CARN - Certified Addictions Registered Nurse Managing Co-Occurring Disorders Questions and Answers

Question 1

A client with a known history of Bipolar I Disorder and Alcohol Use Disorder is admitted to an inpatient unit.
The client is exhibiting pressured speech, psychomotor agitation, and grandiose delusions, and reports not sleeping for three days.
What is the nurse's priority intervention?

Accepted Answer

Provide a low-stimulation, safe environment and monitor physiological status.

Answer

Initiate a referral to a dual-diagnosis support group.

Answer

Administer a long-acting antipsychotic medication as ordered.

Answer

Develop a detailed, long-term relapse prevention plan with the client.

Question 2

Which treatment model is considered the gold standard for clients with co-occurring substance use and severe mental illness, emphasizing that the same clinicians or team provide care for both disorders concurrently?

Accepted Answer

Integrated Dual Disorder Treatment (IDDT)

Answer

Sequential Treatment

Answer

Parallel Treatment

Answer

The Four-Quadrant Model

Question 3

A nurse is co-facilitating a group using the "Seeking Safety" therapeutic model for clients with co-occurring PTSD and a substance use disorder. Which of the following is a core principle of this model?

Accepted Answer

Teaching present-focused coping skills to establish safety from both trauma symptoms and substance use.

Answer

Requiring clients to create a detailed narrative of their traumatic experiences.

Answer

Focusing on past traumas as the primary cause of current substance use.

Answer

Utilizing confrontational techniques to challenge denial about substance use.

Question 4

A client who is stable in treatment for Opioid Use Disorder (OUD) with buprenorphine is newly diagnosed with Generalized Anxiety Disorder (GAD). The addictions nurse should anticipate the provider will AVOID prescribing which class of medication due to its high potential for misuse and dangerous synergistic effects?

Accepted Answer

Benzodiazepines

Answer

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer

Buspirone

Answer

Hydroxyzine

Question 5

A client is admitted for detoxification from a severe Alcohol Use Disorder. They report persistent anhedonia, low mood, and poor energy. What is the most critical factor for the nurse and treatment team to consider when differentiating between a substance-induced depressive disorder and a primary Major Depressive Disorder?

Accepted Answer

The persistence of depressive symptoms after a sustained period of abstinence.

Answer

The client's family history of depression.

Answer

The severity of the depressive symptoms reported on admission.

Answer

The client's score on a standardized depression screening tool like the PHQ-9.

Question 6

When developing a plan of care for a client with co-occurring Schizophrenia and Cocaine Use Disorder who has a history of homelessness and frequent hospitalizations, which of the following interventions is most crucial for promoting treatment adherence and long-term stability?

Accepted Answer

Integrating care through an Assertive Community Treatment (ACT) team.

Answer

Mandating daily attendance at a 12-step support group.

Answer

Focusing exclusively on antipsychotic medication management to stabilize psychosis.

Answer

Recommending the client find a new peer group immediately upon discharge.

A client with a known history of Bipolar I Disorder and Alcohol Use Disorder is admitted to an inpatient unit.The client is exhibiting pressured speech, psychomotor agitation, and grandiose delusions, and reports not sleeping for three days.What is the nurse's priority intervention?

A client with a known history of Bipolar I Disorder and Alcohol Use Disorder is admitted to an inpatient unit.
The client is exhibiting pressured speech, psychomotor agitation, and grandiose delusions, and reports not sleeping for three days.
What is the nurse's priority intervention?