ALL QUESTIONS AND ANSWERS SURE A+
✔✔Because buprenorphine is a mu opioid-receptor partial agonist it is not abusable
unless combined with another central nervous system depressant.
A. True
B. False - ✔✔E. A, B, C and D
✔✔A patient gives a history of 3 years of daily opioid misuse and asks to be started on
buprenorphine. Which of the following should be completed as part of the determination
regarding whether to prescribe this medication:
A. Medical, psychiatric and substance abuse history
B. Urine toxicology screen
C. Physical examination
D. Check state prescription drug monitoring program if available
E. A, B, C and D - ✔✔B. Assure the patient your objective is concern for his/her health
✔✔The goals of buprenorphine maintenance treatment include:
A. Discontinued or markedly reduced use of other opioids
B. Persistent craving
C. Persistent withdrawal symptoms
D. The expectation of sedation - ✔✔A. Discontinued or markedly reduced use of other
opioids
, ✔✔A patient in your treatment program, who has been doing very well for months,
provides a urine that is below body temperature. You suspect this is a tampered urine.
Which of the following is the best response when meeting with the patient?
A. Assume that there is a logical explanation for the cold temperature and accept the
urine. The patient has been very stable and will let you know if they relapsed.
B. Inform patient "Your urine is cold so I cannot accept it today. Tampering with urine
screens is a violation of our treatment agreement. Per protocol, you will be discharged
from the program, but are welcome back after completing detox."
C. Inform patient "The urine you provided today is below body temp. I am concerned
that this is a tampered urine. I will need another urine sample today, but I hope you
know that if you are struggling, it is better to let your treatment team know so that we
can help you. So are ther - ✔✔C. Inform patient "The urine you provided today is below
body temp. I am concerned that this is a tampered urine. I will need another urine
sample today, but I hope you know that if you are struggling, it is better to let your
treatment team know so that we can help you. So are there any issues we need to
address? Any recent substance use?"
✔✔A patient with polysubstance dependence (including opioid addiction) and HCV
infection with mild fibrosis prescribed buprenorphine/naloxone is found non-responsive
and dies several hours after being brought to the ED. Blood levels of buprenorphine are
consistent with the prescribed dose. Which of the following is the most likely explanation
for the death:
A. Liver impairment resulted in buprenorphine accumulation
B. Illicit benzodiazepine use with buprenorphine/naloxone produced a toxic
pharmacodynamic drug-drug interaction
C. Buprenorphine-associated cardiac arrhythmia
D. Liver and renal impairment resulted in accumulation of buprenorphine metabolites
E. Acute liver failure related to buprenorphine/naloxone use - ✔✔
✔✔Patients with substance use disorder who undergo surgical procedures don't need
additional analgesics management when prescribed buprenorphine or methadone for
opioid use disorder.
A. True
B. False - ✔✔
✔✔In patients prescribed buprenorphine for opioid use disorder with acute pain, which
of the following statements is true?
A. Clinicians should avoid treating acute pain with opioids because it will lead to relapse
B. The acute pain is likely to be psychomatic and does not require treatment
C. Treating the acute pain with opioids does not increase the risk of relapse
D. Multimodal approaches have been shown to be ineffective. - ✔✔C. Treating the
acute pain with opioids does not increase the risk of relapse