CARN Certification 1-27 UPDATED
ACTUAL Questions and CORRECT
Answers
What occurs with the induction of anesthesia using only nitrous oxide?
1. Increased intracranial pressure
2. Decreased cerebral blood flow
3. Decreased intracranial pressure
4. Cerebrovascular dilatation - CORRECT ANSWER - Increased intracranial pressure
Explanations: Induction with nitrous oxide is associated with elevated cerebral blood flow and
increased intracranial pressure. Nitrous oxide induces intoxication, euphoria, dysphoria, spatial
disorientation, temporal disorientation, and reduced pain sensitivity. Some users will have
uncontrolled vocalizations and muscle spasms. If pure nitrous oxide is inhaled without oxygen,
this can cause oxygen deprivation resulting in hypotension, syncope, and myocardial infarction.
Long-term exposure may cause vitamin B12 deficiency. Symptoms of vitamin B12 deficiency
include sensory neuropathy, myelopathy, and encephalopathy. Symptoms are treated with high
doses of vitamin B12, but recovery can be incomplete.
A 45-year-old female comes in for her wellness check-up. She has a 13-year-old son who is
going to be starting high school next year, and she often hears him and his friends discuss ways
to prepare for high school so they can "fit in." The mother is concerned her son may use drugs as
he often talks about "partying." She is most concerned about marijuana use as it was recently
legalized in her home state. She wants to know what she can do to deter cannabis use by her son.
She denies any personal substance use history. Her husband, who is the boy's father, does not
have any substance use history either. Which of the following is the correct response to her
question? Choices: 1. Parental observation and opposition to cannabis use have been shown to be
protective factors for cannabis use in children
2. The risk of developing cannabis use disorder in adolescents who "experiment" with cannabis
is very low
, 3. Cannabis is a - CORRECT ANSWER -
A 45-year-old female comes in for her wellness check-up. She has a 13-year-old son who is
going to be starting high school next year, and she often hears him and his friends discuss ways
to prepare for high school so they can "fit in." The mother is concerned her son may use drugs as
he often talks about "partying." She is most concerned about marijuana use as it was recently
legalized in her home state. She wants to know what she can do to deter cannabis use by her son.
She denies any personal substance use history. Her husband, who is the boy's father, does not
have any substance use history either. Which of the following is the correct response to her
question? - CORRECT ANSWER -
A 37-year-old woman presents to the clinic for smoking cessation. She has a 15-pack-year
history and has failed to quit in the past using abstinence-only methods. Significant past medical
history includes hypertension, major depression, and bulimia nervosa. She would like to know
what her best options are for quitting smoking. Which of the following has the highest success
rate at 6 months?
1. Varenicline
2. Bupropion
3. Nicotine patches
4. E-cigarettes - CORRECT ANSWER - Varenicline
Varenicline has the best efficacy for smoking cessation in large, randomized, controlled trials. It
is a partial agonist at nicotinic acetylcholine receptors. Varenicline reduces smoking by binding
nicotinic acetylcholine receptors in the CNS. This binding reduces cravings and withdrawal
symptoms in patients. It is safe compared to other smoking cessation therapies with a low risk of
neurologic and psychologic side effects Varenicline has the highest success rate in patients who
inhale tobacco at 6 months. Rarely varenicline is associated with depression, mania, psychosis,
hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, anxiety, and panic,
as well as suicidal ideation, suicide attempt, and completed suicide. Varenicline has the most
evidence of success in reducing smoking behaviors.Buproprion and nicotine replacement are
second-line agents. Bupropion is contraindicated in patients with a history of bulimia because
purging behaviors disturb electrolytes and lower the seizure threshold. Buproprion further lowers
the seizure threshold and may trigger a seizure in patients with bulimia. E-cigarettes should only
be used in patients resistant to all other forms of treatment.
ACTUAL Questions and CORRECT
Answers
What occurs with the induction of anesthesia using only nitrous oxide?
1. Increased intracranial pressure
2. Decreased cerebral blood flow
3. Decreased intracranial pressure
4. Cerebrovascular dilatation - CORRECT ANSWER - Increased intracranial pressure
Explanations: Induction with nitrous oxide is associated with elevated cerebral blood flow and
increased intracranial pressure. Nitrous oxide induces intoxication, euphoria, dysphoria, spatial
disorientation, temporal disorientation, and reduced pain sensitivity. Some users will have
uncontrolled vocalizations and muscle spasms. If pure nitrous oxide is inhaled without oxygen,
this can cause oxygen deprivation resulting in hypotension, syncope, and myocardial infarction.
Long-term exposure may cause vitamin B12 deficiency. Symptoms of vitamin B12 deficiency
include sensory neuropathy, myelopathy, and encephalopathy. Symptoms are treated with high
doses of vitamin B12, but recovery can be incomplete.
A 45-year-old female comes in for her wellness check-up. She has a 13-year-old son who is
going to be starting high school next year, and she often hears him and his friends discuss ways
to prepare for high school so they can "fit in." The mother is concerned her son may use drugs as
he often talks about "partying." She is most concerned about marijuana use as it was recently
legalized in her home state. She wants to know what she can do to deter cannabis use by her son.
She denies any personal substance use history. Her husband, who is the boy's father, does not
have any substance use history either. Which of the following is the correct response to her
question? Choices: 1. Parental observation and opposition to cannabis use have been shown to be
protective factors for cannabis use in children
2. The risk of developing cannabis use disorder in adolescents who "experiment" with cannabis
is very low
, 3. Cannabis is a - CORRECT ANSWER -
A 45-year-old female comes in for her wellness check-up. She has a 13-year-old son who is
going to be starting high school next year, and she often hears him and his friends discuss ways
to prepare for high school so they can "fit in." The mother is concerned her son may use drugs as
he often talks about "partying." She is most concerned about marijuana use as it was recently
legalized in her home state. She wants to know what she can do to deter cannabis use by her son.
She denies any personal substance use history. Her husband, who is the boy's father, does not
have any substance use history either. Which of the following is the correct response to her
question? - CORRECT ANSWER -
A 37-year-old woman presents to the clinic for smoking cessation. She has a 15-pack-year
history and has failed to quit in the past using abstinence-only methods. Significant past medical
history includes hypertension, major depression, and bulimia nervosa. She would like to know
what her best options are for quitting smoking. Which of the following has the highest success
rate at 6 months?
1. Varenicline
2. Bupropion
3. Nicotine patches
4. E-cigarettes - CORRECT ANSWER - Varenicline
Varenicline has the best efficacy for smoking cessation in large, randomized, controlled trials. It
is a partial agonist at nicotinic acetylcholine receptors. Varenicline reduces smoking by binding
nicotinic acetylcholine receptors in the CNS. This binding reduces cravings and withdrawal
symptoms in patients. It is safe compared to other smoking cessation therapies with a low risk of
neurologic and psychologic side effects Varenicline has the highest success rate in patients who
inhale tobacco at 6 months. Rarely varenicline is associated with depression, mania, psychosis,
hallucinations, paranoia, delusions, homicidal ideation, aggression, hostility, anxiety, and panic,
as well as suicidal ideation, suicide attempt, and completed suicide. Varenicline has the most
evidence of success in reducing smoking behaviors.Buproprion and nicotine replacement are
second-line agents. Bupropion is contraindicated in patients with a history of bulimia because
purging behaviors disturb electrolytes and lower the seizure threshold. Buproprion further lowers
the seizure threshold and may trigger a seizure in patients with bulimia. E-cigarettes should only
be used in patients resistant to all other forms of treatment.
