CARN CERTIFICATION 1-27 EXAM
QUESTIONS AND ANSWERS
What happens when you induce anesthesia with only nitrous oxide?
1. Increased intracranial pressure.
2. Reduced cerebral blood flow.
3. Reduced intracranial pressure
4. Cerebrovascular dilatation causes increased intracranial pressure.
Explanation: Nitrous oxide induction causes increased cerebral blood flow and
intracranial pressure. Nitrous oxide causes intoxication, euphoria, dysphoria,
spatial/temporal disorientation, and decreased pain sensitivity. Some users will
experience uncontrolled vocalizations and muscle spasms. If pure nitrous oxide is
inhaled without oxygen, it can produce oxygen deprivation, leading to hypotension,
syncope, and myocardial infarction. Long-term exposure may result in vitamin B12
deficiency. Symptoms of vitamin B12 insufficiency include sensory neuropathy,
myelopathy, and encephalopathy. Symptoms are treated with large doses of vitamin
B12, although recovery may be partial.
A 45-year-old woman comes in for a wellness checkup. She has a 13-year-old son
who will begin high school next year, and she frequently hears him and his friends
discussing how to prepare for high school so they can "fit in." The mother is
concerned that her son will use drugs because he frequently mentions "partying."
She is most concerned about marijuana use because it was recently legalized in her
home state. She wants to know what she can do to prevent her son from using
cannabis. She denies having any personal substance usage history. Her husband,
the boy's father, also has no history of substance usage. Which of the following is
an appropriate ANSWER to her question? Choices: 1. Parental monitoring and
opposition to cannabis use are protective factors for cannabis use in children.
,2. Adolescents who "experiment" with cannabis are quite unlikely to acquire
cannabis use disorder.
3. Cannabis is a - Answer
A 45-year-old woman comes in for a wellness checkup. She has a 13-year-old son
who will begin high school next year, and she frequently hears him and his friends
discussing how to prepare for high school so they can "fit in." The mother is
concerned that her son will use drugs because he frequently mentions "partying."
She is most concerned about marijuana use because it was recently legalized in her
home state. She wants to know what she can do to prevent her son from using
cannabis. She denies having any personal substance usage history. Her husband,
the boy's father, also has no history of substance usage. Which of the following is
an appropriate ANSWER to her question? - ANSWER
A 37-year-old woman arrives at the clinic seeking help to quit smoking. She has
been smoking for 15 years and has previously failed to quit using abstinence-only
methods. Hypertension, serious depression, and bulimia nervosa are among the
significant prior medical histories. She wants to know what her best options are for
stopping smoking. Which of the following has the highest 6-month success rate?
1. Varenicline
2. Bupropion
3. Nicotine Patches
4. E-cigarettes: Varenicline
Varenicline has shown the greatest efficacy for smoking cessation in large,
randomized, controlled trials. It is a partial agonist of nicotinic acetylcholine
receptors. Varenicline lowers smoking via binding to nicotinic acetylcholine
receptors in the CNS. This binding helps patients reduce cravings and withdrawal
symptoms. It is safer than other smoking cessation medications, with a minimal
risk of neurologic and psychologic side effects. Varenicline has the highest success
rate in patients who inhale tobacco at 6 months. Rarely, varenicline is linked to
, depression, mania, psychosis, hallucinations, paranoia, delusions, homicidal
ideation, aggression, hostility, anxiety, and panic, as well as suicidal ideation,
suicide attempt, and committed suicide. Varenicline offers the most evidence of
success in reducing smoking behavior. Buproprion and nicotine replacement
therapy are second-line treatments. Bupropion is contraindicated in bulimia patients
because purging disrupts electrolytes and lowers the seizure threshold. Bupropion
decreases the seizure threshold and may cause a seizure in patients with bulimia.
E-cigarettes should only be used when all other therapeutic options have failed.
A 13-year-old youngster is brought in by his mother due to odd behavior. He has
grown "lazier" at school, and as a result, his grades have dropped. She believes he
has become more depressed since he spends his leisure time sitting in his room and
eating more than normal. On physical examination, his conjunctivae are injected,
but no other significant symptoms are discovered. What would be the best next
step?
1. Referral to a psychiatrist for depression.
2. Urine drug screen
3. Call child protection services.
4. Referral to ophthalmologist - ANSWER Urine drug screening
Cannabis intoxication is frequently associated with injected conjunctiva and a brief
increase in hunger. Cannabis usage has also been linked to lethargy, impairment of
attention, memory, executive functioning, and short-term memory, all of which can
lead to academic difficulties for students. Chronic use may have long-term
consequences for cognitive performance, a motivational syndrome, and a loss of
energy and motivation to work. A urine drug screen is the most effective way to
measure THC toxicity, with positive results reported up to 10 days after weekly
usage and up to 56 days following daily use.
A 52-year-old guy was discovered unresponsive. A friend contacts 911 and informs
the dispatcher that his friend is still breathing, albeit barely. EMS discovers that the
patient is lethargic, bradycardic, bradypnea, hypotensive, and has pinpoint pupils.
His point-of-care glucose level is 72 mg/dL. What treatment is best for him?
QUESTIONS AND ANSWERS
What happens when you induce anesthesia with only nitrous oxide?
1. Increased intracranial pressure.
2. Reduced cerebral blood flow.
3. Reduced intracranial pressure
4. Cerebrovascular dilatation causes increased intracranial pressure.
Explanation: Nitrous oxide induction causes increased cerebral blood flow and
intracranial pressure. Nitrous oxide causes intoxication, euphoria, dysphoria,
spatial/temporal disorientation, and decreased pain sensitivity. Some users will
experience uncontrolled vocalizations and muscle spasms. If pure nitrous oxide is
inhaled without oxygen, it can produce oxygen deprivation, leading to hypotension,
syncope, and myocardial infarction. Long-term exposure may result in vitamin B12
deficiency. Symptoms of vitamin B12 insufficiency include sensory neuropathy,
myelopathy, and encephalopathy. Symptoms are treated with large doses of vitamin
B12, although recovery may be partial.
A 45-year-old woman comes in for a wellness checkup. She has a 13-year-old son
who will begin high school next year, and she frequently hears him and his friends
discussing how to prepare for high school so they can "fit in." The mother is
concerned that her son will use drugs because he frequently mentions "partying."
She is most concerned about marijuana use because it was recently legalized in her
home state. She wants to know what she can do to prevent her son from using
cannabis. She denies having any personal substance usage history. Her husband,
the boy's father, also has no history of substance usage. Which of the following is
an appropriate ANSWER to her question? Choices: 1. Parental monitoring and
opposition to cannabis use are protective factors for cannabis use in children.
,2. Adolescents who "experiment" with cannabis are quite unlikely to acquire
cannabis use disorder.
3. Cannabis is a - Answer
A 45-year-old woman comes in for a wellness checkup. She has a 13-year-old son
who will begin high school next year, and she frequently hears him and his friends
discussing how to prepare for high school so they can "fit in." The mother is
concerned that her son will use drugs because he frequently mentions "partying."
She is most concerned about marijuana use because it was recently legalized in her
home state. She wants to know what she can do to prevent her son from using
cannabis. She denies having any personal substance usage history. Her husband,
the boy's father, also has no history of substance usage. Which of the following is
an appropriate ANSWER to her question? - ANSWER
A 37-year-old woman arrives at the clinic seeking help to quit smoking. She has
been smoking for 15 years and has previously failed to quit using abstinence-only
methods. Hypertension, serious depression, and bulimia nervosa are among the
significant prior medical histories. She wants to know what her best options are for
stopping smoking. Which of the following has the highest 6-month success rate?
1. Varenicline
2. Bupropion
3. Nicotine Patches
4. E-cigarettes: Varenicline
Varenicline has shown the greatest efficacy for smoking cessation in large,
randomized, controlled trials. It is a partial agonist of nicotinic acetylcholine
receptors. Varenicline lowers smoking via binding to nicotinic acetylcholine
receptors in the CNS. This binding helps patients reduce cravings and withdrawal
symptoms. It is safer than other smoking cessation medications, with a minimal
risk of neurologic and psychologic side effects. Varenicline has the highest success
rate in patients who inhale tobacco at 6 months. Rarely, varenicline is linked to
, depression, mania, psychosis, hallucinations, paranoia, delusions, homicidal
ideation, aggression, hostility, anxiety, and panic, as well as suicidal ideation,
suicide attempt, and committed suicide. Varenicline offers the most evidence of
success in reducing smoking behavior. Buproprion and nicotine replacement
therapy are second-line treatments. Bupropion is contraindicated in bulimia patients
because purging disrupts electrolytes and lowers the seizure threshold. Bupropion
decreases the seizure threshold and may cause a seizure in patients with bulimia.
E-cigarettes should only be used when all other therapeutic options have failed.
A 13-year-old youngster is brought in by his mother due to odd behavior. He has
grown "lazier" at school, and as a result, his grades have dropped. She believes he
has become more depressed since he spends his leisure time sitting in his room and
eating more than normal. On physical examination, his conjunctivae are injected,
but no other significant symptoms are discovered. What would be the best next
step?
1. Referral to a psychiatrist for depression.
2. Urine drug screen
3. Call child protection services.
4. Referral to ophthalmologist - ANSWER Urine drug screening
Cannabis intoxication is frequently associated with injected conjunctiva and a brief
increase in hunger. Cannabis usage has also been linked to lethargy, impairment of
attention, memory, executive functioning, and short-term memory, all of which can
lead to academic difficulties for students. Chronic use may have long-term
consequences for cognitive performance, a motivational syndrome, and a loss of
energy and motivation to work. A urine drug screen is the most effective way to
measure THC toxicity, with positive results reported up to 10 days after weekly
usage and up to 56 days following daily use.
A 52-year-old guy was discovered unresponsive. A friend contacts 911 and informs
the dispatcher that his friend is still breathing, albeit barely. EMS discovers that the
patient is lethargic, bradycardic, bradypnea, hypotensive, and has pinpoint pupils.
His point-of-care glucose level is 72 mg/dL. What treatment is best for him?
