CARN Managing Co-Occurring Disorders 4

Question 1

A patient with generalized anxiety disorder (GAD) and benzodiazepine use disorder requires anxiolytic treatment. The safest pharmacological option is:

Accepted Answer

Buspirone, a non-benzodiazepine anxiolytic

Answer

Lorazepam at a reduced dose

Answer

Diazepam with weekly prescription refills

Answer

Alprazolam due to its rapid onset of action

Question 2

When conducting a suicide risk assessment in a patient with co-occurring depression and alcohol use disorder, which factor increases suicide risk most significantly?

Accepted Answer

Active alcohol intoxication combined with depressive symptoms

Answer

Participation in group therapy

Answer

Prescribed antidepressant therapy

Answer

Engagement with a sponsor in a 12-step program

Question 3

A patient with schizophrenia in recovery from methamphetamine use disorder begins experiencing worsening psychosis. The CARN should first:

Accepted Answer

Assume relapse to methamphetamine and obtain a urine drug screen

Answer

Increase antipsychotic medication immediately without assessment

Answer

Discharge the patient to an emergency psychiatric facility

Answer

Reduce the antipsychotic dose to minimize side effects

Question 4

Which stage of the Prochaska transtheoretical model describes a patient who acknowledges their substance use is problematic but is not yet planning to change?

Accepted Answer

Contemplation

Answer

Precontemplation

Answer

Preparation

Answer

Action

Question 5

Naltrexone is contraindicated in a patient with co-occurring opioid use disorder and:

Accepted Answer

Acute hepatitis with elevated liver enzymes (more than 3-5x normal)

Answer

Major depressive disorder

Answer

Generalized anxiety disorder

Answer

Post-traumatic stress disorder

Question 6

A patient with co-occurring major depressive disorder and opioid use disorder on buprenorphine/naloxone reports that their antidepressant is 'not working.' The most important consideration is:

Accepted Answer

Confirm the patient is taking the antidepressant as prescribed and assess for ongoing substance use

Answer

Buprenorphine has antidepressant properties that may mask the need for additional medication

Answer

Immediately switch to a different antidepressant class

Answer

Discontinue buprenorphine therapy to enhance antidepressant effectiveness

Question 7

Family involvement in the treatment of co-occurring disorders is important primarily because:

Accepted Answer

Family systems often enable both the substance use and mental illness

Answer

Families can control patient behavior more effectively than clinicians

Answer

Families should be held legally responsible for patient relapses

Answer

Family therapy replaces the need for individual treatment