Naltrexone
o Answer: C.
o Rationale: Bupropion is contraindicated in clients with a seizure
disorder.
Addiction :100 Questions & Answers
(Holistic Foundations in Psychiatric Differential Diagnosis)
Section 1: General Definitions & Core Concepts
1. Which term describes a change in behavior caused by biochemical brain
changes, characterized by preoccupation with a substance despite
negative outcomes?
o A) Dependence
o B) Tolerance
o C) Addiction
o D) Intoxication
o Answer: C.
o Rationale: Addiction is a behavioral change resulting from
biochemical changes in the brain after continued use.
2. What occurs when a drug shows a decreased effect with repeated
ingestion, requiring higher doses to achieve the original effect?
o A) Tolerance
o B) Withdrawal
o C) Addiction
o D) Behavioral dependence
o Answer: A.
o Rationale: Tolerance is defined by the need for increasing doses to
achieve effects noted with original administration.
3. Physical symptoms that occur when a drug is discontinued abruptly after a
state of adaptation is known as:
, o A) Psychological dependence
o B) Physical dependence
o C) Intoxication
o D) Substance use disorder
o Answer: B.
o Rationale: Physical dependence is a state of adaptation where
physical symptoms occur upon abrupt discontinuation.
4. Substance Use Disorder (SUD) is defined as recurrent substance use
causing clinically significant impairment in which area?
o A) Health problems
o B) Disability
o C) Failure to meet responsibilities at home/work
o D) All of the above
o Answer: D.
o Rationale: SUD involves impairment across health, disability, and
major life responsibilities.
5. Which neurotransmitters are primarily related to the brain-reward
circuitry and the development of SUDs?
o A) Serotonin and Norepinephrine
o B) Opioid, catecholamine, and GABA
o C) Acetylcholine and Glutamate
o D) Histamine and Dopamine
o Answer: B.
o Rationale: The opioid, catecholamine, and y-aminobutyric acid
(GABA) neurotransmitters are central to brain-reward circuitry.
,Section 2: Clinical Medication Scenarios (MAT)
1. Bernita (64yo) has used heroin for 6 years, is unemployed, and has no
insurance. What is the most appropriate MAT given her flexibility for daily
attendance?
o A) Methadone
o B) Buprenorphine
o C) Naltrexone
o D) Naloxone
o Answer: A.
o Rationale: Methadone is a full mu-receptor agonist that prevents
withdrawal and is suitable for those who can attend daily federally
regulated programs.
2. Antoine (34yo) wants MAT for oxycodone abuse but is concerned about
roommates stealing his medication to get high. Which is the best option?
o A) Methadone
o B) Buprenorphine plus naloxone (Suboxone)
o C) Naltrexone
o D) Varenicline
o Answer: B.
o Rationale: Suboxone is less desirable as a "street drug" because the
naloxone component prevents rewarding effects if the drug is
injected.
3. Lisa (29yo) uses pills, heroin, and alcohol. She lives in a rural area and has
poor compliance history. What is the best long-acting option?
o A) Buprenorphine
, o B) Methadone
o C) Naltrexone (Vivitrol injection)
o D) Disulfiram
o Answer: C.
o Rationale: Monthly long-acting naltrexone (Vivitrol) is efficacious for
those with poor adherence and dual opioid/alcohol use.
4. Miranda (20yo) is 18 weeks pregnant and uses heroin. What is the
recommended MAT?
o A) Buprenorphine
o B) Buprenorphine/Naloxone
o C) Naltrexone
o D) Methadone
o Answer: A.
o Rationale: Buprenorphine is the recommended MAT for pregnant
women who use opioids.
5. A 56-year-old smoker with a history of seizure disorder wants to quit.
Which medication is contraindicated?
o A) Varenicline
o B) Nicotine gum
o C) Bupropion
o D) Naltrexone
o Answer: C.
o Rationale: Bupropion is contraindicated in clients with a seizure
disorder.
