CARN Addiction Assessment & Diagnosis 3 — Questions and Answers
Question 1: Which withdrawal syndrome is considered the most medically dangerous and potentially life-threatening?
- Opioid withdrawal
- Cannabis withdrawal
- Alcohol withdrawal (Correct answer)
- Stimulant withdrawal
Correct answer: Alcohol withdrawal
Alcohol withdrawal can progress to delirium tremens with seizures and autonomic instability, making it potentially fatal without treatment.
Question 2: A nurse uses the Clinical Opiate Withdrawal Scale (COWS). A score of 25 indicates which severity level?
- Mild withdrawal
- Moderate withdrawal
- Moderately severe withdrawal
- Severe withdrawal (Correct answer)
Correct answer: Severe withdrawal
On the COWS, a score of 25 falls in the severe withdrawal range (scores ≥25 = severe).
Question 3: Which DSM-5 specifier indicates that a patient with substance use disorder has been abstinent for more than 12 months?
- In early remission
- In sustained remission (Correct answer)
- On maintenance therapy
- In a controlled environment
Correct answer: In sustained remission
Sustained remission is specified when no SUD criteria have been met for 12 months or longer.
Question 4: Which finding on the CIWA-Ar scale would most urgently prompt a nurse to administer as-needed benzodiazepines?
- Score of 4 with mild tremors
- Score of 8 with mild diaphoresis
- Score of 18 with agitation and perceptual disturbances (Correct answer)
- Score of 2 with slight anxiety
Correct answer: Score of 18 with agitation and perceptual disturbances
A CIWA-Ar score of 18 with agitation and perceptual disturbances indicates severe withdrawal requiring immediate pharmacological intervention.
Question 5: Motivational interviewing (MI) is based on which theoretical foundation?
- Cognitive behavioral therapy
- Transtheoretical model and person-centered counseling (Correct answer)
- Psychodynamic theory
- Behavioral extinction principles
Correct answer: Transtheoretical model and person-centered counseling
MI integrates the transtheoretical model's stages of change with Carl Rogers' person-centered, empathic counseling approach.
Question 6: A patient admits to using heroin but denies having a problem because 'everyone in my neighborhood does it.' This defense mechanism is best described as:
- Projection
- Rationalization (Correct answer)
- Minimization
- Denial
Correct answer: Rationalization
Rationalization involves providing logical-sounding justifications (social normalization) to excuse problematic behavior.
Question 7: Which assessment tool is specifically validated to screen for substance use disorders in pregnant women?
- CAGE
- TWEAK (Correct answer)
- AUDIT-C
- MAST
Correct answer: TWEAK
The TWEAK screening tool was specifically developed and validated for detecting risk drinking in pregnant women.
CARN Addiction Assessment & Diagnosis 3
Which withdrawal syndrome is considered the most medically dangerous and potentially life-threatening?