CARN AP EXAM TEST BANK ACTUAL 2026/2027 HIGH YIELD PRACTICE
QUESTIONS AND STUDY GUIDE ACCURATE EXAM
1. A patient with a long history of alcohol use disorder is admitted to an
inpatient addiction treatment unit approximately 12 hours after the last
reported alcohol intake. The patient is anxious, tremulous, diaphoretic,
mildly hypertensive, and reports nausea and insomnia. Which nursing
assessment is the highest priority during this stage of withdrawal?
A. Assess for the development of peripheral neuropathy
B. Monitor for progression to severe alcohol withdrawal and seizures
C. Determine whether the patient meets criteria for sustained remission
D. Evaluate the patient's readiness to participate in family therapy
Answer: B
2. A CARN-AP nurse is completing an initial assessment of a patient who
reports using heroin daily for several years and has recently stopped. The
patient has abdominal cramping, diarrhea, rhinorrhea, yawning, muscle
aches, and marked anxiety. Which interpretation best describes these
findings?
A. Typical opioid withdrawal
B. Acute opioid intoxication
C. Benzodiazepine intoxication
D. Alcohol withdrawal delirium
Answer: A
3. During an addiction assessment, a patient states, “I only drink socially,” but
later reports consuming six alcoholic drinks every evening and experiencing
shaking when attempting to stop. Which approach by the addiction nurse is
most appropriate?
A. Confront the patient about lying during the interview
B. Document the patient's statement without further assessment
C. Explore the discrepancy using a nonjudgmental, motivational
interviewing approach
D. Immediately discharge the patient because treatment engagement is
pg. 1
, inadequate
Answer: C
4. A patient receiving treatment for opioid use disorder asks why
buprenorphine can reduce opioid cravings without producing the same
degree of euphoria as heroin. Which explanation by the CARN-AP nurse is
most accurate?
A. Buprenorphine is a full antagonist at opioid receptors
B. Buprenorphine permanently eliminates opioid receptors from the brain
C. Buprenorphine prevents all neurotransmitter activity associated with
reward
D. Buprenorphine is a partial opioid agonist with high receptor affinity
Answer: D
5. A patient with severe alcohol use disorder is admitted for medically
supervised withdrawal. The patient has a history of withdrawal seizures.
Which medication class is commonly used to reduce the risk of severe
alcohol-withdrawal complications?
A. Benzodiazepines
B. Stimulants
C. Anticholinergics
D. Dopamine agonists
Answer: A
6. A patient in an outpatient addiction program repeatedly misses
appointments and then returns requesting medication refills. The nurse
wants to maintain therapeutic engagement while addressing the behavior.
Which response is most consistent with a recovery-oriented approach?
A. “You clearly are not committed to recovery.”
B. “Your missed appointments show that treatment cannot work.”
C. “Let us explore what has made attending appointments difficult and how
we can address those barriers.”
D. “I will provide medication only after you demonstrate complete
pg. 2
, abstinence.”
Answer: C
7. A patient with opioid use disorder has been taking methadone consistently
and asks why the medication is administered in a structured treatment
setting. Which explanation is most appropriate?
A. Methadone is ineffective when taken outside a hospital
B. Methadone treatment requires individualized monitoring because of its
pharmacologic effects and safety considerations
C. Methadone is prescribed only for patients who have never used heroin
D. Methadone prevents all future opioid cravings after one dose
Answer: B
8. During an assessment, a patient reports that cocaine use produces intense
pleasure followed several hours later by fatigue, depressed mood, and
strong cravings. Which neurobiological process most directly contributes to
the reinforcing effects of cocaine?
A. Increased dopamine signaling associated with reward pathways
B. Permanent destruction of all dopamine receptors
C. Complete inhibition of sympathetic nervous system activity
D. Suppression of glutamate transmission throughout the brain
Answer: A
9. A patient with a history of injection drug use presents for an addiction-
health evaluation. Which assessment is particularly important because
injection drug use increases exposure to bloodborne infections?
A. Visual acuity testing only
B. Hearing screening only
C. Screening for HIV, hepatitis B, and hepatitis C according to clinical
indications
D. Routine bone-density testing as the primary assessment
Answer: C
10. A patient says, “I know my drinking is causing problems, but I am not ready
to stop.” The patient is considering whether alcohol use fits with personal
pg. 3
, goals but has not committed to change. Which stage of change is most
consistent with this presentation?
A. Maintenance
B. Precontemplation
C. Action
D. Contemplation
Answer: D
11. A CARN-AP nurse uses motivational interviewing with a patient who is
ambivalent about stopping cannabis use. Which statement best
demonstrates the principle of developing discrepancy?
A. “You must stop using cannabis before we can work together.”
B. “You have said being dependable at work is important to you; how does
your current cannabis use fit with that goal?”
C. “Your cannabis use is clearly the reason you have employment
problems.”
D. “You should listen to your family because they understand your situation
better.”
Answer: B
12. A patient undergoing alcohol withdrawal develops increasing agitation,
disorientation, visual hallucinations, fever, tachycardia, and severe
hypertension several days after stopping alcohol. Which condition should
the nurse suspect?
A. Alcohol-induced sleep disorder
B. Opioid intoxication
C. Delirium tremens
D. Mild nicotine withdrawal
Answer: C
13. A patient receiving opioid agonist treatment asks what overdose risk
remains if illicit opioids are used while treatment continues. Which teaching
point is most important?
A. Combining opioids can still produce life-threatening respiratory
pg. 4
QUESTIONS AND STUDY GUIDE ACCURATE EXAM
1. A patient with a long history of alcohol use disorder is admitted to an
inpatient addiction treatment unit approximately 12 hours after the last
reported alcohol intake. The patient is anxious, tremulous, diaphoretic,
mildly hypertensive, and reports nausea and insomnia. Which nursing
assessment is the highest priority during this stage of withdrawal?
A. Assess for the development of peripheral neuropathy
B. Monitor for progression to severe alcohol withdrawal and seizures
C. Determine whether the patient meets criteria for sustained remission
D. Evaluate the patient's readiness to participate in family therapy
Answer: B
2. A CARN-AP nurse is completing an initial assessment of a patient who
reports using heroin daily for several years and has recently stopped. The
patient has abdominal cramping, diarrhea, rhinorrhea, yawning, muscle
aches, and marked anxiety. Which interpretation best describes these
findings?
A. Typical opioid withdrawal
B. Acute opioid intoxication
C. Benzodiazepine intoxication
D. Alcohol withdrawal delirium
Answer: A
3. During an addiction assessment, a patient states, “I only drink socially,” but
later reports consuming six alcoholic drinks every evening and experiencing
shaking when attempting to stop. Which approach by the addiction nurse is
most appropriate?
A. Confront the patient about lying during the interview
B. Document the patient's statement without further assessment
C. Explore the discrepancy using a nonjudgmental, motivational
interviewing approach
D. Immediately discharge the patient because treatment engagement is
pg. 1
, inadequate
Answer: C
4. A patient receiving treatment for opioid use disorder asks why
buprenorphine can reduce opioid cravings without producing the same
degree of euphoria as heroin. Which explanation by the CARN-AP nurse is
most accurate?
A. Buprenorphine is a full antagonist at opioid receptors
B. Buprenorphine permanently eliminates opioid receptors from the brain
C. Buprenorphine prevents all neurotransmitter activity associated with
reward
D. Buprenorphine is a partial opioid agonist with high receptor affinity
Answer: D
5. A patient with severe alcohol use disorder is admitted for medically
supervised withdrawal. The patient has a history of withdrawal seizures.
Which medication class is commonly used to reduce the risk of severe
alcohol-withdrawal complications?
A. Benzodiazepines
B. Stimulants
C. Anticholinergics
D. Dopamine agonists
Answer: A
6. A patient in an outpatient addiction program repeatedly misses
appointments and then returns requesting medication refills. The nurse
wants to maintain therapeutic engagement while addressing the behavior.
Which response is most consistent with a recovery-oriented approach?
A. “You clearly are not committed to recovery.”
B. “Your missed appointments show that treatment cannot work.”
C. “Let us explore what has made attending appointments difficult and how
we can address those barriers.”
D. “I will provide medication only after you demonstrate complete
pg. 2
, abstinence.”
Answer: C
7. A patient with opioid use disorder has been taking methadone consistently
and asks why the medication is administered in a structured treatment
setting. Which explanation is most appropriate?
A. Methadone is ineffective when taken outside a hospital
B. Methadone treatment requires individualized monitoring because of its
pharmacologic effects and safety considerations
C. Methadone is prescribed only for patients who have never used heroin
D. Methadone prevents all future opioid cravings after one dose
Answer: B
8. During an assessment, a patient reports that cocaine use produces intense
pleasure followed several hours later by fatigue, depressed mood, and
strong cravings. Which neurobiological process most directly contributes to
the reinforcing effects of cocaine?
A. Increased dopamine signaling associated with reward pathways
B. Permanent destruction of all dopamine receptors
C. Complete inhibition of sympathetic nervous system activity
D. Suppression of glutamate transmission throughout the brain
Answer: A
9. A patient with a history of injection drug use presents for an addiction-
health evaluation. Which assessment is particularly important because
injection drug use increases exposure to bloodborne infections?
A. Visual acuity testing only
B. Hearing screening only
C. Screening for HIV, hepatitis B, and hepatitis C according to clinical
indications
D. Routine bone-density testing as the primary assessment
Answer: C
10. A patient says, “I know my drinking is causing problems, but I am not ready
to stop.” The patient is considering whether alcohol use fits with personal
pg. 3
, goals but has not committed to change. Which stage of change is most
consistent with this presentation?
A. Maintenance
B. Precontemplation
C. Action
D. Contemplation
Answer: D
11. A CARN-AP nurse uses motivational interviewing with a patient who is
ambivalent about stopping cannabis use. Which statement best
demonstrates the principle of developing discrepancy?
A. “You must stop using cannabis before we can work together.”
B. “You have said being dependable at work is important to you; how does
your current cannabis use fit with that goal?”
C. “Your cannabis use is clearly the reason you have employment
problems.”
D. “You should listen to your family because they understand your situation
better.”
Answer: B
12. A patient undergoing alcohol withdrawal develops increasing agitation,
disorientation, visual hallucinations, fever, tachycardia, and severe
hypertension several days after stopping alcohol. Which condition should
the nurse suspect?
A. Alcohol-induced sleep disorder
B. Opioid intoxication
C. Delirium tremens
D. Mild nicotine withdrawal
Answer: C
13. A patient receiving opioid agonist treatment asks what overdose risk
remains if illicit opioids are used while treatment continues. Which teaching
point is most important?
A. Combining opioids can still produce life-threatening respiratory
pg. 4
