COMPLETE 200 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
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1. A patient presents to the emergency room following an
opioid overdose, having received 12 mg of intranasal
naloxone in the community. They have a history of more than
five overdoses and a recent admission for cellulitis. Chart
review indicates the patient was receiving methadone last
year to manage withdrawal and cravings. The patient is
unemployed and estranged from family due to substance use.
What is the most accurate diagnosis?
A) Opioid use disorder, mild
B) Opioid use disorder, moderate
C) Opioid use disorder, severe
D) Does not meet criteria
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,Answer: C) Opioid use disorder, severe
Rationale: According to DSM-5 criteria, severity is determined
by the number of criteria met (2-3 = mild, 4-5 = moderate, 6+
= severe). This patient meets at least 6 criteria: (1) taken in
larger amounts/longer than intended (overdose history), (2)
persistent desire/unsuccessful efforts to cut down, (3) excessive
time spent obtaining/using, (4) craving, (5) continued use despite
negative consequences (overdoses, cellulitis, family
estrangement), and (6) tolerance (as evidenced by needing
methadone previously). The history of multiple overdoses
indicates severe, life-threatening OUD requiring urgent
intervention .
2. A patient with opioid use disorder reports they are
scheduled for elective knee surgery next week and are
concerned about post-operative pain management. The
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,patient received an extended-release naltrexone injection 14
days prior. What is the most appropriate treatment plan?
A) The patient received their last naltrexone injection two weeks
ago, so it will not impact pain management
B) The patient should receive their naltrexone injection today
since surgery may interfere with the next injection
C) The patient should postpone the elective procedure for four
weeks following the last naltrexone injection
D) The patient should reschedule the procedure for when they
have completed treatment with naltrexone and plan to manage
pain with NSAIDs only
Answer: C) The patient should postpone the elective
procedure for four weeks following the last naltrexone
injection
Rationale: Extended-release naltrexone (Vivitrol) blocks mu-
opioid receptors for approximately 4 weeks. Standard opioids
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, will be ineffective for pain management during this period, and
attempting to overcome the blockade with high doses risks
respiratory depression once the blockade diminishes. Elective
surgery should be postponed until at least 4 weeks after the last
injection to allow for standard post-operative pain management.
The patient should be transitioned to an alternative MOUD if
clinically indicated .
3. Following an opioid overdose, the CARN-AP identifies that
it is a priority to provide patients with education regarding:
A) Harm reduction interventions to reduce overdose risk
B) Information about community support services
C) Access to sterile supplies to reduce skin infections
D) Adherence to medications for alcohol use disorder
Answer: A) Harm reduction interventions to reduce overdose
risk
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