NU 665C Regis College Exam – Psychiatric Mental Health Nurse Practitioner (PMHNP) Clinical
Competency Assessment
What criteria are used to diagnose alcohol use disorder (AUD) in the DSM-5-TR? - (ANSWER)The DSM-5-
TR uses 11 criteria, including impaired control, social impairment, risky use, and pharmacologic
indicators (tolerance/withdrawal). A diagnosis is made based on:
Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6 or more symptoms
What are common behavioral signs of alcohol use disorder? - (ANSWER)Cravings for alcohol
Continued use despite consequences
Drinking larger amounts or for longer than intended
Failed attempts to cut down
Neglect of responsibilities
What are the symptoms of alcohol intoxication? - (ANSWER)Slurred speech
Incoordination
Unsteady gait
Nystagmus
Impaired attention or memory
Stupor or coma (in severe cases)
What are the symptoms of alcohol withdrawal? - (ANSWER)Tremors (6-12 hours after last drink)
Anxiety, agitation
Tachycardia, hypertension
Insomnia
Seizures (12-48 hours after last drink)
Delirium tremens (DTs) - Hallucinations, confusion, autonomic instability (48-72 hours after last drink)
What is delirium tremens (DTs), and when does it occur? - (ANSWER)A severe alcohol withdrawal
syndrome with confusion, hallucinations, and autonomic hyperactivity (tachycardia, hypertension).
Occurs 48-72 hours after last drink.
, NU 665C Regis College Exam – Psychiatric Mental Health Nurse Practitioner (PMHNP) Clinical
Competency Assessment
What is the first-line treatment for acute alcohol withdrawal? - (ANSWER)Benzodiazepines (e.g.,
lorazepam, diazepam, chlordiazepoxide) to prevent seizures and DTs.
What medications are FDA-approved for alcohol use disorder? - (ANSWER)Naltrexone - Blocks opioid
receptors, reduces cravings
Acamprosate - Modulates glutamate, reduces cravings
Disulfiram - Inhibits aldehyde dehydrogenase, causing an aversive reaction if alcohol is consumed
Which medication should be avoided in patients with liver disease? - (ANSWER)Naltrexone (can cause
hepatotoxicity)
What are common screening tools for alcohol use disorder? - (ANSWER)AUDIT (Alcohol Use Disorders
Identification Test) - Identifies hazardous drinking
CAGE questionnaire - 4-question screening for alcohol dependence (Cut down, Annoyed, Guilty, Eye-
opener)
CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) - Assesses alcohol withdrawal severity
What are common screening tools for opioid use disorder? - (ANSWER)ORT (Opioid Risk Tool) - Assesses
risk of opioid misuse
SOAPP (Screener and Opioid Assessment for Patients with Pain) - Evaluates risk of opioid abuse in
chronic pain patients
DAST (Drug Abuse Screening Test) - General screening for drug use disorders
What are the medication-assisted treatments (MAT) for opioid use disorder? - (ANSWER)Methadone -
Full opioid agonist, reduces cravings and withdrawal symptoms
Buprenorphine/Naloxone (Suboxone) - Partial agonist, reduces cravings and withdrawal, lower overdose
risk
Naltrexone - Opioid antagonist, blocks euphoric effects, best for highly motivated patients
Which medication is first-line for pregnant patients with opioid use disorder? - (ANSWER)Methadone or
Buprenorphine (without naloxone)
Competency Assessment
What criteria are used to diagnose alcohol use disorder (AUD) in the DSM-5-TR? - (ANSWER)The DSM-5-
TR uses 11 criteria, including impaired control, social impairment, risky use, and pharmacologic
indicators (tolerance/withdrawal). A diagnosis is made based on:
Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6 or more symptoms
What are common behavioral signs of alcohol use disorder? - (ANSWER)Cravings for alcohol
Continued use despite consequences
Drinking larger amounts or for longer than intended
Failed attempts to cut down
Neglect of responsibilities
What are the symptoms of alcohol intoxication? - (ANSWER)Slurred speech
Incoordination
Unsteady gait
Nystagmus
Impaired attention or memory
Stupor or coma (in severe cases)
What are the symptoms of alcohol withdrawal? - (ANSWER)Tremors (6-12 hours after last drink)
Anxiety, agitation
Tachycardia, hypertension
Insomnia
Seizures (12-48 hours after last drink)
Delirium tremens (DTs) - Hallucinations, confusion, autonomic instability (48-72 hours after last drink)
What is delirium tremens (DTs), and when does it occur? - (ANSWER)A severe alcohol withdrawal
syndrome with confusion, hallucinations, and autonomic hyperactivity (tachycardia, hypertension).
Occurs 48-72 hours after last drink.
, NU 665C Regis College Exam – Psychiatric Mental Health Nurse Practitioner (PMHNP) Clinical
Competency Assessment
What is the first-line treatment for acute alcohol withdrawal? - (ANSWER)Benzodiazepines (e.g.,
lorazepam, diazepam, chlordiazepoxide) to prevent seizures and DTs.
What medications are FDA-approved for alcohol use disorder? - (ANSWER)Naltrexone - Blocks opioid
receptors, reduces cravings
Acamprosate - Modulates glutamate, reduces cravings
Disulfiram - Inhibits aldehyde dehydrogenase, causing an aversive reaction if alcohol is consumed
Which medication should be avoided in patients with liver disease? - (ANSWER)Naltrexone (can cause
hepatotoxicity)
What are common screening tools for alcohol use disorder? - (ANSWER)AUDIT (Alcohol Use Disorders
Identification Test) - Identifies hazardous drinking
CAGE questionnaire - 4-question screening for alcohol dependence (Cut down, Annoyed, Guilty, Eye-
opener)
CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) - Assesses alcohol withdrawal severity
What are common screening tools for opioid use disorder? - (ANSWER)ORT (Opioid Risk Tool) - Assesses
risk of opioid misuse
SOAPP (Screener and Opioid Assessment for Patients with Pain) - Evaluates risk of opioid abuse in
chronic pain patients
DAST (Drug Abuse Screening Test) - General screening for drug use disorders
What are the medication-assisted treatments (MAT) for opioid use disorder? - (ANSWER)Methadone -
Full opioid agonist, reduces cravings and withdrawal symptoms
Buprenorphine/Naloxone (Suboxone) - Partial agonist, reduces cravings and withdrawal, lower overdose
risk
Naltrexone - Opioid antagonist, blocks euphoric effects, best for highly motivated patients
Which medication is first-line for pregnant patients with opioid use disorder? - (ANSWER)Methadone or
Buprenorphine (without naloxone)
