LATEST STUDY GUIDE QUESTIONS WITH
CORRECT ANSWERS LATEST EDITION
1. A 30-year-old male who was started on sertraline for
generalized anxiety disorder was also started on lorazepam 1
mg for sleep during the first 2 weeks as he was adjusting to the
medication. At the 2-week follow-up visit his psychiatrist
increased the sertraline, but the dose of lorazepam does not
seem to be helping with sleep and the patient is requesting a
higher dose. Which of the following best describes the patient’s
condition?
Tolerance
2. The clinical management of patients differs depending on the
substance-related syndrome exhibited. A patient with a history
of alcohol use disorder who presents for a monthly injection of
naltrexone is disinhibited, emotionally labile, inattentive, and
impulsive and is likely in which of the following phases?
Acute intoxication
3. Which pupillary changes would one expect to observe with
acute stimulant intoxication?
Dilated pupils
Stimulant intoxication is associated with pupillary dilation. Narcotic drugs
are associated with pupil constriction. Unequal pupil sizes (anisocoria)
are associated with both benign and life threatening emergencies.
4. Which of the following agents could cause a patient to
behave restlessly, agitated, grandiose, aggressive, and
emotionally labile?
Amphetemines
5. Jade is a 44 year old female who works second shift as an ICU
nurse. She decided to skip her daily 3 cups of coffee. She is
complaining of headache, fatigue, depressed mood, difficulty
concentrating and muscle pain. Which of the following is not
true regarding caffeine withdrawal?
Withdrawal headaches may last 3 months
Caffeine withdrawal does include Flu-like symptoms as listed in criterion
B of the DSM-5, along with headache, fatigue, depressed or irritable
mood and
, difficulty concentrating. Withdrawal headaches beyond 3-4 weeks of
caffeine abstinence would raise concern that the headaches have
other etiology.
6. Individuals with a history of prenatal alcohol exposure are at
increased risk for what disorder?
The risk for all of these disorders is increased.
Individuals with a history of prenatal alcohol exposure are at increased
risk for ADHD, bipolar, depressive disorders, ODD, conduct disorders,
alcohol use disorder and substance use disorders.
7. What would a COWS score of
16 indicate? Moderate Withdrawal
The COWS or Clinical Opiate Withdrawal Scale can range from 0 -
36+. A Score of 5 - 12 would be considered mild. A score of 13 - 24
would be considered moderate. A score of 25 - 36 would be
considered moderately severe and a score of more than 36 would
indicate severe withdrawal.
8. A patient who has been drinking a six-pack of beer each night
to relax after work has been having trouble staying asleep
through the night. When she wakes up at 2 a.m. she takes
diphenhydramine 25 mg to help her fall back asleep, but this
makes her sleep through the alarm clock and late for work. She
also reports having a headache through midmorning until she
gets her second cup of coffee. She thinks this is related to her
alcohol use and has unsuccessfully tried to cut down several
times in the past year. Which of the following disorders best
describes this patient’s condition?
Alcohol use disorder
9. A 49-year-old female is on Fentanyl patch at 25 mcg/hr. In
the last week the patient's valproate was increased from
750mg po BID to 1000mg po BID. In the last 4 days the
patient was placed on clarithromycin for strep throat and
started cepacol lozenges. This morning she was
resuscitated with Naloxone and she returned to baseline
mantation. Which medication likely contributed to her
unresponsive episode?
All of these contributed to this episode.