CARN Assessment and Diagnosis 4 — Questions and Answers
Question 1: A nurse assesses a patient for benzodiazepine withdrawal. Which symptom, if present, indicates the most serious complication requiring immediate medical attention?
- Anxiety and irritability
- Insomnia and sweating
- Generalized tonic-clonic seizure (Correct answer)
- Mild hand tremor
Correct answer: Generalized tonic-clonic seizure
Generalized seizures are the most life-threatening complication of benzodiazepine withdrawal and require immediate medical intervention.
Question 2: Which component of the ASI (Addiction Severity Index) evaluates the patient's subjective perception of their problem and motivation for treatment?
- Composite score
- Patient rating subscale
- Interviewer severity rating (Correct answer)
- Medical status domain
Correct answer: Interviewer severity rating
The ASI includes an interviewer severity rating that captures the patient's subjective distress and perceived need for treatment in each domain.
Question 3: When performing a urine drug screen interpretation, a nurse knows that false-positive results for opioids can be caused by which common substance?
- Ibuprofen
- Quinolone antibiotics
- Poppy seed consumption (Correct answer)
- Vitamin C supplementation
Correct answer: Poppy seed consumption
Poppy seeds contain morphine and codeine in small amounts and can cause false-positive immunoassay results for opioids.
Question 4: A nurse is conducting a trauma-informed addiction assessment. Which approach best aligns with trauma-informed care principles?
- Asking detailed trauma questions in the first session to complete the intake form
- Focusing exclusively on substance use history before addressing trauma
- Creating a safe environment, obtaining consent, and allowing the patient to control the pace (Correct answer)
- Documenting trauma history without discussing it with the patient
Correct answer: Creating a safe environment, obtaining consent, and allowing the patient to control the pace
Trauma-informed care prioritizes safety, trustworthiness, choice, and empowerment—allowing patients to control the pace and content of trauma disclosure.
Question 5: A patient presents with constricted pupils, bradycardia, and respiratory depression. Which substance is most likely responsible?
- Cocaine
- Alcohol
- An opioid (Correct answer)
- Methamphetamine
Correct answer: An opioid
The classic triad of miosis (constricted pupils), bradycardia, and respiratory depression is the hallmark of opioid intoxication.
Question 6: Which of the following best describes the concept of 'cross-tolerance' in addiction assessment?
- The patient tolerates adverse effects of a substance without physical dependence
- Tolerance developed to one substance confers tolerance to pharmacologically similar substances (Correct answer)
- The patient requires two substances simultaneously to achieve intoxication
- A patient switches substances to avoid detection on drug screens
Correct answer: Tolerance developed to one substance confers tolerance to pharmacologically similar substances
Cross-tolerance occurs when tolerance to one substance (e.g., alcohol) reduces sensitivity to pharmacologically similar substances (e.g., benzodiazepines) due to shared mechanisms of action.
Question 7: A nurse documents that a patient meets criteria for 'alcohol use disorder with physiological dependence.' Which DSM-5 criterion must be present to add this specifier?
- Daily alcohol consumption for at least 90 days
- Evidence of tolerance or withdrawal (Correct answer)
- Three or more prior treatment episodes
- Blood alcohol level above 0.15% at admission
Correct answer: Evidence of tolerance or withdrawal
The DSM-5 physiological dependence specifier is applied when either tolerance or withdrawal (or both) are present as part of the alcohol use disorder criteria.
CARN Assessment and Diagnosis 4
A nurse assesses a patient for benzodiazepine withdrawal.
Which symptom, if present, indicates the most serious complication requiring immediate medical attention?