CARN 2025 Study Material –
Solved Questions and
Graded Answers.
Question 1:
A patient undergoing alcohol withdrawal is experiencing tremors, agitation, and diaphoresis.
What is the most appropriate first-line pharmacologic treatment for this condition?
A. Haloperidol
B. Lorazepam
C. Clonidine
D. Naloxone
Answer: B. Lorazepam
Rationale: Benzodiazepines like lorazepam are the first-line treatment for alcohol withdrawal
symptoms because they help prevent seizures and reduce agitation. Haloperidol is used for
psychotic symptoms but is not a primary treatment for withdrawal. Clonidine may alleviate
autonomic symptoms but does not address the risk of seizures. Naloxone is for opioid overdose,
not alcohol withdrawal.
Question 2:
Which of the following is a priority nursing intervention for a patient receiving methadone
maintenance therapy?
A. Encouraging the patient to stop methadone immediately to prevent dependence.
B. Monitoring the patient for signs of respiratory depression.
C. Providing a high-protein diet to improve metabolism of methadone.
D. Administering naloxone in case of overdose.
Answer: B. Monitoring the patient for signs of respiratory depression.
Rationale: Methadone, a long-acting opioid, can cause respiratory depression, especially at
,higher doses. Gradual tapering is preferred for discontinuation. Diet has minimal effect on
methadone metabolism, and naloxone is used in emergencies, not routinely.
Question 3:
A patient is using buprenorphine/naloxone (Suboxone) for opioid use disorder. The nurse
understands that naloxone is included in this combination to:
A. Enhance the pain-relieving properties of buprenorphine.
B. Prevent withdrawal symptoms during detoxification.
C. Deter misuse by injection.
D. Increase the absorption of buprenorphine when taken orally.
Answer: C. Deter misuse by injection.
Rationale: Naloxone is included in Suboxone to prevent misuse by injection. When taken
sublingually as prescribed, naloxone has minimal bioavailability, but it induces withdrawal
symptoms if injected, deterring misuse.
Question 4:
A patient with a history of opioid use disorder is scheduled for surgery. The physician prescribes
a full opioid agonist for postoperative pain. The nurse recognizes that the patient is also taking
naltrexone. What is the nurse's priority action?
A. Administer the prescribed opioid as scheduled.
B. Consult the physician about discontinuing naltrexone before surgery.
C. Administer a higher dose of the opioid to overcome naltrexone's effects.
D. Substitute naltrexone with methadone temporarily.
Answer: B. Consult the physician about discontinuing naltrexone before surgery.
Rationale: Naltrexone is an opioid antagonist that blocks the effects of opioids, making them
ineffective for pain relief. Discontinuing naltrexone before surgery ensures effective pain
management with prescribed opioids.
Question 5:
A patient receiving treatment for stimulant use disorder complains of severe depression and
fatigue. Which medication might the provider consider for managing these symptoms?
A. Bupropion
B. Methadone
C. Acamprosate
D. Disulfiram
Answer: A. Bupropion
Rationale: Bupropion, an antidepressant, is effective in managing depression associated with
,stimulant use disorders. Methadone is for opioid use, acamprosate is for alcohol dependence,
and disulfiram is for alcohol use disorder.
Question 6:
A nurse is educating a patient on the side effects of disulfiram (Antabuse). Which statement by
the patient indicates a need for further teaching?
A. "I can use over-the-counter cough medicine if I get a cold."
B. "I need to avoid foods prepared with cooking wine."
C. "Even small amounts of alcohol can make me very sick."
D. "I should inform my dentist that I am taking disulfiram."
Answer: A. "I can use over-the-counter cough medicine if I get a cold."
Rationale: Many over-the-counter medications, including cough syrups, contain alcohol, which
can cause a severe reaction in patients taking disulfiram. This indicates the patient needs
further teaching about avoiding hidden sources of alcohol.
Question 7:
Which of the following is most indicative of opioid intoxication?
A. Restlessness, tachycardia, and elevated blood pressure.
B. Respiratory depression, pinpoint pupils, and decreased level of consciousness.
C. Agitation, dilated pupils, and hyperreflexia.
D. Nausea, vomiting, and abdominal cramps.
Answer: B. Respiratory depression, pinpoint pupils, and decreased level of consciousness.
Rationale: These are classic signs of opioid intoxication. Restlessness and tachycardia are
signs of withdrawal, agitation and dilated pupils are seen with stimulants, and nausea and
abdominal cramps are associated with withdrawal.
Question 8:
A patient with a history of opioid use disorder is prescribed naltrexone. The nurse knows that
the patient must:
A. Start naltrexone while still using opioids to avoid withdrawal symptoms.
B. Be opioid-free for 7-10 days before starting naltrexone.
C. Combine naltrexone with methadone for the best outcomes.
D. Take naltrexone only when craving opioids.
Answer: B. Be opioid-free for 7-10 days before starting naltrexone.
Rationale: Starting naltrexone while opioids are still in the system can precipitate acute
withdrawal symptoms. It should only be started once the patient has been opioid-free for an
adequate duration.
, Question 9:
The nurse is providing care for a patient with benzodiazepine dependence. What is the safest
approach for discontinuing the medication?
A. Abruptly stopping the medication and monitoring withdrawal symptoms.
B. Gradually tapering the dose over weeks or months.
C. Replacing benzodiazepines with over-the-counter sedatives.
D. Administering flumazenil to reverse dependence.
Answer: B. Gradually tapering the dose over weeks or months.
Rationale: Gradual tapering minimizes the risk of severe withdrawal symptoms such as
seizures. Abrupt discontinuation can lead to life-threatening complications. Flumazenil is used
for overdose, not long-term dependence treatment.
Question 10:
A patient in recovery from alcohol use disorder is prescribed acamprosate. The nurse explains
that this medication works by:
A. Blocking the euphoric effects of alcohol.
B. Reducing alcohol cravings and preventing relapse.
C. Causing an aversive reaction when alcohol is consumed.
D. Treating withdrawal symptoms in the acute phase.
Answer: B. Reducing alcohol cravings and preventing relapse.
Rationale: Acamprosate helps maintain abstinence by reducing cravings and restoring
neurotransmitter balance. It does not block euphoria (like naltrexone), cause an aversive
reaction (like disulfiram), or treat withdrawal symptoms.
Question 11:
A patient with a history of stimulant use disorder presents with chest pain and tachycardia. What
is the priority intervention?
A. Administer naloxone.
B. Monitor vital signs and obtain an ECG.
C. Provide the patient with benzodiazepines.
D. Initiate a clonidine patch for hypertension.
Answer: B. Monitor vital signs and obtain an ECG.
Rationale: Chest pain and tachycardia in a patient with stimulant use disorder could indicate
cardiac complications such as arrhythmias or myocardial infarction. Monitoring and an ECG are
critical to determine the appropriate treatment.
Solved Questions and
Graded Answers.
Question 1:
A patient undergoing alcohol withdrawal is experiencing tremors, agitation, and diaphoresis.
What is the most appropriate first-line pharmacologic treatment for this condition?
A. Haloperidol
B. Lorazepam
C. Clonidine
D. Naloxone
Answer: B. Lorazepam
Rationale: Benzodiazepines like lorazepam are the first-line treatment for alcohol withdrawal
symptoms because they help prevent seizures and reduce agitation. Haloperidol is used for
psychotic symptoms but is not a primary treatment for withdrawal. Clonidine may alleviate
autonomic symptoms but does not address the risk of seizures. Naloxone is for opioid overdose,
not alcohol withdrawal.
Question 2:
Which of the following is a priority nursing intervention for a patient receiving methadone
maintenance therapy?
A. Encouraging the patient to stop methadone immediately to prevent dependence.
B. Monitoring the patient for signs of respiratory depression.
C. Providing a high-protein diet to improve metabolism of methadone.
D. Administering naloxone in case of overdose.
Answer: B. Monitoring the patient for signs of respiratory depression.
Rationale: Methadone, a long-acting opioid, can cause respiratory depression, especially at
,higher doses. Gradual tapering is preferred for discontinuation. Diet has minimal effect on
methadone metabolism, and naloxone is used in emergencies, not routinely.
Question 3:
A patient is using buprenorphine/naloxone (Suboxone) for opioid use disorder. The nurse
understands that naloxone is included in this combination to:
A. Enhance the pain-relieving properties of buprenorphine.
B. Prevent withdrawal symptoms during detoxification.
C. Deter misuse by injection.
D. Increase the absorption of buprenorphine when taken orally.
Answer: C. Deter misuse by injection.
Rationale: Naloxone is included in Suboxone to prevent misuse by injection. When taken
sublingually as prescribed, naloxone has minimal bioavailability, but it induces withdrawal
symptoms if injected, deterring misuse.
Question 4:
A patient with a history of opioid use disorder is scheduled for surgery. The physician prescribes
a full opioid agonist for postoperative pain. The nurse recognizes that the patient is also taking
naltrexone. What is the nurse's priority action?
A. Administer the prescribed opioid as scheduled.
B. Consult the physician about discontinuing naltrexone before surgery.
C. Administer a higher dose of the opioid to overcome naltrexone's effects.
D. Substitute naltrexone with methadone temporarily.
Answer: B. Consult the physician about discontinuing naltrexone before surgery.
Rationale: Naltrexone is an opioid antagonist that blocks the effects of opioids, making them
ineffective for pain relief. Discontinuing naltrexone before surgery ensures effective pain
management with prescribed opioids.
Question 5:
A patient receiving treatment for stimulant use disorder complains of severe depression and
fatigue. Which medication might the provider consider for managing these symptoms?
A. Bupropion
B. Methadone
C. Acamprosate
D. Disulfiram
Answer: A. Bupropion
Rationale: Bupropion, an antidepressant, is effective in managing depression associated with
,stimulant use disorders. Methadone is for opioid use, acamprosate is for alcohol dependence,
and disulfiram is for alcohol use disorder.
Question 6:
A nurse is educating a patient on the side effects of disulfiram (Antabuse). Which statement by
the patient indicates a need for further teaching?
A. "I can use over-the-counter cough medicine if I get a cold."
B. "I need to avoid foods prepared with cooking wine."
C. "Even small amounts of alcohol can make me very sick."
D. "I should inform my dentist that I am taking disulfiram."
Answer: A. "I can use over-the-counter cough medicine if I get a cold."
Rationale: Many over-the-counter medications, including cough syrups, contain alcohol, which
can cause a severe reaction in patients taking disulfiram. This indicates the patient needs
further teaching about avoiding hidden sources of alcohol.
Question 7:
Which of the following is most indicative of opioid intoxication?
A. Restlessness, tachycardia, and elevated blood pressure.
B. Respiratory depression, pinpoint pupils, and decreased level of consciousness.
C. Agitation, dilated pupils, and hyperreflexia.
D. Nausea, vomiting, and abdominal cramps.
Answer: B. Respiratory depression, pinpoint pupils, and decreased level of consciousness.
Rationale: These are classic signs of opioid intoxication. Restlessness and tachycardia are
signs of withdrawal, agitation and dilated pupils are seen with stimulants, and nausea and
abdominal cramps are associated with withdrawal.
Question 8:
A patient with a history of opioid use disorder is prescribed naltrexone. The nurse knows that
the patient must:
A. Start naltrexone while still using opioids to avoid withdrawal symptoms.
B. Be opioid-free for 7-10 days before starting naltrexone.
C. Combine naltrexone with methadone for the best outcomes.
D. Take naltrexone only when craving opioids.
Answer: B. Be opioid-free for 7-10 days before starting naltrexone.
Rationale: Starting naltrexone while opioids are still in the system can precipitate acute
withdrawal symptoms. It should only be started once the patient has been opioid-free for an
adequate duration.
, Question 9:
The nurse is providing care for a patient with benzodiazepine dependence. What is the safest
approach for discontinuing the medication?
A. Abruptly stopping the medication and monitoring withdrawal symptoms.
B. Gradually tapering the dose over weeks or months.
C. Replacing benzodiazepines with over-the-counter sedatives.
D. Administering flumazenil to reverse dependence.
Answer: B. Gradually tapering the dose over weeks or months.
Rationale: Gradual tapering minimizes the risk of severe withdrawal symptoms such as
seizures. Abrupt discontinuation can lead to life-threatening complications. Flumazenil is used
for overdose, not long-term dependence treatment.
Question 10:
A patient in recovery from alcohol use disorder is prescribed acamprosate. The nurse explains
that this medication works by:
A. Blocking the euphoric effects of alcohol.
B. Reducing alcohol cravings and preventing relapse.
C. Causing an aversive reaction when alcohol is consumed.
D. Treating withdrawal symptoms in the acute phase.
Answer: B. Reducing alcohol cravings and preventing relapse.
Rationale: Acamprosate helps maintain abstinence by reducing cravings and restoring
neurotransmitter balance. It does not block euphoria (like naltrexone), cause an aversive
reaction (like disulfiram), or treat withdrawal symptoms.
Question 11:
A patient with a history of stimulant use disorder presents with chest pain and tachycardia. What
is the priority intervention?
A. Administer naloxone.
B. Monitor vital signs and obtain an ECG.
C. Provide the patient with benzodiazepines.
D. Initiate a clonidine patch for hypertension.
Answer: B. Monitor vital signs and obtain an ECG.
Rationale: Chest pain and tachycardia in a patient with stimulant use disorder could indicate
cardiac complications such as arrhythmias or myocardial infarction. Monitoring and an ECG are
critical to determine the appropriate treatment.
