CARN-AP EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
Opioid Use Disorders and Treatment
Alcohol Use Disorders and Withdrawal Management
Stimulant and Other Substance Use Disorders
Co-Occurring Psychiatric and Medical Conditions
Pharmacology and Psychotherapeutic Interventions
Screening, Assessment, and Diagnosis
Ethics, Legal Issues, and Professional Standards
Special Populations and Health Promotion
INTRODUCTION
The Certified Addiction Registered Nurse-Advanced Practice (CARN-AP) examination is a rigorous assessment designed
to validate the advanced knowledge and clinical judgment of APRNs specializing in addiction nursing. This exam
evaluates the candidate's ability to apply evidence-based practice, perform comprehensive biopsychosocial assessments,
diagnose substance use disorders, and develop individualized, culturally competent treatment plans. The examination is
composed of multiple-choice and scenario-based questions that challenge the nurse to integrate complex
pharmacological, psychotherapeutic, and ethical principles. Success on this exam requires not only memorization of
facts but the ability to synthesize information and make critical, real-world decisions. It is an essential step in
demonstrating proficiency and commitment to the highest standards of care in addiction medicine.
,Question 1
A 45-year-old patient with a history of chronic back pain and a current diagnosis of severe Opioid Use Disorder is
seeking treatment. Which of the following is the most appropriate first-line pharmacological intervention to
recommend for long-term management?
A. Naloxone as needed for cravings
B. Buprenorphine/naloxone maintenance therapy
C. Methadone administered on a weekly basis
D. Naltrexone daily
🟢 Correct Answer: B. Buprenorphine/naloxone maintenance therapy
🔴 Explanation: Buprenorphine/naloxone is a first-line, evidence-based medication for opioid use disorder (MOUD)
that can be prescribed in an office-based setting. It effectively reduces cravings and withdrawal symptoms. Naloxone
is for overdose reversal, methadone requires specialized clinics, and naltrexone requires complete detoxification first.
Question 2
A patient is admitted with symptoms of severe agitation, diaphoresis, tremors, and confusion. The patient's family
reports a history of heavy daily alcohol consumption. What is the priority nursing action?
A. Administer a dose of haloperidol to manage agitation
B. Implement seizure precautions and initiate a CIWA-Ar protocol
C. Restrict fluids to prevent overhydration
D. Administer IV dextrose for possible hypoglycemia
🟢 Correct Answer: B. Implement seizure precautions and initiate a CIWA-Ar protocol
🔴 Explanation: The patient is exhibiting signs of alcohol withdrawal, which can progress to life-threatening seizures
,and delirium tremens. The priority is to monitor withdrawal severity using the CIWA-Ar scale and provide
pharmacologic management, typically with benzodiazepines, to prevent complications .
Question 3
A 23-year-old patient presents with tachycardia, hypertension, and psychomotor agitation. Laboratory findings
indicate a recent use of cocaine. Which of the following is a critical assessment finding that suggests a life-
threatening complication?
A. Hypothermia
B. Chest pain with ST-segment elevation
C. Pinpoint pupils
D. Bradycardia
🟢 Correct Answer: B. Chest pain with ST-segment elevation
🔴 Explanation: Cocaine causes coronary vasospasm and increases myocardial oxygen demand, leading to acute
myocardial infarction. ST-segment elevation indicates an acute cardiac event that requires immediate intervention to
prevent mortality. Tachycardia and hypertension are expected with stimulant use.
Question 4
When considering the DSM-5 criteria for Alcohol Use Disorder, which of the following symptom clusters represents a
severe diagnosis?
A. Meeting 2 to 3 of the 11 criteria
B. Meeting 4 to 5 of the 11 criteria
, C. Meeting 6 or more of the 11 criteria
D. Meeting any single criterion with tolerance
🟢 Correct Answer: C. Meeting 6 or more of the 11 criteria
🔴 Explanation: The DSM-5 classifies severity based on the number of criteria met: mild (2-3), moderate (4-5), and
severe (6 or more). This classification helps determine the appropriate level of care and treatment intensity .
Question 5
A patient is prescribed disulfiram. What is the most critical patient education topic to emphasize?
A. It will cause drowsiness, so avoid driving
B. It is safe to consume alcohol-free products
C. It will cause a severe reaction if alcohol is ingested, including in some foods and mouthwashes
D. It can be taken every other day if side effects occur
🟢 Correct Answer: C. It will cause a severe reaction if alcohol is ingested, including in some foods and
mouthwashes
🔴 Explanation: Disulfiram is an aversion therapy agent that blocks acetaldehyde dehydrogenase. The resulting
accumulation of acetaldehyde causes a severe reaction (flushing, nausea, vomiting, palpitations) if alcohol is
consumed. Patients must be educated to avoid all forms of alcohol, including hidden sources like cough syrups,
mouthwashes, and some foods.
Question 6
Which of the following is an evidence-based screening tool specifically validated for use with adolescents to identify
GUARANTEED PASS | LATEST EXAM UPDATE
CORE DOMAINS
Opioid Use Disorders and Treatment
Alcohol Use Disorders and Withdrawal Management
Stimulant and Other Substance Use Disorders
Co-Occurring Psychiatric and Medical Conditions
Pharmacology and Psychotherapeutic Interventions
Screening, Assessment, and Diagnosis
Ethics, Legal Issues, and Professional Standards
Special Populations and Health Promotion
INTRODUCTION
The Certified Addiction Registered Nurse-Advanced Practice (CARN-AP) examination is a rigorous assessment designed
to validate the advanced knowledge and clinical judgment of APRNs specializing in addiction nursing. This exam
evaluates the candidate's ability to apply evidence-based practice, perform comprehensive biopsychosocial assessments,
diagnose substance use disorders, and develop individualized, culturally competent treatment plans. The examination is
composed of multiple-choice and scenario-based questions that challenge the nurse to integrate complex
pharmacological, psychotherapeutic, and ethical principles. Success on this exam requires not only memorization of
facts but the ability to synthesize information and make critical, real-world decisions. It is an essential step in
demonstrating proficiency and commitment to the highest standards of care in addiction medicine.
,Question 1
A 45-year-old patient with a history of chronic back pain and a current diagnosis of severe Opioid Use Disorder is
seeking treatment. Which of the following is the most appropriate first-line pharmacological intervention to
recommend for long-term management?
A. Naloxone as needed for cravings
B. Buprenorphine/naloxone maintenance therapy
C. Methadone administered on a weekly basis
D. Naltrexone daily
🟢 Correct Answer: B. Buprenorphine/naloxone maintenance therapy
🔴 Explanation: Buprenorphine/naloxone is a first-line, evidence-based medication for opioid use disorder (MOUD)
that can be prescribed in an office-based setting. It effectively reduces cravings and withdrawal symptoms. Naloxone
is for overdose reversal, methadone requires specialized clinics, and naltrexone requires complete detoxification first.
Question 2
A patient is admitted with symptoms of severe agitation, diaphoresis, tremors, and confusion. The patient's family
reports a history of heavy daily alcohol consumption. What is the priority nursing action?
A. Administer a dose of haloperidol to manage agitation
B. Implement seizure precautions and initiate a CIWA-Ar protocol
C. Restrict fluids to prevent overhydration
D. Administer IV dextrose for possible hypoglycemia
🟢 Correct Answer: B. Implement seizure precautions and initiate a CIWA-Ar protocol
🔴 Explanation: The patient is exhibiting signs of alcohol withdrawal, which can progress to life-threatening seizures
,and delirium tremens. The priority is to monitor withdrawal severity using the CIWA-Ar scale and provide
pharmacologic management, typically with benzodiazepines, to prevent complications .
Question 3
A 23-year-old patient presents with tachycardia, hypertension, and psychomotor agitation. Laboratory findings
indicate a recent use of cocaine. Which of the following is a critical assessment finding that suggests a life-
threatening complication?
A. Hypothermia
B. Chest pain with ST-segment elevation
C. Pinpoint pupils
D. Bradycardia
🟢 Correct Answer: B. Chest pain with ST-segment elevation
🔴 Explanation: Cocaine causes coronary vasospasm and increases myocardial oxygen demand, leading to acute
myocardial infarction. ST-segment elevation indicates an acute cardiac event that requires immediate intervention to
prevent mortality. Tachycardia and hypertension are expected with stimulant use.
Question 4
When considering the DSM-5 criteria for Alcohol Use Disorder, which of the following symptom clusters represents a
severe diagnosis?
A. Meeting 2 to 3 of the 11 criteria
B. Meeting 4 to 5 of the 11 criteria
, C. Meeting 6 or more of the 11 criteria
D. Meeting any single criterion with tolerance
🟢 Correct Answer: C. Meeting 6 or more of the 11 criteria
🔴 Explanation: The DSM-5 classifies severity based on the number of criteria met: mild (2-3), moderate (4-5), and
severe (6 or more). This classification helps determine the appropriate level of care and treatment intensity .
Question 5
A patient is prescribed disulfiram. What is the most critical patient education topic to emphasize?
A. It will cause drowsiness, so avoid driving
B. It is safe to consume alcohol-free products
C. It will cause a severe reaction if alcohol is ingested, including in some foods and mouthwashes
D. It can be taken every other day if side effects occur
🟢 Correct Answer: C. It will cause a severe reaction if alcohol is ingested, including in some foods and
mouthwashes
🔴 Explanation: Disulfiram is an aversion therapy agent that blocks acetaldehyde dehydrogenase. The resulting
accumulation of acetaldehyde causes a severe reaction (flushing, nausea, vomiting, palpitations) if alcohol is
consumed. Patients must be educated to avoid all forms of alcohol, including hidden sources like cough syrups,
mouthwashes, and some foods.
Question 6
Which of the following is an evidence-based screening tool specifically validated for use with adolescents to identify
