NR 547
Week 8 NR 547 Exam Questions And
Answers
Bernita is a 64-year-old who has been using heroin for 6 years. She is currently unemployed and lives
with her daughter in the city center. She does not have health insurance.
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Methadone
Methadone is a full μ-receptor agonist with a long half-life, which can prevent withdrawal symptoms for
24 hours and provide steady control of cravings throughout the day. It is only administered in
methadone federally regulated opioid treatment programs (OTP). Methadone clinics incorporate
psychosocial interventions and require daily attendance for the first several months, so this is a good
option for a client that has the flexibility to attend daily meetings. Use of methadone in MAT for opioid
use disorder helps extend client survival. When patients stop methadone, they have a high likelihood of
relapsing, even 10 years after starting treatment.
Antoine is a 34-year-old who has been abusing prescription oxycodone. He is employed but is on
probation at work for increased absenteeism. He desires MAT but is concerned about his roommates
stealing his medication to get high.
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Buprenorphine plus naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is a mu opioid receptor antagonist and can
therefore block the effects of buprenorphine; however, because naloxone has poor sublingual
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bioavailability, it does not interfere with buprenorphine's effects when used properly. Naloxone does
have good parenteral bioavailability; thus, if one tries to administer the buprenorphine/naloxone
formulation intravenously, naloxone will prevent any rewarding effects from buprenorphine, making
this drug a less desirable street drug. Suboxone is a good option for a client who may not be able to
leave work for medication dosing, as it does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin, and booze" regularly. She lives in a rural area and
is employed part-time. She has a history of poor compliance with past treatments.
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Naltrexone
Naltrexone blocks mu opioid receptors, preventing exogenous opioids from binding there and thus
preventing the pleasurable effects of opioid consumption. This medication also reduces alcohol
consumption through modulation of opioid systems, thereby reducing the reinforcing effects of alcohol.
For those patients with alcohol use disorder, who have poor adherence to a regimen, and are unable to
maintain abstinence, long-acting injection naltrexone (Vivitrol) administered monthly can be efficacious.
Miranda is a 20-year-old who is 18 weeks pregnant and uses heroin. She wants to get clean "for her
baby."
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Buprenorphine
Buprenorphine is a partial opioid agonist which binds with strong affinity to the mu opioid receptor,
preventing exogenous opioids from binding at the receptor site, preventing the pleasurable effects of
opioid consumption. Buprenorphine is the recommended MAT for pregnant women who use opioids.
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, NR 547
Juan is a 19-year-old who has a history of using oxycodone that he has taken from his grandfather and
drinking occasional alcohol. He wants to stop using both substances.
Prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - ANS ✔✔ - Naltrexone
Naltrexone is a good option for clients who use opioids and alcohol and are committed to abstinence.
Nori is a 24-year-old who has a history of abusing opioid medications and binge drinking. She is not
committed to abstain from using at this time.
Prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - ANS ✔✔ - Naloxone
Since Nori is not committed to abstaining at this time, it is important to provide naloxone along with
education to help her remain safe from overdose.
3
Week 8 NR 547 Exam Questions And
Answers
Bernita is a 64-year-old who has been using heroin for 6 years. She is currently unemployed and lives
with her daughter in the city center. She does not have health insurance.
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Methadone
Methadone is a full μ-receptor agonist with a long half-life, which can prevent withdrawal symptoms for
24 hours and provide steady control of cravings throughout the day. It is only administered in
methadone federally regulated opioid treatment programs (OTP). Methadone clinics incorporate
psychosocial interventions and require daily attendance for the first several months, so this is a good
option for a client that has the flexibility to attend daily meetings. Use of methadone in MAT for opioid
use disorder helps extend client survival. When patients stop methadone, they have a high likelihood of
relapsing, even 10 years after starting treatment.
Antoine is a 34-year-old who has been abusing prescription oxycodone. He is employed but is on
probation at work for increased absenteeism. He desires MAT but is concerned about his roommates
stealing his medication to get high.
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Buprenorphine plus naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is a mu opioid receptor antagonist and can
therefore block the effects of buprenorphine; however, because naloxone has poor sublingual
1
, NR 547
bioavailability, it does not interfere with buprenorphine's effects when used properly. Naloxone does
have good parenteral bioavailability; thus, if one tries to administer the buprenorphine/naloxone
formulation intravenously, naloxone will prevent any rewarding effects from buprenorphine, making
this drug a less desirable street drug. Suboxone is a good option for a client who may not be able to
leave work for medication dosing, as it does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin, and booze" regularly. She lives in a rural area and
is employed part-time. She has a history of poor compliance with past treatments.
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Naltrexone
Naltrexone blocks mu opioid receptors, preventing exogenous opioids from binding there and thus
preventing the pleasurable effects of opioid consumption. This medication also reduces alcohol
consumption through modulation of opioid systems, thereby reducing the reinforcing effects of alcohol.
For those patients with alcohol use disorder, who have poor adherence to a regimen, and are unable to
maintain abstinence, long-acting injection naltrexone (Vivitrol) administered monthly can be efficacious.
Miranda is a 20-year-old who is 18 weeks pregnant and uses heroin. She wants to get clean "for her
baby."
Prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - ANS ✔✔ - Buprenorphine
Buprenorphine is a partial opioid agonist which binds with strong affinity to the mu opioid receptor,
preventing exogenous opioids from binding at the receptor site, preventing the pleasurable effects of
opioid consumption. Buprenorphine is the recommended MAT for pregnant women who use opioids.
2
, NR 547
Juan is a 19-year-old who has a history of using oxycodone that he has taken from his grandfather and
drinking occasional alcohol. He wants to stop using both substances.
Prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - ANS ✔✔ - Naltrexone
Naltrexone is a good option for clients who use opioids and alcohol and are committed to abstinence.
Nori is a 24-year-old who has a history of abusing opioid medications and binge drinking. She is not
committed to abstain from using at this time.
Prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
Methadone
Naloxone
Naltrexone
Varenicline - ANS ✔✔ - Naloxone
Since Nori is not committed to abstaining at this time, it is important to provide naloxone along with
education to help her remain safe from overdose.
3
