NR 565 - advanced pharmacology midterm – Chamberlain Real Exam Questions & Verified Answers - Pass First Attempt Guaranteed

Topic: Opioid Agonist-Antagonists — Do opioid agonist-antagonists have high or low potential for abuse? A) High potential for abuse, similar to full opioid agonists B) Low potential for abuse when compared with opioid agonists C) No potential for abuse D) Variable potential depending on route of administration Correct Answer: B Rationale: Opioid agonist-antagonists (such as buprenorphine and pentazocine) have a lower potential for abuse compared to full opioid agonists due to their partial agonist activity and ceiling effect. Question 2 Topic: Buprenorphine — If you switch a patient from oxycodone to buprenorphine quickly, what may we expect to see? A) Enhanced analgesic effect B) No change in symptoms C) Precipitated withdrawal D) Increased sedation Correct Answer: C Rationale: Buprenorphine is a partial agonist with high receptor affinity. If given to a patient physically dependent on a full agonist (like oxycodone), it can displace the full agonist and precipitate acute withdrawal symptoms. Question 3 Topic: Tramadol — What level of pain is tramadol approved for? A) Mild pain B) Moderate to moderately severe pain C) Severe pain only D) Chronic neuropathic pain only Correct Answer: B Rationale: Tramadol is indicated for the management of moderate to moderately severe pain. It is not typically used for severe pain, which may require stronger opioids. Question 4 Topic: Tramadol — What schedule is tramadol classified as? A) Schedule II B) Schedule III C) Schedule IV D) Schedule V Correct Answer: C Rationale: Tramadol is classified as a Schedule IV controlled substance due to its lower potential for abuse compared to Schedule II and III opioids. Question 5 Topic: Tramadol — What population should tramadol be AVOIDED in? A) Patients with hypertension B) Patients with epilepsy, neurologic disorders, and elderly C) Patients with diabetes D) Patients with asthma Correct Answer: B Rationale: Tramadol lowers the seizure threshold and should be avoided in patients with epilepsy, neurologic disorders, and the elderly who are at increased risk for seizures and adverse effects. Question 6 Topic: Tramadol — What drugs should be avoided for patients taking tramadol? A) Antihypertensives B) CNS depressants, MAOIs, SSRIs, SNRIs, TCAs, triptans C) Antibiotics D) Antacids Correct Answer: B Rationale: Tramadol interacts with CNS depressants (increasing sedation), MAOIs (risk of serotonin syndrome), SSRIs/SNRIs/TCAs/triptans (risk of serotonin syndrome and seizures). Question 7 Topic: Opioid Crisis — What government branch declared the opioid crisis a public health emergency? A) Centers for Disease Control (CDC) B) Food and Drug Administration (FDA) C) Health and Human Services (HHS) D) Drug Enforcement Administration (DEA) Correct Answer: C Rationale: The Department of Health and Human Services (HHS) declared the opioid crisis a public health emergency, leading to coordinated federal efforts to address the epidemic. Question 8 Topic: HHS Priorities — What are the top 5 priorities of HHS regarding the opioid crisis? (Select All That Apply) A) Improving access to treatment and recovery services B) Promoting use of overdose-reversing drugs C) Legalizing all opioids for recreational use D) Strengthening understanding through better public health surveillance E) Providing support for cutting-edge research on pain and addiction F) Advancing better practices for pain management Correct Answers: A, B, D, E, and F Rationale: The five priorities are: improving treatment access, promoting overdose-reversing drugs, strengthening surveillance, supporting research, and advancing pain management practices. Legalization is not a priority. Question 9 Topic: Opioid Prescribing Guidelines — What provisions were made to the guidelines for prescribing opioids to non-cancer patients? (Select All That Apply) A) Using opioids only after non-opioid analgesics or conservative methods have failed B) Discussing benefits and risks for long-term opioids with patient C) Using multiple prescribers and pharmacies to prevent diversion D) Ensuring comprehensive follow-up to assess efficacy and monitor for abuse E) Stopping opioids after opioid rotation produces inadequate benefits F) Fully documenting the entire process Correct Answers: A, B, D, E, and F Rationale: Guidelines recommend one prescriber and one pharmacy, not multiple. All other options are correct provisions for responsible opioid prescribing. Question 10 Topic: Opioid Initiation — When prescribing opioids, should a patient be initially started on IR or ER? A) Extended-release (ER) for steady pain control B) Immediate-release (IR) at the lowest dose for the shortest amount of time C) Either is acceptable D) Only non-opioid analgesics initially Correct Answer: B Rationale: Guidelines recommend starting with immediate-release opioids at the lowest effective dose for the shortest duration to minimize risk of dependence and adverse effects. Question 11 Topic: Opioid Exposure — How are patients initially exposed to opioids? A) Only through recreational use B) Either recreationally (illicitly) or in the context of pain management in a medical setting C) Only through prescription from providers D) Only through emergency department visits Correct Answer: B Rationale: Patients may be initially exposed to opioids either through recreational use or through legitimate medical prescribing for pain management. Question 12 Topic: Opioid Abuse Risk — Which group of professionals are at greater risk for abusing opioids? A) Teachers B) Healthcare providers, nurses, pharmacists C) Lawyers D) Construction workers Correct Answer: B Rationale: Healthcare professionals, including nurses and pharmacists, have greater access to opioids and are at higher risk for substance abuse due to availability and occupational stress. Question 13 Topic: Opioid Tolerance — What are some effects of opioid use that do NOT change with longterm use and tolerance? A) Euphoria and respiratory depression B) Nausea and sedation C) Constipation and miosis (pupil constriction) D) Analgesia and cough suppression Correct Answer: C Rationale: Constipation and miosis (pupil constriction) do not develop tolerance and persist with long-term opioid use. Euphoria, respiratory depression, and nausea do develop tolerance. Question 14 Topic: Opioid Tolerance — Tolerance does develop to which opioid effects? (Select All That Apply) A) Euphoria B) Respiratory depression C) Nausea D) Constipation E) Miosis Correct Answers: A, B, and C Rationale: Tolerance develops to euphoria, respiratory depression, and nausea. Tolerance does NOT develop to constipation and miosis. Question 15 Topic: Opioid Withdrawal — Is opioid withdrawal life-threatening? A) Yes, it is often fatal B) Unpleasant but rarely dangerous C) Only dangerous in elderly patients D) Always requires hospitalization Correct Answer: B Rationale: Opioid withdrawal is extremely unpleasant but rarely dangerous or life-threatening, unlike alcohol or benzodiazepine withdrawal which can be fatal. Question 16 Topic: Methadone — Methadone can be used for which two therapies? A) Maintenance and suppressive therapy B) Acute pain and chronic pain C) Sedation and anesthesia D) Cough suppression and diarrhea Correct Answer: A Rationale: Methadone is used for maintenance therapy (transferring addicts to oral methadone) and suppressive therapy (preventing reinforcing effects of opioid-induced euphoria). Question 17 Topic: Methadone — Methadone half-life is: A) Short B) Moderate C) Long D) Variable Correct Answer: C Rationale: Methadone has a long half-life and can only be prescribed by providers with special training in pain management and substance use disorders. Question 18 Topic: Buprenorphine vs. Methadone — Does methadone or buprenorphine have a ceiling effect for respiratory depression? A) Methadone B) Buprenorphine C) Both have a ceiling effect D) Neither has a ceiling effect Correct Answer: B Rationale: Buprenorphine has a ceiling effect for respiratory depression, making it safer than methadone in terms of overdose risk. Question 19 Topic: Morphine — What are the therapeutic uses for morphine? (Select All That Apply) A) Pain management B) Sedation and euphoria C) Respiratory depression D) Cough suppression E) Suppress GI motility for severe diarrhea F) Reduce anxiety and sense of well-being Correct Answers: A, B, C, D, E, and F Rationale: Morphine has multiple therapeutic uses including pain management, sedation, euphoria, respiratory depression, cough suppression, reducing anxiety, and suppressing GI motility.