CARN Cheat Sheet 2026

The 30 highest-yield CARN facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which benzodiazepine property makes long-acting agents preferred for managing alcohol withdrawal syndrome? → Self-tapering effect due to long half-life reducing seizure risk
2. During intake assessment, a patient reports using alcohol daily to prevent morning shakes. This pattern is best described as: → Physical dependence with use to avoid withdrawal symptoms
3. A nurse is providing education to a client who has been prescribed disulfiram. The nurse should warn the client to avoid which of the following products? → Mouthwash containing alcohol
4. A patient minimizes substance use when answering AUDIT questions, reporting only occasional use. Which assessment strategy best addresses underreporting? → Use collateral information and biomarkers alongside self-report
5. Which assessment tool is specifically validated to screen for substance use disorders in pregnant women? → TWEAK
6. Which of the following is a core principle of Trauma-Informed Care (TIC) when establishing a therapeutic environment for clients with substance use disorders? → Emphasizing physical and psychological safety in all interactions and environments.
7. Which medication is FDA-approved for alcohol use disorder and has also shown benefit in reducing cravings in patients with bipolar disorder? → Naltrexone
8. Under the IntNSA Standards of Practice, which activity reflects the CARN's responsibility for self-care? → Monitoring personal stress levels and seeking support when experiencing compassion fatigue
9. Which opioid withdrawal medication works by stimulating alpha-2 adrenergic receptors to reduce autonomic symptoms like diaphoresis and tachycardia? → Clonidine
10. Buprenorphine's 'ceiling effect' on respiratory depression is primarily due to its action as a: → Partial agonist at mu receptors
11. Motivational Interviewing (MI) is considered an evidence-based approach for co-occurring disorders primarily because it: → Addresses ambivalence about change without triggering defensiveness
12. Informed consent for medication-assisted treatment requires that patients receive information about all of the following EXCEPT: → The nurse's personal opinion about the best treatment choice
13. Which statement correctly describes acamprosate's mechanism in treating alcohol use disorder? → It modulates glutamate and GABA activity to reduce post-acute withdrawal symptoms
14. Which receptor type mediates alcohol's positive reinforcing effects through the mesolimbic dopamine system? → Multiple systems including mu-opioid, GABA-A, and dopamine receptors acting in concert
15. Kappa-opioid receptor activation is associated with which affective state that contributes to the negative reinforcement cycle of addiction? → Dysphoria and aversion
16. Nicotine's addictive properties are primarily mediated through its action on: → Nicotinic acetylcholine receptors (nAChRs) on VTA dopamine neurons
17. Which statement accurately reflects the evidence base for peer support in recovery? → Both 12-Step programs and SMART Recovery have evidence supporting effectiveness
18. A nurse is planning brief motivational interventions for a patient identified through SBIRT screening. What does SBIRT stand for? → Screening, Brief Intervention, and Referral to Treatment
19. Which motivational interviewing spirit component emphasizes collaborative decision-making rather than the counselor directing the patient? → Partnership
20. Which protective factor is MOST strongly associated with sustained long-term recovery outcomes? → Strong social support networks and meaningful community connections
21. When documenting a nursing diagnosis for a patient with opioid use disorder presenting in withdrawal, which NANDA-I diagnosis is most appropriate? → Risk for injury related to altered neurological status secondary to opioid withdrawal
22. Which withdrawal syndrome is considered the most medically dangerous and potentially life-threatening? → Alcohol withdrawal
23. A nurse observes pinpoint pupils, respiratory depression, and decreased level of consciousness. Which substance intoxication is most likely? → Opioids
24. A patient with bipolar disorder begins using methamphetamine. Which mood episode is MOST likely to be precipitated by stimulant use? → Manic or hypomanic episode
25. When performing a nursing assessment on a patient prescribed methadone for OUD, which cardiac risk does the nurse most need to monitor? → QTc interval prolongation
26. Which screening tool uses the mnemonic CAGE to assess alcohol use disorder? → CAGE questionnaire
27. The 'dark side of addiction' described by Koob refers to: → The negative emotional state driving drug use for relief rather than pleasure
28. Which psychiatric disorder has the HIGHEST comorbidity rate with substance use disorders? → Antisocial personality disorder
29. What role does goal setting play in addiction treatment planning? → To provide clear, measurable objectives that guide treatment and track progress
30. The role of the hippocampus in addiction is best characterized as: → Encoding and contextual retrieval of drug-related memories that trigger craving