Guide Wilkes University Medication Classes +
150 Clinical Q&A | 2026/2027
1. A 45-year-old patient with chronic back pain has been on oxycodone (10 mg) every 6 hours
for 3 years. The patient reports needing to take extra doses to achieve the same pain relief. The
PMHNP recognizes this phenomenon as:
A. Addiction
B. Tolerance
C. Physical dependence
D. Pseudoaddiction
Correct Answer: B. Tolerance
Rationale: Tolerance is defined as the need for increasing doses of a substance to achieve the
same effect. It is a physiological adaptation that occurs with chronic opioid use. Addiction
involves compulsive use despite harm; physical dependence is characterized by withdrawal
symptoms upon cessation; pseudoaddiction refers to medication-seeking behavior due to
undertreated pain .
2. A patient with opioid use disorder is started on buprenorphine/naloxone (Suboxone). The
nurse explains that the naloxone component is included to:
A. Enhance the analgesic effect of buprenorphine
B. Prevent diversion and IV misuse
,C. Reduce the risk of respiratory depression
D. Increase the half-life of buprenorphine
Correct Answer: B. Prevent diversion and IV misuse
Rationale: Naloxone is added to buprenorphine to deter intravenous misuse. When taken
sublingually as prescribed, naloxone has poor bioavailability and does not precipitate
withdrawal. However, if the medication is crushed and injected, naloxone will precipitate acute
withdrawal .
3. Which of the following medications is a full opioid agonist used for the treatment of opioid
use disorder?
A. Buprenorphine
B. Naltrexone
C. Methadone
D. Naloxone
Correct Answer: C. Methadone
Rationale: Methadone is a full mu-opioid agonist used for opioid maintenance therapy.
Buprenorphine is a partial agonist, naltrexone is an antagonist, and naloxone is a short-acting
antagonist used for overdose reversal .
, 4. A patient with opioid use disorder is prescribed naltrexone. The PMHNP should ensure the
patient has been opioid-free for at least:
A. 1–2 days
B. 3–5 days
C. 7–10 days
D. 14–21 days
Correct Answer: C. 7–10 days
Rationale: Naltrexone is an opioid antagonist that will precipitate severe withdrawal if the
patient has any opioids in their system. Patients must be opioid-free for 7–10 days before
starting naltrexone to avoid precipitated withdrawal .
5. A patient presents with pinpoint pupils, respiratory depression, and altered mental status.
The PMHNP suspects opioid overdose. Which medication should be administered?
A. Naltrexone
B. Naloxone
C. Buprenorphine
D. Methadone
Correct Answer: B. Naloxone