NR546 WEEK 6 TEST YOUR KNOWLEDGE QUIZ COMPLETE
EXAM STUDY GUIDE WITH PRACTICE QUESTIONS AND
VERIFIED ANSWERS 2025–2026
Addiction is often driven by the client's attempts to: - correct answer -self-medicate an
underlying mental health disorder
adverse effects associated with the acute use of opioids: - correct answer --Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation
Opioid medication: Morphine - correct answer --Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending pain pathways, altering the
perception & response to pain
-also produces CNS depression and potentially respiratory depression
*may be life-threatening, especially if utilized with benzodiazepines, CNS depressants, or
alcohol
onset of action:
-immediate release formulation is patient-dependent, with variable absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin) and extended-release morphine
(Avinza).
,Opioid medication: Fentanyl - correct answer --has an almost immediate onset of action when
given IV, with a duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine or hydromorphone and in those
with severe hepatic and renal disease
-same indications as morphine and is also used frequently in procedural sedation and general
anesthesia
-Conversion between fentanyl products is NOT mcg for mcg
Opioid medication: Hydromorphone - correct answer --Similar opioid agonist as morphine but
more potent
-Oral and parenteral doses are not equivalent (parenteral doses up to 5 times more potent)
Opioid medication: Meperidine - correct answer --No longer recommended as an analgesic,
and not widely available.
-Has numerous concerning adverse effects such as seizures and delirium.
Opioid medication: Methadone - correct answer --Utilized in detoxification and maintenance
treatment of opioid addiction and heroin addiction, with high variability among patients
-long acting opioid that binds to and occupies mu-opioid receptors, reducing craving for opioids
and prevents withdrawal symptoms for 24 hours
-potential for abuse, only licensed opioid treatment programs or licensed inpatient hospital
units permitted to order and dispense this medication
-potential for life threatening respiratory depression and QT prolongation
-Equianalgesic conversion ratios between methadone and other opioids are individually
variable, with deaths occurring during conversion from chronic high dose opiate history or
opioid abuse to methadone
-Discontinuation requires a wean to avoid withdrawal
, -pregnant, a risk benefit ratio is necessary as fetal outcomes are improved as compared to illicit
drug use, however can have decreased birth weight, length, head circumference and fetal
growth
Opioid medication: Ketamine - correct answer --Medication useful in general anesthesia and
procedural sedation
-off label usage as infusions for acute pain, as both a stand-alone treatment, as an adjunctive
option with opioids, as well as an intranasal formulation.
Opioid medication: Tramadol - correct answer --Opioid agonist, with similar indications and side
effect profile as other opioids, but that also blocks reuptake of serotonin and norepinephrine.
-Indicated for acute pain management, with added benefit for patients with neuropathic pain
and nociceptive pain.
-Has a lower risk of constipation and dependence than other opioids, but does have risk of
serotonin syndrome.
Opioid medication: Naloxone - correct answer --pure antagonist, with clinical indication for
treatment of acute opioid overdose.
-IV naloxone can dramatically reverse opioids, even in comatose states
-recent widespread community availability of intramuscular and intranasal administration
options available given the prescription and recreational opiate crisis, and related deaths. -
Given the short duration of action, patients can relapse into coma or previous overdose state,
and may need continued monitoring and potentially further doses or constant infusion.
Opioid medication: Clonidine - correct answer --antihypertensive agent, and Alpha2-Adrenergic
Agonist
-off-label adjunctive treatment for medically supervised opioid withdrawal.
-Initial treatment is 0.1mg-0.2mg, with ability to repeat up to 4 doses until symptoms resolve,
while assuring stability of blood pressure and heart rate.
-Maintenance would be determined by severity of symptoms, with treatment every 6-8 hours.
EXAM STUDY GUIDE WITH PRACTICE QUESTIONS AND
VERIFIED ANSWERS 2025–2026
Addiction is often driven by the client's attempts to: - correct answer -self-medicate an
underlying mental health disorder
adverse effects associated with the acute use of opioids: - correct answer --Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation
Opioid medication: Morphine - correct answer --Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending pain pathways, altering the
perception & response to pain
-also produces CNS depression and potentially respiratory depression
*may be life-threatening, especially if utilized with benzodiazepines, CNS depressants, or
alcohol
onset of action:
-immediate release formulation is patient-dependent, with variable absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin) and extended-release morphine
(Avinza).
,Opioid medication: Fentanyl - correct answer --has an almost immediate onset of action when
given IV, with a duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine or hydromorphone and in those
with severe hepatic and renal disease
-same indications as morphine and is also used frequently in procedural sedation and general
anesthesia
-Conversion between fentanyl products is NOT mcg for mcg
Opioid medication: Hydromorphone - correct answer --Similar opioid agonist as morphine but
more potent
-Oral and parenteral doses are not equivalent (parenteral doses up to 5 times more potent)
Opioid medication: Meperidine - correct answer --No longer recommended as an analgesic,
and not widely available.
-Has numerous concerning adverse effects such as seizures and delirium.
Opioid medication: Methadone - correct answer --Utilized in detoxification and maintenance
treatment of opioid addiction and heroin addiction, with high variability among patients
-long acting opioid that binds to and occupies mu-opioid receptors, reducing craving for opioids
and prevents withdrawal symptoms for 24 hours
-potential for abuse, only licensed opioid treatment programs or licensed inpatient hospital
units permitted to order and dispense this medication
-potential for life threatening respiratory depression and QT prolongation
-Equianalgesic conversion ratios between methadone and other opioids are individually
variable, with deaths occurring during conversion from chronic high dose opiate history or
opioid abuse to methadone
-Discontinuation requires a wean to avoid withdrawal
, -pregnant, a risk benefit ratio is necessary as fetal outcomes are improved as compared to illicit
drug use, however can have decreased birth weight, length, head circumference and fetal
growth
Opioid medication: Ketamine - correct answer --Medication useful in general anesthesia and
procedural sedation
-off label usage as infusions for acute pain, as both a stand-alone treatment, as an adjunctive
option with opioids, as well as an intranasal formulation.
Opioid medication: Tramadol - correct answer --Opioid agonist, with similar indications and side
effect profile as other opioids, but that also blocks reuptake of serotonin and norepinephrine.
-Indicated for acute pain management, with added benefit for patients with neuropathic pain
and nociceptive pain.
-Has a lower risk of constipation and dependence than other opioids, but does have risk of
serotonin syndrome.
Opioid medication: Naloxone - correct answer --pure antagonist, with clinical indication for
treatment of acute opioid overdose.
-IV naloxone can dramatically reverse opioids, even in comatose states
-recent widespread community availability of intramuscular and intranasal administration
options available given the prescription and recreational opiate crisis, and related deaths. -
Given the short duration of action, patients can relapse into coma or previous overdose state,
and may need continued monitoring and potentially further doses or constant infusion.
Opioid medication: Clonidine - correct answer --antihypertensive agent, and Alpha2-Adrenergic
Agonist
-off-label adjunctive treatment for medically supervised opioid withdrawal.
-Initial treatment is 0.1mg-0.2mg, with ability to repeat up to 4 doses until symptoms resolve,
while assuring stability of blood pressure and heart rate.
-Maintenance would be determined by severity of symptoms, with treatment every 6-8 hours.
