CARN-AP 2ND SET 2025 UPDATE QUESTIONS| WITH ALREADY SOLVED CORRECTLY ANSWERS!! | ASSURED SUCCESS

CARN-AP 2ND SET 2025 UPDATE QUESTIONS| WITH ALREADY SOLVED CORRECTLY ANSWERS!! | ASSURED SUCCESS ______ is more specific for liver injury - RIGHT ANSWER -AST _________ is a safe and effective second-line treatment of symptoms refractory to opined therapy in newborns - RIGHT ANSWER -Clonidine _________ prevention aims to reduce the impact of a disease or injury that has ALREADY OCCURED _______ & Treatment! - RIGHT ANSWER -Tertiary Detection _________ therapy- patients with depression. ________ therapy- employed in SUD. __________ therapy- patients with BiP and SUD ________ ________- PTSD & SUD - RIGHT ANSWER -Interpersonal Supportive Integrated Seeking safety __________ should be initiated for suspected non-ST-segment elevation myocardial infarction. - RIGHT ANSWER -Metoprolol ___________ are the preferred modality of treatment of ketamine toxicity. - RIGHT ANSWER -Benzodiazepines ___________ is a benzodiazepine medication and is classified as DEA Schedule IV. It is used to treat alcohol withdrawal.Route? - RIGHT ANSWER -Chlordiazepoxide,PO __________million adults have SUD and over 37% of those individuals also have mental illness. 42.1 million adults have a mental illness and _____% of those individuals have a SUD - RIGHT ANSWER -20.3 18 _______-acting benzodiazepines like midazolam are not useful with DT's - RIGHT ANSWER -Short _______% of those with co-occurring conditions received neither mental health care not substance use treatment. - RIGHT ANSWER -52.5 "Substance abuse" is a term that is used when - RIGHT ANSWER -a person uses repeatedly, but NOT compulsively or addictively; the person who is abusing substances will not experience withdrawal. *WARNING* Assess for SI on what antidepressant? NEVER _______ abruptly - RIGHT ANSWER -SSRI discontinue •"________ __________ is an abstinence-based, not-for-profit organization with a sensible self-help program for people having problems with drinking and using - RIGHT ANSWER -SMART Recovery 1. kleptomania 2. pyromania 3. intermittent explosive disorder 4. pathological gambling 5. trichotillomania - RIGHT ANSWER -Impulse control disorders 5 principles of MET - Express _______ show support through reflective listening; not confrontation. - Develop ___________ - Avoid __________/avoid criticism - Roll with ____________ - Support ______-__________ - RIGHT ANSWER -empathy: discrepancy argumentation: resistance self-efficacy A 17-year-old male patient displays symptoms of attention deficit hyperactivity disorder (ADHD). The provider seeks to prescribe a non-amphetamine-based drug. What is the mechanism of this drug based on the most likely medication being prescribed? - RIGHT ANSWER -Methylphenidate MOA block the reuptake of dopamine and NE A 22-year-old woman is brought into the emergency department by EMS with a blood pressure of 180/102 mmHg and heart rate of 110/min. She is agitated and appears to have paranoid delusions of people chasing her. Her behavior is hypersexual, and her speech is incoherent. Psychomotor agitation is present. Which of the following substances is most likely to cause the patient's presentation? - RIGHT ANSWER -Methamphetamine A 32-year-old young male presents to the emergency department with complaints of rhinorrhea, diarrhea, and malaise. History reveals that he had recent surgery for an ankle fracture after a fall and required intensive physical therapy along with high doses of opiate medications for pain control. On examination, he is afebrile with normal blood pressure and heart rate. The physical exam is essentially normal except for mild pupil dilation. What is the next step in the management of this patient? - RIGHT ANSWER -prescribe clonidine for symptom control A 39-year-old with a significant smoking history presents to the office for a follow-up appointment. The patient states that she feels guilty and irresponsible about her smoking habits and wants to quit as soon as possible. she is started on varenicline. what baseline lab test should be obtained before initiating treatment with varenicline? - RIGHT ANSWER -Urea and creatinine A 40-year-old male with a history of AUD is admitted to the hospital for skin lacerations following a motor vehicle accident. Urgent care is given with intravenous fluids and sutures where required. On physical examination, the blood pressure is 130/82 mmHg. The pulse is 86/min, respiratory rate is 18/min, and temperature is 98.7 F. After 5 hours, the nurse goes to draw blood, and the patient refuses, citing restlessness and agitation. The patient yells and states that his heart is pounding and he would not let anyone come close to him. He has a previous history of hepatitis C that has been treated. What is the next step in management? (hint: what type of benzo does he need?) - RIGHT ANSWER -Oxazepam A male patient presents in the emergency room with severe hypertension, diaphoresis, flushing and muscle rigidity. A friend presents with him stating that he was having a regular "night with the boys" drinking beer and eating cheese dips while watching football. The patient has a history of depression and social use of cocaine. What medication might the patient have been taking to induce these symptoms? what class of medication is it? - RIGHT ANSWER -Phenelzine MAOI A pregnant patient with heroin addiction puts her child at risk for developing _______-deficiency anemia. This addiction can also lead to _______, preeclampsia, eclampsia - RIGHT ANSWER -iron; stillbirth A severe adverse effect of ________ that limits its more widespread use is agranulocytosis - RIGHT ANSWER -clozapine A social work client reports that he is "addicted to exercise" and can't spend a day where he does not exercise. The production of which of the following substances leads to an addictive cycle in this individual? - RIGHT ANSWER -Beta-endorphins A young adult patient is dropped off outside the emergency department by her friends, and they drive off before any history can be obtained. The patient has altered mental status and shows signs of intoxication. Sudden dorsiflexion of her ankle produces a rhythmic reproduction of her ankle jerk reflex. Which of the following drugs did she most likely ingest? - RIGHT ANSWER -MDMA AA and NA are both 12-step programs that maintain that ________ is a prerequisite for successful treatment - RIGHT ANSWER -abstinence Abuse of alcohol is the most common cause of __________ disease of the US. - RIGHT ANSWER -cerebellar Acute toluene inhalation causes _______tubular acidosis and _______ paralysis. - RIGHT ANSWER -renal hypokalemic Aerosolized glycerol and propylene glycol, chemicals found in vape pens have been associated with focal _______ _______ of the upper airways - RIGHT ANSWER -squamous metaplasia After the detection of antibodies to HCV (anti-HCV), the infection can be confirmed by _________- for HCV RNA by qualitative and quantitative methods - RIGHT ANSWER -NAAT After the first episode of pancreatitis, there is an elevated risk of developing what ?, seen as early as within the first 12 months - RIGHT ANSWER -prediabetes and diabetes mellitus Alcohol withdrawal is characterized by ________ glutamatergic neurotransmission & __________GABA functioning - RIGHT ANSWER -excessive decreased Alcohol Withdrawal Stage: Time and symptoms Stage 1: ___ to ____ hours after last drink Stage 2: ___ to ____ hours after last drink Stage 3: ___ to ____ hours after last drink The greatest risk for seizure or arrest from sedative-hypnotics is during when? - RIGHT ANSWER -6-12- anxiety, nausea, abdominal pain, insomnia 12-48- HTN, tachypnea, hallucinations, temp 48-72- can progress to DT!!- sweating, tachy, seizures days three to five after stopping the drug Anesthesia and pain management generally require much _______ doses than usual in the patient with opioid use disorder. - RIGHT ANSWER -higher Antihistamines may cause _____Prolongation CNS _________ - RIGHT ANSWER -QT Depression Assertive Community Treatment (ACT): This is a form of community-based mental health care that emphasizes outreach to the _________and an ________treatment approach - RIGHT ANSWER -community individualized Babies born to mothers who use opioids may need treatment with what? ________ can be used adjunctively to treat withdrawal seizures. - RIGHT ANSWER -morphine or methadone Phenobarbital Becoming withdrawn and dysphoric is the rebound effect of _______commonly called comedown or crash. - RIGHT ANSWER -cocaine Benzodiazepines are the first-line treatment for _______________-_________ agitation. They are safe and can be titrated with escalating and more frequent doses as required. There is no risk of QTc prolongation or extrapyramidal effects. - RIGHT ANSWER -methamphetamine-induced Benzos work by potentiating the effects of GABA by _______ the frequency of the GABA chloride channel opening - RIGHT ANSWER -increasing Both monotherapy and combine therapy inpatient for OUD have the propensity to precipitate withdrawal T or F - RIGHT ANSWER -True Both the monotherapy and combined therapy inpatient for OUD contain ________ as the active ingredient - RIGHT ANSWER -buprenorphine Buprenorphine can displace most _____ ______ opiates from mu receptors. - RIGHT ANSWER -full agonist Bupropion acts by preventing the uptake of _____ and ____ into the nerve cells - RIGHT ANSWER -NE; dopamine Bupropion has a dose-related risk of seizure. The maximum daily dose of bupropion is suggested to be ________ mg per day, prescribed as 150 mg TID. This maximum daily dose should not be exceeded. - RIGHT ANSWER -450 CBT is a type of _______ therapy aimed at helping people learn how to cope with difficult situations by challenging _______thoughts and ________ behaviors. Dialectical Behavior Therapy (DBT): DBT uses concepts of _______ and acceptance or being aware of and attentive to the _______situation and emotional state. - RIGHT ANSWER -talk, irrational, changing mindfulness, current clinical diagnosis of alcoholic hepatitis is determined in a patient with: - rapid development/worsening of _______ + _____-related complications - serum total bili > ___ -____ &_____ elevated > 1.5x the upper limit of normal but < 400 with AST/ALT > ___. - RIGHT ANSWER -jaundice, liver 3 ALT and AST 2 Clonidine (Catapres) is most effective for which of the following symptoms of opioid withdrawal? - RIGHT ANSWER -Diarrhea Clonidine Precautions - Overuse likely result in ________ - Overdose symptoms -______ pupils, faintness, feeling _____ - RIGHT ANSWER -hypotension pinpoint cold Clonus and _____________ are particularly common in serotonin syndrome. - RIGHT ANSWER -hyperreflexia Clozapine is a D___ receptor _____________ - RIGHT ANSWER -4 antagonist Cocaine blocks the reuptake of what 3 NT? - RIGHT ANSWER -dopamine, NE, and serotonin at the synapse. Cocaine-induced pulmonary edema can be treated with _______ ________ similar to acute heart failure - RIGHT ANSWER -loop diuretics COWS Score 5-12- _____ withdrawal 13-24 _______ withdrawal 25-36 moderately ______ withdrawal > 36 indicates _______ withdrawal. - RIGHT ANSWER -mild moderate severe severe CRAFFT Questionnaire stands for what? How many indicates a need for further eval? - RIGHT ANSWER -6-item screen for alcohol or drugs in adolescents, 12-21 C=car R=relax A=alone F=forget F= family or friends T= trouble 2+ depressants like alcohol and opiates can diminish _______ as opposed to producing clonus. - RIGHT ANSWER -DTR Depression, SI/ attempts, and suicide develop in around 20%-45% of individuals taking what HepC medication? - RIGHT ANSWER -interferon-alfa Developing discrepancy between the patient's current situation and their recovery goals describes what therapeutic modality? - RIGHT ANSWER -Motivational interviewing Does not utilize 'war stories', sponsors, or meetings for life - RIGHT ANSWER -SMART Recovery DSM V- Criteria for Anxiety: Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least ___ months, about a number of events or activities (such as work or school performance). 3 of the following 6 symptoms: Note: Only one item required in children. 1. ________, feeling keyed up or on edge. 2. easily __________ 3. Difficulty ________ or mind going blank. 4. Irritability. 5. Muscle tension. 6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). - RIGHT ANSWER -3 Restlessness fatigued. concentrating During a mental status examination, an 18-year-old patient reports feeling bugs crawling under the skin. The psychiatric-mental health nurse practitioner documents this statement as: - RIGHT ANSWER -perceptual disturbance, and suspects the use of cocaine. During the contemplation stage, the therapist must take on the persona of a _______ _________ as they aim to challenge the client's beliefs to gain new insights about their behaviors - RIGHT ANSWER -Socratic teacher, During the preparation stage, the therapist takes on the character of an experienced _______as they work with the client to develop a game plan that is executable when the client is ready - RIGHT ANSWER -coach During what stage does the therapist must take on the role of a nurturing parent, showing empathy, using active listening, and going with the client's resistance rather than against it. - RIGHT ANSWER -pre-contemplation Exam shows muscle rigidity, increased DTRs increased salivation, and rotary nystagmus. He is hypertensive and catatonic. Which of the following is the most likely diagnosis? - RIGHT ANSWER -PCP Examples of SNRIs - RIGHT ANSWER -Duloxetine (Cymbalta) Venlafaxine (Effexor) Fluoxetine, an SSRI, and venlafaxine, an SNRI, target the neurotransmitter serotonin (_____) - RIGHT ANSWER -5-HT For mild opioid withdrawal symptoms, ________ can be prescribed on an as-needed basis. - RIGHT ANSWER -clonidine For patients receiving methadone who require opioids for acute pain management, (a) continue methadone without interruption and use ________ pain treatments whenever possible Doses should be ________ - RIGHT ANSWER -nonopioid scheduled GABA is the main ________ NT of the CNS - RIGHT ANSWER -inhibitory Gabapentin precautions Great risk for misuse especially when taken in ________ doses and combined with_________/high sugar content beverages (energy drinks) - RIGHT ANSWER -high caffeinated Goal is to improve a youth's behavior by improving family interactions that are presumed to be directly related to the child's symptoms. - RIGHT ANSWER -Brief Strategic Family Therapy (BSFT) Haloperidol and related antipsychotics are appropriate for agitated and non-agitated patients with alcohol-related _________ - RIGHT ANSWER -psychosis Holiday heart syndrome is a syndrome caused by excessive ______ use. Excessive alcohol use results in gross and microscopic cardiac changes leading to an atrial _______ - RIGHT ANSWER -alcohol arrhythmia. How do you treat drug induced parkinsonism or NMS? - RIGHT ANSWER -Dantrolene If terminating usage is unlikely, small steps are introduced to reduce usage. _______ _______ views any changes that lead to reduced usage as positive and healthy. - RIGHT ANSWER -Harm reduction In AUD, the AST will be _________ than the ALT - RIGHT ANSWER -greater In the center of the brain behind the temporal lobe sits the ______ system, which controls our emotions, instincts, and memories, and includes the brain's ______ system. The main job of the________ system is to help us avoid harmful/painful experiences and to makes us feel good when we engage in behaviors necessary for our survival - RIGHT ANSWER -LIMBIC REWARD reward increase in what lipid panel value should be expected in a patient who quits smoking. - RIGHT ANSWER -increase in HDL should be expected in a patient who quits smoking. Involves giving patients tangible rewards to reinforce positive behaviors such as abstinence; used for patients with SUD - RIGHT ANSWER -Contingency Management IV Flumazenil works _________ Can provoke a________ especially in a patient with a chronic history of benzo use. - RIGHT ANSWER -immediately seizure, Ketamine works by a non-competitive ________ of the N-Methyl-D-Aspartate (_______) glutamate receptor. - RIGHT ANSWER -antagonist NMDA Laboratory findings for a patient with an AUD will show ________MCV _________ triglycerides - RIGHT ANSWER -Increased MCV and elevated triglyceride levels Lastly, in the stages of action and maintenance, the therapist takes on the role of a ________, as they provide guidance, advice, and support when needed - RIGHT ANSWER -consultant Liquid sertraline contains alcohol, so this can react with what medication used for AUD detox? - RIGHT ANSWER -disulfiram Lisdexamfetamine (Vyvanse) is used to treat ADHD & what eating disorder?. It is schedule ___ - RIGHT ANSWER -Binge, II Lisdexamfetamine dimesylate (Vyvanse) is the first FDA-approved medication to treat moderate to severe what? - RIGHT ANSWER -binge-eating disorder. Lithium Precautions •Monitor lab values -Cr, TSH, CBC, weight •Monitor _____/fluid intake •Monitor for _____ toxicity - RIGHT ANSWER -salt renal long-acting benzodiazepines such as: (name 3) can be used to treat DTs - RIGHT ANSWER -diazepam, chlordiazepoxide, or lorazepam. Lower extremity edema in liver damage is due to _______ oncotic pressure secondary to the decreased synthesis of ________ by the liver. - RIGHT ANSWER -decreased, albumin LSD lasts ___ hours in the body - RIGHT ANSWER -12 Managing cocaine addiction with __________ helps reduce cravings for cocaine and makes recovery more feasible for those suffering from addictions. - RIGHT ANSWER -vigabatrin MAOI drugs include - RIGHT ANSWER -Isocarboxazid (Marplan) Phenelzine (Nardil) Tranylcypromine (Parnate) Marijuana most commonly abused _______ substance Alcohol most commonly abused _______ substance - RIGHT ANSWER -illegal legal Marijuana use can be detected in the urine up to ___days after exposure for infrequent users and up to ____ days for chronic or heavy users. - RIGHT ANSWER -5 15 Methylnaltrexone is the quaternary amine of naltrexone that does not cross the BBB and is a GI-specific opioid ________ that can be prescribed to reverse refractory opioid-induced __________ - RIGHT ANSWER -antagonist constipation MOUD, group therapy for eating disordered behavior are examples of level of prevention? - RIGHT ANSWER -Tertiary prevention Naltrexone challenge: After an initial starting dose of 0.1 mg naloxone, which is the most appropriate next step? - RIGHT ANSWER -A doubled dose of 0.2 mg is then given, and the patient is observed. Thirty minutes later, a final dose of 0.4 mg is given. If the patient is asymptomatic, it can be assumed that the patient can safely receive naltrexone without fear of withdrawal symptoms. Name 1st gen antipsychotics: MONITOR: - RIGHT ANSWER -Chlorpromazine (Thorazine), Haloperidol - QT interval - Can induce NMS Name the anticonvulsants - RIGHT ANSWER -Carbamazepine (Tegretol) Divalproex (Depakote) Lamotrigine (Lamictal) Oxcarbazepine NDRI's Contraindicated in patients undergoing what kind of withdrawal? May lower _______ threshold Example of medication: - RIGHT ANSWER -alcohol or benzodiazepine withdrawal seizure Bupropion (Wellbutrin) Neuroleptic Malignant Syndrome (NMS) symptoms - RIGHT ANSWER -FEVER •Fever •Encephalopathy •Vital instability •Elevated enzymes (CPK) •Rigidity of muscles Nicotine binds_______to nicotinic-_______ receptors - RIGHT ANSWER -selectively; cholinergic Nonparaphilic -engaging in sexual behavior in an _________, compulsive or obsessive manner - RIGHT ANSWER -excessive On average, uncomplicated alcohol withdrawal usually lasts 5-7 days. If the withdrawal is prolonged, the healthcare provider should suspect what? - RIGHT ANSWER -that another medication is being used by the patient Opiate withdrawal is usually mild and not life-threatening. It usually resembles a flu-like illness characterized by yawning, sneezing, rhinorrhea, nausea, diarrhea, vomiting, and dilated pupils. Depending on the half-life of the drug, the symptoms may last for three to ten days. For mild symptoms, __________ can be prescribed on an as needed basis - RIGHT ANSWER -Clonidine opioid overdose: - respiratory depression - hypotension - _______ pupils. The best treatment is naloxone - RIGHT ANSWER -pinpoint Patients being enrolled in a methadone program must be monitored regularly. Before entering, one must check the ________ for any alarming behaviors. - RIGHT ANSWER -PDMP Patients taking varenicline may experience _____ and other psychiatric symptoms, including depression, insomnia, and agitation. - RIGHT ANSWER -SI Patients who are demonstrating what phase would still be ambivalent about change, or "sitting on the fence," and not preparing for a change within the next month. - RIGHT ANSWER -contemplation Patients who are involved in what phase of behaviour change are already working toward desired behavioural change, including modification of environment, experiences, or behaviour. - RIGHT ANSWER -Action Patients with _______ _________ syndrome often present with abdominal pain and nausea, which may be refractory to standard antiemetics - RIGHT ANSWER -cannabis hyperemesis Patients with injection drug abuse are most likely to have _____sided bacterial endocarditis. _______ should be used empirically, which can be switched to _______ if MRSA infection is confirmed. - RIGHT ANSWER -right Vancomycin; nafcillin Pattern in certain addictive disorders where women begin use or behaviors at lower levels than men but it escalates more quickly and ultimately becomes more severe - RIGHT ANSWER -Telescoping PCP (Name 3) reuptake is blocked What 3 receptor stimulation NTs are increased: Out of the 3 which one leads to lethargy and coma - RIGHT ANSWER -Dopamine & NE, serotonin Acetylcholine, GABA, Sigma Sigma PCP cause miosis T or F - RIGHT ANSWER -true PCP is known to produce a syndrome that mimics _______ in humans with no prior psychiatric illness. - RIGHT ANSWER -schizophrenia Primary prevention: - addiction ________ in schools - legislation that prohibits the sales of nicotine products (_______) - RIGHT ANSWER -education JUUL recreational drug that causes dissociative anesthesia? - RIGHT ANSWER -PCP Relapse is most likely to occur at the _______stages of recovery. - RIGHT ANSWER -early Research has found that addicted patients have a history of being prone to such behaviors due to specific nature and nurture criteria. Amongst these are differences in responses to stressful stimuli. Specifically, the __________ pathway within the _______ invites notable changes in the brains of addicted patients. These patients are prone to addiction to these changes (amongst others). - RIGHT ANSWER -cortisol, HPA Serotonergic drugs include: - RIGHT ANSWER -triptans MAOIs TCA buspirone amphetamines, cocaine, levodopa, dextromethorphan, and several opioids Serotonin syndrome is caused by toxic levels of serotonin. It presents with: SHIVERS - _________ - Hyperreflexia/clonus - Increase temp - Vital signs (HTN/HR) - Encephalopathy (______) - _________ - S___________ dilated pupils and diarrhea(DD) - RIGHT ANSWER -Shivers AMS Restlessness sweating Similar to schizophrenia, alcohol-related psychosis responds best to dopamine D2 antagonist antipsychotics, such as __________ - RIGHT ANSWER -haloperidol SNRI's Not indicated in patients with ________ If dose is missed, do you make it up? - RIGHT ANSWER -hypertension NO! Sober house- have programs that deal less with transitioning to a new ________ and more with learning how to ______ without the addiction. - RIGHT ANSWER -environment cope Sober houses may be funded by the government T or F - RIGHT ANSWER -False; transitional houses/HWH are usually funded Stevens-Johnson Syndrome - RIGHT ANSWER -A severe, possibly fatal reaction that mimics a burn; may be due to a medication. (fever, sore throat, bruising, mucosal membrane rash) Stopping lamotrigine (Lamictal) suddenly can cause: - RIGHT ANSWER -Steven Johnson's Syndrome Substance ________ is a pattern of drug or alcohol use that leads to negative consequences. It often brings about problems in work or school, impacts relationships with friends or family members, and introduces dangerous or potentially life-threatening situations. - RIGHT ANSWER -abuse Substance _________ is a physical and mental reliance on drugs or alcohol. People who struggle are unable to stop using despite the negative consequences, and experience cravings and WITHDRAWAL symptoms when they do - RIGHT ANSWER -Dependence substance induced psychiatric disorder occurs within ____ days of intoxication or __________ - RIGHT ANSWER -30; withdrawal Substance use disorder refers to the excessive use of drugs that tend to activate which of the following portions of the brain? - RIGHT ANSWER -Brain reward system Substance use screening tool interpretation is an important part of advanced assessment and of the role of the psychiatric-mental health nurse practitioner. The most common tool used to assess for alcohol abuse is: - RIGHT ANSWER -CAGE Substance use screening tool interpretation is an important part of advanced assessment and of the role of the psychiatric-mental health nurse practitioner. The most common tool used to assess for opiate withdrawal is: - RIGHT ANSWER -Clinical Opiate Withdrawal Score Symptomatic treatment in opioid withdrawal includes: - ________ for diarrhea - ______ for nausea and vomiting - ________for myalgia - RIGHT ANSWER -loperamide promethazine ibuprofen T-ACE and T-ACER-3 were designed by an obstetrician with a goal of better identifying alcohol use disorder in __________ females. - RIGHT ANSWER -pregnant TCA's: Contraindicated in patients with what? Examples Include: - RIGHT ANSWER -urinary retention and narrow angle glaucoma AmitriptylINE (Elavil) DoxepINE (Sinequan) ClomipramINE (Anafranil) TCAs may cause: - sedation, - flattened ___ waves - __________ effects - RIGHT ANSWER -T anticholinergic Teaches self-help to empower patients to abstain and develop a more positive lifestyle through MUTUAL-SUPPORT GROUP meetings. - RIGHT ANSWER -SMART (self-management and recovery training) The _______ _______ is involved in the sense of reward from cocaine use. - RIGHT ANSWER -nucleus accumbens The ________ is one of the most widely used measures for assessing alcohol abuse. The measure is a 25-item questionnaire designed to provide a rapid and effective screening for lifetime alcohol-related problems and alcoholism. - RIGHT ANSWER -MAST The ___________ region of the brain, including the nucleus accumbens is affected by drug abuse. - RIGHT ANSWER -limbic The 5 major sections in the Opioid Risk Tool include: - a ________ history of substance abuse - a _________ history of substance abuse - age between ____ to 45 years - personal history of _________ sexual abuse - personal history of _________ disease - RIGHT ANSWER -family personal 16 preadolescent psychological The CARN/CARN-AP recognizes that motivational enhancement therapy is based on the five stages of change. The contemplation stage is when the patient is: - RIGHT ANSWER -Aware of the problem and the desired behavioral change The comorbidity of personality disorders with panic disorder is strongly associated with _______ attempts - RIGHT ANSWER -suicide The continuous supplementation of thiamine even cannot revert _______ damage which is permanent - RIGHT ANSWER -brain The first-line pharmacologic treatment for patients with AUD is _________. MOA: a mu-________ receptor______. - It can be given orally or as _______-acting IM formulations. Also alters the ________ axis and effectively suppresses ethanol consumption - RIGHT ANSWER -naltrexone opioid, antagonist long HPA The inhibitory reuptake of dopamine and NE while someone is on PCP leads to: - RIGHT ANSWER -HTN/tachy agitation bronchodilation The mainstay in diagnosing infection with HCV initially is to screen high-risk groups for __________to HCV (anti-HCV). Anti-HCV is typically identified by using________ - RIGHT ANSWER -antibodies (ELISA). The mechanism of action of LSD is the activation of ________ receptors - RIGHT ANSWER -serotonin The medication of choice for the treatment of psychotic symptom in a patient with delirium is what? - RIGHT ANSWER -Haloperidol The most common tool used to assess for alcoholism in geriatric (65+) populations is: - RIGHT ANSWER -S-MASTG Michigan Alcoholism Screening test for Geriatrics The patient must first be detoxified from opioid dependence before starting _______ Long acting opioids, such as methadone, require at least how many hours since last use before initiating buprenorphine? Short acting opioids (for example, heroin) require approximately ____ hours since last use for sufficient withdrawal to occur in order to safely initiate treatment. - RIGHT ANSWER -naltrexone. 48-72 12 The SSRI with least sedation? Where is it also FDA approved to treat? What treatment is this medication effective in, in women? - RIGHT ANSWER -Fluoxetine Bulimia PMDD The tachyphylaxis following administration of indirect-acting sympathomimetic amines such as amphetamines results from what? - RIGHT ANSWER -the rapid emptying of synaptic vesicles containing the NTs The vasoconstriction experienced while on cocaine is caused by what NT? - RIGHT ANSWER -increase in NE There are five types of dopamine receptors with different functions. Which dopamine receptor best correlates? Memory, attention, impulse control, regulation of renal function, locomotion - RIGHT ANSWER -DI There is a risk for Metabolic syndrome in what second generation antipsychotic? - RIGHT ANSWER -Olanzapine This drug is effective in treating meth-induced agitation however it leads to BP and HR elevation. This may exacerbate the methamphetamine-induced hyperadrenergic symptoms. This antihistamine may worsen tachycardia induced by methamphetamine. - RIGHT ANSWER -Ketamine benadryl This individual therapy is grounded in the concept that addiction is a multi-faceted illness influenced by medical, social, emotional, and spiritual factors. - RIGHT ANSWER -12 step therapy This is a counseling approach designed to help individuals resolve ambivalence about their alcohol and/or drug use, and support efforts to change it. - RIGHT ANSWER -Motivational Interviewing (MI) This medication is used as an alternative to benzos for anxiety; poorly understood MOA? Take _________ (not PRN) - RIGHT ANSWER -Buspirone consistently Transitional/HWH housing is normally the term for a residence that allows people to transition from an _______ environment to an outpatient one - RIGHT ANSWER -inpatient Transitional/HWH is the next step after Sober housing T of F - RIGHT ANSWER -False Sober housing is typically the next steps after HWH Trazodone: - Can cause QT prolongation Do not combine with _________ - Contraindicated in patients with ________ disease - RIGHT ANSWER -METHADONE hepatic Twelve-Step Facilitation (TSF) originates from what model? - RIGHT ANSWER -Minnesota Two biomarkers 90% sensitivity for heavy alcohol use? - RIGHT ANSWER -GGT & CDT (2-3 weeks) Uses a cognitive-behavioral (thinking/doing) psychotherapy called REBT which stands for Rational Emotive Behavior Therapy. - RIGHT ANSWER -SMART Valproate can cause what 3 adverse effects - RIGHT ANSWER -1. hepatotoxicity 2. pancreatitis 3. thrombocytopenia Verapamil and other CCBs effectively treat ___________- __________ _________, not tachycardia. - RIGHT ANSWER -methamphetamine-induced hypertension What are 4 major dimensions of recovery? - RIGHT ANSWER -health, home, purpose, community What are the 5 stages of addiction? - RIGHT ANSWER -1. First Use 2. Continued use 3. Tolerance 4. Dependence 5. Addiction What group of people would benefit from assertiveness training? - RIGHT ANSWER -people with depression What happens when one person enables another person's addictions? - RIGHT ANSWER -Co-dependency What illicit substances increase the risk for serotonin syndrome? - RIGHT ANSWER -LSD, cocaine, ecstasy, amphetamines What is the range of QTc intervals in which a patient on methadone therapy can have a potential risk of torsades de pointes? - RIGHT ANSWER -450-500 What medication for ADHD is contraindicated with a MOAI and should not be given for at least 14 days after an MAOI is discontinued due to the risk of hypertensive crisis. - RIGHT ANSWER -Methylphenidate What percent of patients with untreated depression commit suicide? - RIGHT ANSWER -15% What respiratory condition are benzos are contraindicated in? - RIGHT ANSWER -sleep apnea What type of laxatives are contraindicated in opioid-induced constipation - RIGHT ANSWER -Bulk-forming laxatives, such as psyllium When a pregnant mom comes into the hospital needing help with smoking, The NP knows what? _____ Bupropion is pregnancy category ___. - RIGHT ANSWER -NRT should be avoided during pregnancy. C When administered 1-2 hours preoperatively has been shown to reduce opioid requirements postoperatively, especially in opioid-tolerant patients. Although the exact mechanism of action is unclear, it is thought to reduce the release of excitatory neurotransmitters that participate in nociceptive pain fiber stimulation - RIGHT ANSWER -Gabapentin When asked a client to walk a straight line placing heel to toe, you are assessing the _________- aspect of the nervous system, which controls posture, balance, and coordination. - RIGHT ANSWER -proprioceptive When can alcohol related seizures occur? - RIGHT ANSWER -1-2 days after last drink When the provider uses Screening, Brief Intervention and Referral to Treatment (SBIRT) during a patient encounter this is an example of what level of prevention? - RIGHT ANSWER -secondary Where is dopamine firing occurring? - RIGHT ANSWER -Nucleus Accumbens & Ventral Tegmental Which Neonatal withdrawal syndromes may present weeks after birth? Name the drug. - RIGHT ANSWER -Methadone Which of the following terms describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking? - RIGHT ANSWER -Tolerance break Which opioids has both agonist and antagonist activity? - RIGHT ANSWER -Nalbuphine Which prevention strategy aims to manage long-term or chronic diseases through treatment - RIGHT ANSWER -tertiary Which pt behaviours should the nurse suspect as related to alcohol withdrawal? 1. Hyperalert state, jerky movements, easily startled 2. Tachycardia, diaphoresis, elevated BP 3. Peripheral vascular collapse, electrolyte imbalance 4. Paranoid delusions, fever, fluctuating levels of consciousness - RIGHT ANSWER -1 2, 3, & 4. are associated with alcohol delirium and are considered a medical emergency and can result in death if not treated. Why is naltrexone the preferred first line treatment for AUD? Naltrexone binds and blocks _______ receptors, and reduces and suppresses opioid cravings. There is no _______ and _______ potential with naltrexone - RIGHT ANSWER -1. ease of dosing 2. ability to begin treatment while the individual is still drinking. opioid abuse, diversion You are a nurse practitioner working at an addiction clinic. Today, a 45-year-old male presents to your clinic with the chief complaint, "I am about to lose my family; I have to stop drinking." You understand that it is important to fully screen this patient and you decide to use a tool to do so. The most common tool used in screening for alcohol abuse in this particular patient age group and setting is: - RIGHT ANSWER -CAGE